Harmik J. Soukiasian, MD (right) is in charge of robotic surgery.
Newswise-Los Angeles (November 16, 2021). ——"I want to know the true state of my illness, and I don't want to wait," said Cronenfield, a resident of Riverside, California, who is 78 years old, a poet, writer, and honorary lecturer in the creative writing department of the University of California, Binjiang . "I can't imagine any other way to achieve this goal."
The method Kronenfeld chose is a simplified surgical option that uses two robotic surgeries to treat patients with suspected lung cancer. It is very different from traditional "open surgery", which requires a large chest incision and a recovery period of several weeks.
The first robotic surgery used a high-tech biopsy platform called Ion, which can create a special 3D map of the patient’s lungs. When the patient is under anesthesia, the surgical team uses the map and camera to accurately navigate the robotic bronchoscope to the suspicious mass and perform a biopsy. The tissue sample is precisely removed and then given to a pathologist, who can determine whether the patient has cancer within 15 minutes.
"This is a paradigm change in the treatment and care of lung cancer patients," said Harmik J. Soukiasian, MD, thoracic surgeon, director of thoracic surgery and robotic surgery specialist at Cedars-Sinai Cancer Center. "Through this procedure, we can use the most cutting-edge technology to provide patients with the best care as early as possible-from meeting patients to treating them, within a day."
If cancer is diagnosed after bronchoscopy, the patient is still under anesthesia so that the Da Vinci surgical robot can be used for the second robotic surgery. The surgeon makes several small incisions in the chest, inserts surgical equipment and cameras to guide and perform the operation. The surgeon sits in front of a console in front of a video screen a few feet away from the operating table, and guides the operation with the assistance of a multidisciplinary team. The magnified 3D image from the camera appears on the console screen, enabling the surgeon to robotically remove lumps, lymph nodes and even entire lung lobes.
The combination of the two programs takes about three hours. After the operation, the patient will spend a period of time in the recovery room, then be transferred to a private room for a few days, and then go home to recuperate and make a treatment plan.
"The shorter the time the patient has cancer in his body, the better it is," Soukiasian said. "Whether it is at the biological or psychological level, this is better. We can shorten the time for patients and their families to fight the unknown, so that patients can get rid of the disease."
If the tumor and lymph node biopsy results show that the cancer has spread, indicating that the operation is more complicated, the patient will be released from anesthesia. The second robotic surgery was postponed until the chemotherapy was completed to shrink the tumor.
Usually, in-depth understanding of cancer diagnosis and initiation of treatment (if necessary) includes imaging, biopsy, lengthy pathological analysis, disease staging, invasive surgery that may require breaking the chest cavity, and consultation with an oncologist to develop a treatment plan. Soukiasian said that achieving this goal may take up to 52 days of pain.
"My mother-in-law lives in another city and was diagnosed with lung cancer. It took nearly two months from the discovery of the lump to the operation," Soukiasian said. "It makes my whole family feel anxious."
In March of this year, Kronenfeld had undergone Soukiasian robotic surgery to remove a benign cyst on the thymus, a gland in the upper chest below the breastbone. The CT scan associated with the procedure also detected an opaque area or increased density in her left lung, prompting a subsequent biopsy.
Kronenfeld chose robotic surgery based on the success of her early surgery and her desire to avoid more invasive open surgery options. When she woke up from twin surgery, she was diagnosed with lung cancer and learned that Soukiasian had removed the cancer from her lungs.
"Psychologically, it is beneficial to get this news quickly, but it is still difficult to find that part of my lung has been removed and I am undergoing treatment," Cronenfeld said. "However, thinking about it later, I knew that I didn't want to wake up from anesthesia, wait for a lengthy pathology report, and then perform the operation in a few days or more. I felt very positive about what I did."
Read about lung cancer on the Cedars-Sinai blog: Should I be screened for lung cancer?
Caption: Harmik J. Soukiasian, MD (right) leads robotic surgery.
Caption: Harmik J. Soukiasian, MD
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