New Surgical Techniques Are Cutting Edge

New surgical techniques can limit the risk of postoperative complications in patients with cancer.

BY NOBLE SPRAYBERRY
PUBLISHED: DECEMBER 17, 2012
Removing the stage 1 tumor on Kathy Leiser’s lung required only three small incisions in a minimally invasive laparoscopic procedure, one of a range of tools and techniques capable of limiting postoperative complications.

Removing the stage 1 tumor on Kathy Leiser’s lung required only three small incisions in a minimally invasive laparoscopic procedure, one of a range of tools and techniques capable of limiting postoperative complications.

Still, soreness remained nearly nine months after the surgery at Vanderbilt-Ingram Cancer Center in Nashville, Tenn., says Leiser, 63. “Recently, I saw my pulmonologist, and he said it might take as long as a year for everything to heal up,” she says. “It was laparoscopic, but they still went between my ribs.”

Risk of complications exists even with the least invasive surgeries, and efforts to limit postoperative problems begin in the days before surgery, continue during each procedure and extend into each patient’s recovery.

[Read "Preparing for Surgery"]

Determining the appropriate type of surgery by balancing risks against potential benefits is a key early step in limiting problems, says Eric Grogan, MD, the thoracic surgeon who treated Leiser.

For example, traditional open surgery generally requires an incision large enough to provide a surgeon direct visual and physical access to a tumor or treatment area.

“The larger the tumor is, and the more invasive the operation is, certainly the more complications that may arise,” Grogan says. “If one can ensure that it’s the correct cancer operation with a less invasive approach, it’s logical the less invasive approach should be chosen.”

Minimally invasive surgeries use tools such as a laparoscope, a telescoping camera system inserted via a small incision. But, there are several forms of these procedures, many with benefits for cancer surgeries. In lung surgery, for example, video-assisted thoracoscopic surgery (VATS) uses a scope to send a small video camera into the patient’s body, while surgical instruments enter through separate incisions. “It uses the camera to assist the lung resection, so you don’t have to crack or spread the ribs,” Grogan says. “Everything should be the same oncologically as a traditional open surgery, but there’s less pain.”

The larger the tumor is, and the more invasive the operation is, certainly the more complications that may arise.

Other forms of minimally invasive surgery include robotic surgery, which relies on a computer or a remote manipulator to guide and control the endoscope and other instruments. Single-incision operations allow surgeons to visualize and work through a lone opening instead of multiple openings. Natural orifice translumenal endoscopic surgery (NOTES) inserts a flexible endoscope into an opening, such as the mouth, and allows instruments to go through that scope to perform procedures.

Talk about this article with other patients, caregivers, and advocates in the General Discussions CURE discussion group.
x-button
 
CURE wants to hear from you! We are inviting you to Share Your Story with the readers of CURE. Submit your personal experience with cancer by visiting Share Your Story
 
Not yet receiving CURE in your mailbox? Sign up to receive CURE Magazine by visiting GetCureNow.com
x