Robot-assisted lung surgery lets patients breathe easier

Dennis Polomsky was breathing easier on his 70th birthday, once a giant air sac was no longer devouring his lung capacity. Just a few months earlier, a team of surgeons had removed a bulla that was severely compressing both of his lungs. Since the surgery was done robotically with the da Vinci Si in University Hospitals Parma Medical Center’s new 3D HD operating suite, Polomsky had just four small one-inch scars and a smooth recovery.

“They did the surgery robotically, with little incisions,” said Polomsky, who recovered in the Heart Center, where patients have comfortable, private rooms and personalized care from compassionate nurses. “In the olden days, they probably would have cut half my chest open. “I owe Dr. Lahorra my life. I had faith in this doctor. The Lord guides his hands.”

Lung surgeries like Polomsky’s thoracoscopy are greatly improved with the advent of the robotic alternative. Previously, the minimally invasive video-assisted thoracoscopic surgery (VATS) was performed, in which a small camera (thoracoscope) and surgical instruments were inserted in the chest. The camera projects images on a screen to guide the surgeon in performing the procedure.

The da Vinci Si gives the surgeon a higher resolution image in three dimensions. The surgeon also has superior and intuitive instrument control, mobility, degrees of freedom, and range of motion as they perform the surgery with the robot.

“This allows you to do very complex or delicate maneuvers more easily,” Dr. Lahorra said. “The traditional VATS instruments have very limited range of motion and degrees of freedom.” “Certainly compared to open procedures, there is less pain, less blood loss, less impact on pulmonary function and a quicker return to activity. These advantages should lead to more minimally invasive approaches for more complex procedures.”

Over 1,000 miles for prostate surgery, clean slate

Grady Logan of Oklahoma City doesn’t have the patience for “watchful waiting.” 

The 59-year-old mechanical engineer, whose father died of prostate cancer at 86, had been keeping an eye on his serum prostate specific antigen (PSA) level and saw it rising more rapidly than he knew it should. He remembered a urologist who gave an informative lecture some four years earlier, accompanied by testimonials from grateful patients whose lives he had saved.

Now Grady Logan is one of those men.

Logan was among the first patients at UH Parma Medical Center to benefit from robot-assisted laparoscopic surgery, at the hands of  the medical director Carson Wong, MD, FRCSC, FACS. While new to UH Parma Medical Center, Dr. Wong has a long history as a nationally recognized expert in endourologic, minimally invasive and robotic surgery. Dr. Wong has been ranked annually by Castle Connolly Medical Limited as one of “America’s Top Doctors” from 2008 to 2011, included in the Best Doctors of America 2011-12 edition and is rated in the Top 1 percent of urologists in the nation by U.S. News & World Report and Castle Connolly Medical Limited Top Doctors.

Dr. Wong was an Associate Professor of Urology at the University of Oklahoma and Medical Director of the Center for Robotic Surgery at OU Medical Center in Oklahoma City when Logan attended one of his community health events. Now a member of the Medical Staff at UH Parma Medical Center, he welcomed Logan’s desire to come to Cleveland.

“Dr. Wong is very active in helping men return to the quality of life they had before surgery,” said Logan, who believes his father’s quality of life suffered after undergoing an open procedure to remove his prostate. “I was very impressed with Dr. Wong during the patient seminar. There was a genuine caring he had for those patients. 

“Now, I am the beneficiary of my observation.”

No imaging test can diagnose prostate cancer. Only a biopsy performed by a urologist can determine if cancer is present.  [see Men 50+ below] 

“Before routine serum PSA and digital rectal examination (DRE) screening were implemented in the mid 1980s, the diagnosis of prostate cancer was suspect only if it could be felt by DRE or a patient presented with disease that had spread to other parts of the body,” said Dr. Wong. “This sensitive screening tool, while not foolproof, gives urologists a gauge of a man’s prostate health.”

“Routine prostate screening has allowed our profession to diagnose cancer at an earlier, curable stage,” says Dr. Wong. “Once diagnosed, each individual needs to be uniquely addressed when considering all available treatment options.” 

  • Management options for prostate cancer include:
  • Surgical removal (open, laparoscopic, robot-assisted)
  • Radiation therapy (external beam, brachytherapy, image modulated radiation therapy (IMRT), proton therapy)
  • Watchful waiting
  • Injections
  • Cryotherapy

Logan, who travelled to Cleveland with his wife and two grown daughters, felt Dr. Wong was direct in setting realistic expectations. He was discharged from the hospital less than 24 hours after surgery, requiring no pain medication stronger than Tylenol. He chuckles over his friends back home that thought there was only one renowned place to go in Cleveland for surgery.

“You only get one chance to make this operation right,” Logan said.

Men 50+ 

Men age 50 and older should receive a prostate screening annually. African-Americans and those with a family history of prostate cancer should be screened every year after the age of 40.See a urologist if you are experiencing:

  • Frequent urination (day or night)
  • Urgent urination
  • Straining to urinate or dribbling after urination
  • Intermittent or weak urine stream
  • Pain or burning during urination
  • Inability to completely empty the bladder
Grady Logan of Oklahoma City flew to Cleveland to undergo robot-assisted laparoscopic surgery with renowned urologist Carson Wong, MD, FRCSC, FACS.