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CMC physicians pioneer less invasive thoracic surgery

July 16. 2018 9:51PM
Dr. Benjamin Westbrook, right, and Dr. Yvon Baribeau stand next to the daVinci Surgical System in an operating room at Catholic Medical Center in Manchester. (COURTESY)

MANCHESTER — Historically, thoracic surgery — surgery on the lungs or other parts of the respiratory system — is a major operation with a long and uncomfortable recovery, not to mention a sizable scar.

Traditional thoracic surgery requires cutting into the chest wall and moving ribs to gain access to the chest cavity. But these days, Catholic Medical Center’s cardiothoracic surgeons are taking a far less invasive approach.

“Robotic-assisted thoracic surgery is the most rapidly expanding area for surgical robotics,” says Dr. Benjamin Westbrook, a cardiothoracic surgeon at CMC’s New England Heart & Vascular Institute. “It’s at least as effective as open surgery and video-assisted thoracoscopy, and may actually result in decreased length of stay and improved short and long term outcomes.”

Thoracic surgery is the latest application of robotic technology at CMC, which first began offering the daVinci Surgical System nearly twenty years ago.

Procedures that once required a cut into the chest wall can now be performed through a small incision. A tiny video camera and the surgical tools all fit through this incision, and the physician controls them on the robotic system. Benefits include fewer potential complications, less pain during recovery, and shorter hospital stays.

“We have the experience using this technology,” says Dr. Yvon Baribeau, also a New England Heart & Vascular Institute cardiothoracic surgeon. “And we also have a multidisciplinary team. If you have a suspicious mass or a tumor on your lung, we work closely with your oncologist, pulmonologist, radiologist, radiation therapist, a nurse navigator and others to give you complete care.”

The team at CMC also has expertise on video-assisted thorascopic surgery (VATS). A VATS procedure usually involves three incisions — one of them for a small camera and the others for the surgical instruments. Like the robotic-assisted surgery, VATS usually means shorter healing time and less pain for patients.

The lungs, by design, are hard to get to. They’re protected by the rib cage as they take in oxygen and push out carbon dioxide.

“The trend across surgical disciplines is toward less invasive procedures,” says Dr. Baribeau. “It’s generally better for the patient, especially those who are older and sicker. In thoracic surgery, you see a lot of patients who have lung cancer. The robotic or video-assisted procedures are highly effective while offering patients greater comfort.”

Patients benefit after they go home as well, thanks to something called cryoanalgesia. Cryoanalgesia is a process of freezing the nerves around the surgical site. When used along with local anesthesia, a patient can leave the hospital with only a few Tylenol.

“It’s been estimated that one in seven thoracic surgery patients may become addicted to opioids,” says Dr. Westbrook. “With cryoanalgesia, we can control pain without narcotics. The effect can last from 30 to 60 days and has resulted in a significant decrease in the amount of pain medication required in the post-op period.”

Thoracic surgery joins a long list of areas where CMC offers a minimally invasive approach. Robotic or video-assisted alternatives are available for general, spine, colorectal and prostate surgeries. Catheter-based procedures are commonly used to treat cardiac and vascular conditions, manage back pain, and remove soft tissue tumors.

“Going to the hospital for an operation is an entirely different experience than it was just ten years ago,” says Dr. Louis Fink, executive medical director of the New England Heart & Vascular Institute. “What we’ve done recently in thoracic surgery is a perfect example. There are still cases were traditional, open surgery is the best option. But on the whole, we’re giving more advanced, precise care that enhances not only a patient’s outcome but their comfort as well.”

Health Manchester

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