Minimally invasive techniques and tools have transformed many areas of surgery. For some areas of the body, however, robotic surgery can offer unique benefits. Thoracic surgery is one such area. In this specialty, surgeons treat diseases affecting organs within the thorax, or chest area, including the lungs and esophagus.

Robot Changes Everything
"It is very hard to replicate open thoracic procedures using conventional minimally invasive techniques because of the anatomy of the chest and the complexity of many thoracic procedures," says Farid Gharagozloo, MD, Clinical Chief of Cardiothoracic Surgery Services and Clinical Professor of Surgery. "At GW Hospital, the robot is changing everything. Robotic cardiothoracic surgery is the newest frontier in surgery and only a limited number of surgeons have expertise in this field."

With the acquisition of a second da Vinci^® Surgical System robot, surgeons at The George Washington University Hospital have become internationally recognized for leading the academic movement to define new ways of performing thoracic surgery.

	Farid Gharagozloo, MD, Clinical Chief of Cardiothoracic Surgery Services and Clinical Professor of Surgery
	Marc Margolis, MD, Associate Clinical Professor of Surgery

Surgery with Less Trauma
The newest da Vinci robot features smaller arms that give surgeons the ability to reach into the chest cavity without making large incisions. Once inside the body, the system's high-definition three-dimensional camera gives doctors an unparalleled view of the chest.

"We're seeing human anatomy and structures in ways we can't see with the naked eye or with less sophisticated imaging systems," says Marc Margolis, MD, Associate Clinical Professor of Surgery. "In addition, the robotic arms allow us to go places we couldn't go to before and give us the ability to do the fine dissections needed in cardiothoracic surgeries."

Here are some examples of the robotic thoracic procedures now available at GW Hospital:

• Lung cancer: Doctors use the robot to perform lobectomy surgery in patients with lung cancer. They remove the lobe where the cancer is located and all the lymph nodes that drain that lobe. Patients who undergo open lobectomies typically spend five to seven days in the hospital and about six weeks recovering. Those who have the less invasive robotic lobectomies stay an average of three days in the hospital and usually can return to work in a few weeks. The robotic procedure is just as effective in treating patients' cancer as open procedures.
• Esophageal disease: Traditionally, surgeons have performed a complex open procedure to treat patients with benign or cancerous lesions of the esophagus. However, this technique, called the Ivor Lewis procedure, can be traumatic for patients. Now, doctors at GW Hospital perform the same two-step procedure using the da Vinci robot. First, doctors remove the diseased part of the esophagus and the top of the stomach. They then pull the remaining stomach up into the chest to create a new esophagus. Patients who have a robotic esophagectomy usually spend about nine days in the hospital, compared to an average stay of 19 days for those who undergo open surgery.
• Mediastinal tumors: Robotic surgery may be an option for patients with abnormal growths or tumors on the mediastinal -- the area that separates the lungs in the middle of the chest. Doctors can use the da Vinci robot to perform minimally invasive procedures to remove lesions in this difficult-to-reach area. Surgeons also may use this procedure to remove the thymus in patients with an autoimmune disorder called myasthenia gravis. Patients' length of stay varies depending on the procedure they have, but in general those who undergo robotic procedures go home sooner than those who have open procedures.

The da Vinci® robot gives surgeons the ability to reach into the chest cavity without making large incisions. ILLUSTRATION ©2009 INTUITIVE SURGICAL, INC.

Option for Most Patients
For most thoracic patients at GW Hospital, robotic procedures are a viable option. These patients enjoy the same benefits of minimally invasive surgery: shorter hospital stays, less pain, fewer complications and quicker recoveries.

Dr. Gharagozloo isn't surprised by the hospital's successes with robotic surgery. "The robots do more than allow us to complete already proven open procedures in less invasive ways," he says. "They help us define anatomy better and maneuver in tight places so we're able to perform better surgeries. It's an exciting time. The robot has propelled cardiothoracic surgery into the future."

Discover the Benefits of Robotic Surgery
Please visit www.gwhospital.com/roboticsurgery for more information on robotic surgery options or call 1-888-4GW-DOCS for a referral to a surgeon.

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