Paul Goings of Pocahontas is a fortunate man. In the winter, he was diagnosed with Stage I lung cancer.
Not your idea of good fortune?
Well, as it turns out, it was. First, the cancer was caught in an early stage. It was treatable. (Seventy-five percent of lung cancers are not operable.)
Only a couple of years ago, the treatment would have required removal of a lobe of his right lung (where the cancer was found) by a traditional open surgery that would have kept the 72-year-old in the hospital for up to two weeks followed by six or seven weeks of recovery time.
Then, in December, when Goings needed a lobectomy and came to Jonesboro to see St. Bernards surgeon Dr. Lynn Wiggins, he was at the right place at the right time to cash in on more good fortune. About five years ago, St. Bernards invested in a robotics-assisted surgery system known as da Vinci. And as that program became more established, Dr. Wiggins saw the potential for great advantages for using da Vinci with patients who needed lung surgery. So he completed specialized training and now is one of only four surgeons in Arkansas who performs robotics-assisted surgery on lungs.
Goings was an excellent candidate for removal of the diseased lobe through use of robotics-assisted surgery.
Instead of open surgery with a long incision, removal of a rib and a lengthy recovery time, Goings was in the hospital only three days. He had three small incisions and was back in the surgeon’s office for a post-operative checkup just a few days short of the typical inpatient hospital stay for someone who had a lobectomy using traditional surgery.
“There was a spot on my lung – the top lobe of my right lung,” Goings recalls.
Dr. Wiggins told Goings he could do the surgery using the medical center’s da Vinci robotics-assisted surgery. “He explained everything to me in detail. He said that if he did traditional surgery, he would have to remove a rib,” Goings said, adding that using the da Vinci system, he would have a much shorter hospital stay – and a much faster recovery period overall.
“I was in the hospital three days – then I was released to go home. And I had no pain.
“It was just fantastic! I could get up and around and do just about everything I would ordinarily do.
“Three days after I went home, I was out shopping with my wife.”
Almost immediately, Goings found out he could “just go on with my everyday life,” though he does some things in moderation.
“My recovery time was so simple. When I go outside to do things in the yard, I may get tired. So I sit down a few minutes.
“I would recommend this to everybody. This surgery definitely is the way to go” he stresses, pointing in particular to lack of pain, short recovery time and short hospital time.
Of course, he also sings the praises of his surgeon as well. “Dr. Wiggins is fantastic! He takes his time to explain to patients what he is going to do. And I would definitely recommend Dr. Wiggins!”
When St. Bernards invested in the da Vinci robotics-assisted surgery system by Intuitive Surgical, Wiggins thought the system looked like it had promise for things like GYN and prostate procedures, but he didn’t really expect it to become important for most patients he sees.
“I really was not interested in robotics-assisted surgery until I started thinking about the advantages to the patient. But now I think it really is the way to go for chest surgery. And I think we do a better job of cancer surgery using da Vinci,” the LSU Medical School graduate says.
Now he looks to robotics-assisted lung surgery as the way of the future. “The robotic surgery of the lung has huge advantages. You can eliminate a large scar, and you can get people back to their regular activities earlier.”
Patients typically have a three- to four-day hospital stay. Their recovery time is only two to three weeks, the surgeon points out. He compares that to a hospital stay that is three times as long with traditional surgery and a recovery period of up to two months. In addition, “traditional surgery puts a bigger stress on the patient.
“I think for chest surgery, robotics surgery is the way of the future. Patients spend only one night in intensive care. We can get them out of the hospital within three to four days,” he continues. And using the robotics-assisted method allows patients to breath deeper and have fewer lung complications. “It has less overall systemic effects.”
As far as Goings is concerned, the difference in having traditional surgery and da Vinci surgery is amazing. “The difference is almost unexplainable,” he said about the da Vinci surgery that allowed him to pick up on his routine activities almost immediately. “And I had no pain.”
St. Bernards purchased a first generation da Vinci-robotics assisted surgery system from Intuitive Surgical in 2009. Physicians on the medical staff trained in the use of the system, which allows the surgeon to operate using hand controls from a console that is physically located several feet away from the patient in the operating room. Its initial use was heaviest in the areas of gynecology and urology. Now, about a dozen St. Bernards physicians use robotics-assisted surgery regularly for procedures that include colorectal and thoracic cases as well as GYN, prostate and kidney surgery.
St. Bernards physicians have the most experience of any in the region using robotics-assisted surgery. To date they have performed well over 1,000 da Vinci cases.
Within the last few months, St. Bernards has upgraded to the newest da Vinci Xi system, the third generation of robotics-assisted surgery developed by Intuitive. It has a much enhanced 3D visualization, Wiggins says. And it also has something called “Firefly” technology that allows the anesthesiologist to inject a special isotope that literally lights up lymph nodes when viewed in a fluorescence imaging mode on the system’s camera, showing the difference in cancerous and healthy tissue as well as blood supply to a tumor.
The new da Vinci Xi system lets a surgeon operate in multiple quadrants on a patient without having to undock. And that means he or she can do more advanced procedures to be completed in a safer and more timely manner. Other new technologies that are built in are vessel sealer and energy devices.
St. Bernards is the only medical center in the region with the newest da Vinci Xi. It has the largest number of physicians on staff who perform robotics-assisted surgery. And its physicians have the most experience in delivering care using robotics-assisted surgery. That is only one example of the commitment St. Bernards has made to staying on the cutting edge of medical advances to benefit patients throughout Northeast Arkansas and Southeast Missouri.