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A scan of the metal object (left, center) and the bronchoscope used to retrieve it from the lung of a patient at Aurora Medical Center in March, 2022.
The actual metal piece removed from the right lung of patient Tom Jozsi in a robot-assisted surgery at Aurora Medical Center on March 22, 2022.
Dr. Abdul Hamid Alraiyes, pulmonary interventionalist at Aurora Medical Center with the Ion Endoluminal System. Normally used to detect and treat small cancerous lesions, the system was recently used to remove a metal piece from the lung of a patient.
Dr. Abdul Hamid Alraiyes, pulmonary interventionalist at Aurora Medical Center, explains the procedure and technology used to remove a metal piece of a dental tool from the lung of patient Tom Jozsi.
Tom Jozsi, left, and Dr. Abdul Hamid Alraiyes, stand in front of the equipment and images of the procedure that removed a two-centimeter long metal piece from Jozsi's right lung in March.
Patient Tom Jozsi with the medical team that removed a small metal pin from his right lung at Aurora Medical Center. From left, Mauricio Valencia, nurse practitioner; Caitlyn Spencer, registered nurse; Beth Graceffa, registered nurse; Tom Jozsi, patient; Dr. Abdul Hamid Alraiyes; Cassandra Winningham, interventional pulmonary tech.
Sometimes 50% are odds worth taking.
Aurora Hospital patient Tom Jozsi would certainly agree.
Last month, when the Antioch resident underwent a procedure to remove a tiny metal piece from his right lung, the predicted outcome wasn’t a sure bet.
But in the hands of Dr. Abdul Hamid Alraiyes, pulmonary interventionalist at Aurora Medical Center, aided by cutting edge robotic technology, a 50% chance of success turned into 100%.
The surgical drama began March 18, when Jozsi, 60, had a routine dental exam near his home in Antioch, Ill. As his dentist finished filling a tooth, Jozsi accidently breathed in a small metal pin released from a dental tool.
“The dentist thought at first I might have swallowed it, but realized it had gone down my windpipe,” said Jozsi in a recent interview at Aurora Medical Center, Kenosha.
Because he’d had been given a local anesthetic, Jozsi didn’t feel anything at the time. It soon became apparent that he had not swallowed the bit, but aspirated it into his airway.
Jozsi went to the emergency room at Lindenhurst, Ill., hospital where X-rays did not detect the location of the piece. A subsquent CT scan confirmed it had fallen to the bottom of his right lung.
He was transferred to another area hospital where a bronchoscopy — a procedure that looks directly at the airways in the lungs using a thin, lighted tube — was performed in hopes of removing the item.
Jozsi said: “I looked at the doctor’s eyes and even with his mask on could tell it wasn’t good news. My first words to him were, ‘You didn’t get it, did you?’”
Fortunately for Jozsi, the surgical staff knew of Alraiyes and his capability at Aurora Medical Center and its recently acquired latest generation robotic technology.
“They sent me the CT scan and I confirmed that the only way to get the item out was by using smaller tools that would be more precise and able to reach down into the lung,” Alraiyes said.
Alraiyes set a consultation with Jozsi for Monday, March 21, and successfully removed the 2-centimeter metal piece the next day during a 90-minute outpatient procedure.
Moving quickly was critical, explained Alraiyes. “The fact that the dental tool had been in the patient’s mouth presented the enhanced danger due to the high concentration of bacteria in the human mouth. Having that item embedded in the lung could have led to infection and abscess and led to a critical situation,” he said.
The equipment used for the procedure was the Ion Endoluminal System, which was purchased by Aurora Medical Center last summer.
Alraiyes, previously affiliated with Cancer Treatment Centers of America in Zion, Ill., was brought on to work with the machine along with pulmonary specialist Dr. Hasnain Bawaadam.
“This machine was made to reach further into the lung for small lesions we weren’t able to sample before and to try to detect them in the earliest stages of cancer before they get bigger in size,” Alraiyes said.
Since the equipment became operational in September, the doctors have used the system on “dozens of cases,” but using it to retrieve an object from a lung was not one of them.
Explaining the system, Alraiyes said: “This machine takes data from (CT) images and uses artificial intelligence to build a picture (of the lungs) in 3-D. Then it uses a GPS-like guidance system for us to direct a 3.5 mm (bronchoscope) through the windpipe to biopsy the lesion.”
Under normal circumstances, the bronchoscope’s needle-like tip suctions a small sample of tissue for diagnosis and treatment.
In this case, however, instead of collecting tissue, Alraiyes was planning to use the tool to grab the metal tip and draw it out of Jozsi’s lung.
In his consultation with Jozsi, Alraiyes said there was there was no guarantee that the procedure would work.
“These procedures involve muscle memory but because we hadn’t yet used the machine in this way I told Tom there was a 50% to 60% chance of it being successful.”
But circumstances and skill aligned in everyone’s favor.
“In our luck and Tom’s luck, however, the metal bit had landed with the sharp part pointing away from the tissue. So when we tried to grab it we grabbed it by the sharp end so could pull it out without it scratching the surrounding tissue which can lead to bleeding or a collapsed lung,” Alraiyes explained.
It wasn’t all smooth sailing because as they began to draw the bit out, the team was met with resistance because tissue had already begun to close around the piece with a small infection.
“But it was worth it in the end,” Alraiyes said. “Had we not had the Ion system at our disposal, Tom would have had to undergo major surgery involving a cut between the ribs and removal of a wedge of the lung.”
Expressing his relief and gratitude to the team, Jozsi said, “I was never so happy as when I woke up in the ER and Dr. Alraiyes came into the room and even with a mask on I could there was a smile under that mask. He said he got it and shook a pill container with it in it.”
“It’s amazing that this machine did this and that it wasn’t even designed to do it,” Jozsi said.
Trips to the dentists are not known for being cheap. Braces, root canals and crowns can set consumers back a pretty penny, even with insurance factored in. But the amount is by no means uniform across the country.
Using 2016 data from the Council for Community and Economic Research, which tracks cost of living differences across U.S. urban areas (defined as significant cities with a population over 50,000), the following is a look at where trips to the dentist are the most costly. The average cost of toothpaste and the dentists per 100,000 people for each city's county is also included.
Unsurprisingly, dental work was most costly in cities in isolated Alaska, where toothpaste is an imported commodity and there aren't many dentists per capita. But the high cost of toothpaste didn't always coincide with the high cost of a dentist visit. In spite of being one of the largest cities in the world, New York City has the highest average cost of toothpaste in the ranking ($4.49), but only ranks as the No. 12 most costly city to visit the dentist. Middlesex-Monmouth, New Jersey, on the other hand, has an average cost of toothpaste of only $2.14, but ranks No. 13.
Cost of a dentist visit: $98.83 Average cost of toothpaste: $2.20 Dentists per 100K: 155.9
Cost of a dentist visit: $99.07 Average cost of toothpaste: $3.49 Dentists per 100K: 94.7
Cost of a dentist visit: $99.11 Average cost of toothpaste: $2.43 Dentists per 100K: 58.6
Cost of a dentist visit: $99.44 Average cost of toothpaste: $2.34 Dentists per 100K: 79.1
Cost of a dentist visit: $100.08 Average cost of toothpaste: $3.01 Dentists per 100K: 80.4
Cost of a dentist visit: $100.12 Average cost of toothpaste: $2.78 Dentists per 100K: 69.2
Cost of a dentist visit: $100.24 Average cost of toothpaste: $1.96 Dentists per 100K: 19
Cost of a dentist visit: $100.93 Average cost of toothpaste: $2.86 Dentists per 100K: 64.4
Cost of a dentist visit: $101.33 Average cost of toothpaste: $3.34 Dentists per 100K: 56.9
Cost of a dentist visit: $101.56 Average cost of toothpaste: $1.85 Dentists per 100K: 51.1
Cost of a dentist visit: $101.64 Average cost of toothpaste: $2.57 Dentists per 100K: 53.3
Cost of a dentist visit: $101.78 Average cost of toothpaste: $2.63 Dentists per 100K: 99.6
Cost of a dentist visit: $102.30 Average cost of toothpaste: $2.51 Dentists per 100K: 349.3
Cost of a dentist visit: $102.50 Average cost of toothpaste: $3.01 Dentists per 100K: 57.7
Cost of a dentist visit: $102.54 Average cost of toothpaste: $2.47 Dentists per 100K: 70.2
Cost of a dentist visit: $102.94 Average cost of toothpaste: $3.93 Dentists per 100K: 77.9
Cost of a dentist visit: $103.50 Average cost of toothpaste: $2.83 Dentists per 100K: 144.2
Cost of a dentist visit: $104.17 Average cost of toothpaste: $2.93 Dentists per 100K: 81.2
Cost of a dentist visit: $104.25 Average cost of toothpaste: $2.54 Dentists per 100K: 80.3
Cost of a dentist visit: $104.27 Average cost of toothpaste: $2.32 Dentists per 100K: 50.5
Cost of a dentist visit: $104.81 Average cost of toothpaste: $3.75 Dentists per 100K: 50.8
Cost of a dentist visit: $104.83 Average cost of toothpaste: $2.42 Dentists per 100K: 27.2
Cost of a dentist visit: $105.22 Average cost of toothpaste: $2.65 Dentists per 100K: 87.3
Cost of a dentist visit: $105.78 Average cost of toothpaste: $1.60 Dentists per 100K: 161.4
Cost of a dentist visit: $106.67 Average cost of toothpaste: $2.23 Dentists per 100K: 43.8
Cost of a dentist visit: $107.11 Average cost of toothpaste: $4.12 Dentists per 100K: 58.6
Cost of a dentist visit: $107.42 Average cost of toothpaste: $2.08 Dentists per 100K: 97.7
Cost of a dentist visit: $108.22 Average cost of toothpaste: $3.22 Dentists per 100K: 55
Cost of a dentist visit: $108.44 Average cost of toothpaste: $3.16 Dentists per 100K: 98
Cost of a dentist visit: $108.47 Average cost of toothpaste: $2.42 Dentists per 100K: 63.8
Cost of a dentist visit: $110.00 Average cost of toothpaste: $3.78 Dentists per 100K: 89.6
Cost of a dentist visit: $111.48 Average cost of toothpaste: $4.26 Dentists per 100K: 65.2
Cost of a dentist visit: $112.58 Average cost of toothpaste: $2.85 Dentists per 100K: 46.9
Cost of a dentist visit: $113.02 Average cost of toothpaste: $3.03 Dentists per 100K: 88.2
Cost of a dentist visit: $113.83 Average cost of toothpaste: $2.32 Dentists per 100K: 37.1
Cost of a dentist visit: $114.40 Average cost of toothpaste: $3.04 Dentists per 100K: 57.9
Cost of a dentist visit: $115.09 Average cost of toothpaste: $4.44 Dentists per 100K: 60
Cost of a dentist visit: $115.37 Average cost of toothpaste: $2.14 Dentists per 100K: 108.5
Cost of a dentist visit: $116.47 Average cost of toothpaste: $4.49 Dentists per 100K: 171.4
Cost of a dentist visit: $119.23 Average cost of toothpaste: $3.07 Dentists per 100K: 218.9
Cost of a dentist visit: $119.96 Average cost of toothpaste: $2.35 Dentists per 100K: 74.7
Cost of a dentist visit: $120.84 Average cost of toothpaste: $2.72 Dentists per 100K: 216.3
Cost of a dentist visit: $121.78
Cost of a dentist visit: $122.94 Average cost of toothpaste: $3.22 Dentists per 100K: 106.3
Cost of a dentist visit: $123.29 Average cost of toothpaste: $2.56 Dentists per 100K: 59.4
Cost of a dentist visit: $123.36 Average cost of toothpaste: $2.75 Dentists per 100K: 75.
Cost of a dentist visit: $125.99 Average cost of toothpaste: $3.39 Dentists per 100K: 107.8
Cost of a dentist visit: $129.39 Average cost of toothpaste: $3.01 Dentists per 100K: 91.3
Cost of a dentist visit: $145.91 Average cost of toothpaste: $2.94 Dentists per 100K: 68.4
Cost of a dentist visit: $150.36 Average cost of toothpaste: $3.62 Dentists per 100K: 87.1
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A scan of the metal object (left, center) and the bronchoscope used to retrieve it from the lung of a patient at Aurora Medical Center in March, 2022.
The actual metal piece removed from the right lung of patient Tom Jozsi in a robot-assisted surgery at Aurora Medical Center on March 22, 2022.
Dr. Abdul Hamid Alraiyes, pulmonary interventionalist at Aurora Medical Center with the Ion Endoluminal System. Normally used to detect and treat small cancerous lesions, the system was recently used to remove a metal piece from the lung of a patient.
Dr. Abdul Hamid Alraiyes, pulmonary interventionalist at Aurora Medical Center, explains the procedure and technology used to remove a metal piece of a dental tool from the lung of patient Tom Jozsi.
Tom Jozsi, left, and Dr. Abdul Hamid Alraiyes, stand in front of the equipment and images of the procedure that removed a two-centimeter long metal piece from Jozsi's right lung in March.
Patient Tom Jozsi with the medical team that removed a small metal pin from his right lung at Aurora Medical Center. From left, Mauricio Valencia, nurse practitioner; Caitlyn Spencer, registered nurse; Beth Graceffa, registered nurse; Tom Jozsi, patient; Dr. Abdul Hamid Alraiyes; Cassandra Winningham, interventional pulmonary tech.
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