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Winthrop University Hospital

Winthrop Surgeons Perform First Robotic-Assisted Lobectomy on Long Island

Recently, Winthrop-University Hospital, a leader in minimally invasive surgical techniques, became the first hospital on Long Island to perform a Robotic Video Assisted Thoracic Surgery (VATS) lobectomy utilizing the ultra high-tech daVinci Si HD Surgical System.

The first robotic-assisted lung surgery on Long Island was performed by Board certified cardiothoracic surgeon John Goncalves, MD, with the support of a dedicated robotics team. This leadingedge procedure utilized the daVinci's state-of-the-art capabilities – including 3-D High Definition visualization of the chest cavity and precise, flexible surgical tools – to perform minimally invasive surgery to remove a tumor from the lung of 79-year-old patient, Enrique Figueroa.

Traditional surgery in the chest cavity to remove masses in the lobe of the lung can be debilitating and very painful. Surgeons must cut between the ribs in order to access the lung, leaving patients with a large incision on the side of the chest and a long and painful post-operative recovery. Lobectomy with the daVinci enabled Dr. Goncalves to remove a centralized tumor from Mr. Figueroa's right lower lobe without the need for large incisions or spreading of the ribs.

"DaVinci surgery is improving upon the gold standard of traditional open surgery," said Dr. Goncalves. "Unlike thoracotomy (traditional lung surgery) which requires a long incision and often a long recovery, surgery with the daVinci is minimally invasive. It is performed with three small incisions, and spreading the patient's ribs to access the lung is avoided. The end result is a more delicate and precise surgical procedure with smaller incisions, less post-operative pain and shorter hospital stays for most patients."


Winthrop cardiothoracic surgeon John Goncalves, MD, used the daVinci Si HD dual console system to perform the first Robotic Video Assisted Thoracic Surgery (VATS) lobectomy on Long Island.
Seated at a high-tech console located just a few feet away from Mr. Figueroa, Dr. Goncalves attached his fingers to robotic controls, and set his eyes on the high-definition screen where a real-time 3-D, magnified image of Mr. Figueroa's lung cavity provided a better-than-real view of the operative site. Three small incisions made in Mr. Figueroa's chest provided an entry point for robotic arms, equipped with flexible tools and a camera. Proprietary EndoWrist® instruments, situated at the end of the robotic arms, enabled Dr. Goncalves to perform highly precise movements within Mr. Figueroa's chest cavity to remove the section of his lung containing the tumor while minimizing damage to the chest wall and surrounding tissues.

Winthrop was the first hospital on Long Island to acquire the daVinci Si HD dual console system, and Dr. Goncalves is extremely excited about the optical quality of the advanced system. As he said, "When I'm operating, I'm right there. It's as if someone miniaturized me and put me inside of the patient's chest."

The procedure was completed in approximately two hours and Mr. Figueroa, whose tumor was benign, was discharged from the Hospital just three days later with no post-operative pain. Following the success of Mr. Figueroa's lung cancer surgery, Dr. Goncalves and his colleagues have since performed several more robotic-assisted lung surgery cases.

"I use the daVinci in selective cases. Patients must have a limited disease in their chest or an isolated nodule in the lung with minimal evidence of hilar nodal involvement," said Dr. Goncalves.

The number of Winthrop surgeons trained to utilize this highly effective robotic tool to perform surgeries that previously required traditional open surgeries is growing rapidly. Winthrop physicians from various specialties have undergone extensive training on the daVinci to offer an emerging standardof- care treatment with the potential for outcomes that are equal to or better than conventional surgery. Among the fastest growing specialty procedures being performed at Winthrop with the daVinci surgical robot are hysterectomies, gynecological oncology surgeries, colon resections, gastric bypass, partial nephrectomies, and prostatectomies.

"Winthrop will continue to transform the high-tech, minimally invasive surgical experience for patients and surgeons alike," said John F. Collins, Winthrop's President & CEO. "With a growing number of our physicians undergoing training in specialized techniques, Winthrop is expanding its advanced surgical services to become the fastest growing robotics program in the Northeast."

For additional information about minimally invasive surgical services at Winthrop, call 1-866-WINTHROP.
Vol. 21, No. 1
Winter/Spring 2011

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