Minimally Invasive Surgery for Cancer
Small incisions, big rewards
To combat cancer, a combination of medications, chemotherapy, radiation and surgery may be necessary, or a single approach may prove successful. Complementary therapies can also be part of a treatment plan. At Rush University Medical Center, the strategic approach to fighting the disease depends on the patient.
“At Rush, specialists work together to tailor treatment plans for each patient,” says colorectal surgeon Theodore Saclarides, MD. “We also try to find the gentlest approaches possible to fight the disease effectively.” One such tactic is minimally invasive surgery.
What is it?
The term minimally invasive surgery represents a range of procedures designed to minimize incisions and maximize the use of state-of-the-art visualization devices and surgical tools. This equipment allows doctors to enter and exit the body to repair or remove diseased areas without significantly damaging surrounding muscles, organs or tissues.
Minimally invasive surgery offers notable benefits to patients, including shorter hospital stays, shorter recovery times, less postoperative pain and less scarring.
These challenging procedures require skillful navigation of the body’s pathways and vast knowledge of and expertise in using the necessary equipment. Determining which patients will benefit most from these approaches, and performing these surgeries, requires advanced training and experienced medical judgment.
Among those leading the way in performing, and perfecting, minimally invasive procedures to treat cancer are three surgeons at Rush: Michael Liptay, MD, head of thoracic surgery; Guy Petruzzelli, MD, PhD, chief of head and neck surgery; and Saclarides. Each brings a high level of surgical skill to techniques not routinely performed at most hospitals.
In traditional, or open, surgeries to remove tumors in the lungs, surgeons must spread the ribs apart and, in some cases, remove a rib completely. This isn’t the case with video-assisted thoracic surgery (VATS), a minimally invasive technique performed at Rush by Liptay.
By making two small incisions about the length of a golf tee — one for the camera and light source that allow him to see and one for the equipment he uses to remove the diseased parts of the lung — Liptay’s method accomplishes the same objectives as open surgery and reduces the patient’s recovery time from six weeks to two or three weeks.
“Used for patients with early stages of lung cancer, this procedure may be an option for older patients who often aren’t candidates for traditional surgery because of the physical challenges associated with more invasive chest procedures,” Liptay says. VATS gives these patients an option that didn’t exist a few years ago.
Head and neck cancer
In the 1990s, surgeons had to make major incisions in the neck and, in some instances, break a patient’s jaw to access tumors in the head and neck area. To make matters worse, this often required removing part of the voice box and inserting a tracheostomy tube down the patient’s throat, making breathing and talking difficult.
Today this isn’t necessary for many patients at Rush, who have the option of a minimally invasive technique called transoral laser microsurgery (TLM). With this technique, which allows access to some tumors once considered inoperable, most tumors can be reached through the mouth using a laser and a microscope. Rush is the only institution in Chicago that offers TLM for cancer in the back of the tongue or throat.
“By combining the precision of laser surgery with the superior visualization of the microscope, patients can leave the hospital in just four days, as opposed to two weeks with more traditional surgery,” Petruzzelli says. “Plus, they can leave the hospital talking, which isn’t the case with traditional surgery.”
In addition to performing laparoscopies to remove cancerous colons or partial colons — a minimally invasive approach that allows the surgeon to enter the body through the belly button and greatly reduces recovery times — surgeons at Rush use a minimally invasive technique called transanal endoscopic microsurgery (TEM) to take out rectal tumors that have not deeply invaded the rectal walls. More TEMs are performed at Rush than at any facility in the country, Saclarides says.
Rather than cut through the abdomen and surrounding muscles to access the tumor, Saclarides uses a device to expand the rectum. This allows him to insert a scope through which he can see a magnified version of the tumor and insert the equipment he needs to remove it.
“Patients undergoing this procedure can go home the same day as opposed to staying in the hospital several days,” Saclarides says. “And they should feel well enough to perform their normal routine the very next day.”
Is it right for you?
For patients with advanced cancer or tumors in difficult-to-reach locations that require larger incisions, minimally invasive surgery may not be an option. But for those who are eligible, these procedures allow them to spend less time recovering from major operations and more time and energy focusing on enjoying their lives and maintaining their health — which are important advantages when fighting cancer. n
One of the gentler approaches for cancer that Rush now offers is the innovative treatment TomoTherapy. For more information about this unique therapy, visit www.rush.edu/discover.
If you’re considering surgery, minimally invasive procedures might be right for you. Talk to your physician or call Rush at (888) 352-RUSH (7874) to learn more.
Cancer Care at Rush
When it comes to treating cancer, experience matters. And Rush University Medical Center in Chicago, Illinois, has it, with one of the Midwest’s largest and most comprehensive cancer treatment programs, combining leading-edge therapies with vital emotional support.
For more information, visit the Cancer Programs home page.
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