Daniel DeArmond, M.D., assistant professor of surgery, uses the daVinci surgical system© to extract hard-to-remove lung tumors.
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The use of robot-assisted surgery to treat patients at The Cancer Therapy & Research Center at The UT Health Science Center San Antonio has expanded to include those with early-stage lung cancer.

In mid-October, Daniel DeArmond, M.D., assistant professor of surgery, removed the lobe of a patient’s lung by making small incisions in the chest and inserting miniature instruments that he maneuvered remotely, using handles and pedals from a console six feet away.

The daVinci surgical system©, which CHRISTUS Santa Rosa Health Care bought last year for $1.6 million, gave Dr. DeArmond a 3-D image of the operating area and permitted him to move the tiny tools with more dexterity and precision.

“Using conventional instruments would have been like trying to tie your shoes with a pair of pliers,” said Dr. DeArmond, a surgeon at the CTRC Thoracic Cancer Clinic.

Surgical system's precision makes minute movements possible
Robotic-assisted lobectomy represents the next generation of minimally-invasive surgery for early-stage lung cancer. A similar technology known as VATS (video-assisted thoracoscopic surgery) uses a camera lens on the tip of a scope to let the surgeon look inside the chest cavity without opening the chest. But when a tumor is in a difficult location, the robot offers an added advantage: Its arms move like a surgeon’s wrist, making it easier to sew the airway and tie knots.

“Any technology that makes it easier for the surgeon to do a good job is good for the patient,” Dr. DeAmond noted.

Surgical technician Angel Saenz watches progress of the robot-assisted surgery for a recent lung cancer procedure. Robotic arms operated by the surgeon hold miniature instruments that are inserted through small incisions in the patient’s chest to remove the tumor.

Benefits over conventional lung surgery
A conventional lobectomy requires an eight- to 10-inch incision and separating the ribs. Potential benefits of robotic surgery and VATS over conventional surgery include:

• A shorter hospital stay
  
• Less pain
  
• Less risk of infection
  
• Less blood loss and transfusions
  
• Less scarring
  
• Faster recovery

Dr. DeArmond first performed the robotic surgery in June on a non-smoker in her 50s. She was home from the hospital four days after surgery and back at work within a week.

Other surgical uses for the de Vinci system
Dipen Parekh, M.D., a urologic oncologist at the Health Science Center, has performed a large number of robotic-assisted laparoscopic surgeries to remove prostate, bladder and kidney cancers.