By Anonymous
On Monday, Aug. 18, a state-of-the art surgery was performed at Community Medical Center (CMC) in Scranton.
Surgeons Dr. Russell Stahl and Dr. Brian Mott performed VATS – video-assisted thoracic surgery.
Their patient had a suspicious mass in his right lung. Drs. Stahl and Mott were to remove the mass for biopsy and – if cancer was found – to remove a lobe of the lung in hopes of a effecting a cure.
VATS for lobe removal is a new technique and Drs. Stahl and Mott are among the few surgeons in NEPA currently offering it. Dr. Mark R. Katlic also performs VATS lobectomies at Geisinger Wyoming Valley.
How it works:
The older, standard surgery calls for an enormous incision that encircles the rib cage. The ribs are then split apart (and sometimes removed or broken) to allow entry of hands and instruments.
With the new VATS, four tiny incisions are made. Then a scope (light source and camera) is passed through one cut and suddenly the patient’s lung appears on two high-definition video monitors. Next, the surgeons locate the suspicious mass. In the Aug. 18 surgery, Dr. Mott’s gloved forger appeared on the screen, palpating a small, hardened area – the suspicious mass – and then the instruments appeared. With great skill and delicacy, the nodule was clipped from the surrounding tissue and dropped in a little plastic bag before being neatly extncted.The haggle’s purpose: to prevent “tumor spill” – if the nodule was cancerous, the surgeons didn’t want any malignant cells to trail as the mass was pulled from the chest cavity.
Happily, the mass Drs. Stahl and Mott removed that day was benign. No lobectomy was necessary.
Reason for hope:
Geisinger’s Dr. Katlic has performed VATS lobectomies since October 2005. He says the VATS procedure gives hope to lung-cancer patients – not because it cures cancer any better than the open procedure, but rather because VATS is so much easier on the patient. The relative gentleness of the procedure makes it more readily available to high-risk patients who couldn’t tolerate the older, more invasive surgery.
“There is speculation – not proof – that VATS will improve survival, since we’re not knocking down a patient’s defense” with a more rigorous procedure.
“All of my VATS patients but one have gone home the day after the surgery,” Dr. Katlic says.
A reason to keep lighting up?
The doctors agree that lobectomies can provide a cure for Stage I lung cancers. Surgery at this early stage delivers a 70 to 80 percent survival rate – an enormous improvement from the grim statistics of the past. But smokers shouldn’t light up in celebration at this news. Survival rates plummet when lung cancer is found at more advanced stages.
A Stage I lung cancer is most likely to he found accidentally, while doctors are looking for something else. For example, Drs. Stahl, and Mott performed the VATS biopsy on a man whose suspicious CT scan was performed for masons other than potential lung cancer.
Dr. Katlic says, “Usually (these small tumors) are found on chest X-rays done for another purpose. By the time a lung cancer causes coughing or pain, it’s typically beyond Stage I.”
A large national test is currently underway to determine if CT scans could be an effective screening tool for lung cancer. “By next year, I believe there’s a reasonable chance that the study will show there’s value to CT suns for lung-cancer screening in certain populations” (Smokers over age 50, for example), Dr. Katlic says.
A patient’s tale:
Denise Trotta will be 49 in October. She has reason to celebrate each birthday since a devastating phone call two years ago.
She had just undergone an MRI for a problem unrelated to her lungs. Imagine, then, her shock upon receiving the late-night phone call from her doctor. He was sure a spot on her MRI was cancer. Compared to CT scans from years past, a spot on the right lung seemed to be growing. Given the rate of growth, Trotta was advised to see a surgeon – fast.
She turned to Dr. Katlic, who removed the upper lobe of Trotta’s right lung via VATS in November, 2006. She says she was out of bed the next day and back to work a week later. Since the surgery, she’s been cancer-free, though she admits she still smokes. However, her new insurance plan covers the prescription drug, Chantix. With it, she believes she can beat her addiction … and she’s blessed to still have time to do so.
Copyright Northeast Pennsylvania Business Journal Sep 2008
(c) 2008 Northeast Pennsylvania Business Journal. Provided by ProQuest LLC. All rights Reserved.
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