Archive for the ‘Blow Your Mind Technology’ Category

March 19th, around 10AM PT, UC Davis will be Live Tweeting a Patient’s Experience Undergoing Surgery for Lung Cancer. Why?

Posted on March 17th, 2015 in Blow Your Mind Technology, Lung Cancer, Medical Education | No Comments »

“Is there a cure for lung cancer?”  That is a very common question for me.  We all know the statistics.  Lung cancer has around a 15% five year survival rate.  But the truth is in the details.  The majority of patients diagnosed with lung cancer are diagnosed at an advance stage, i.e. stages III and IV (there are four stages).  Only 25% of people diagnosed with lung cancer are diagnosed at the earliest stages, stages I and II.  The standard of care treatment for the physically fit person with stage I and II lung cancer is surgery, or removal of part of the lung where the cancer is located.  The five year survival for someone treated with surgery for Stage I lung cancer is around 80%.  That means 80% of those individuals are effectively cured of their lung cancer.

This is great news right?  What’s the hesitation?  We all know that the information bin on lung cancer is a black box.  Public awareness about lung cancer and the treatment modalities to fight it is minimal…though improving.  Forums like #LCSM Chat, the American Lung Association and Addario Lung Cancer Foundation, are leading the charge to disseminate evidence-based information.  But the bottom line is: people are afraid of surgery.   Patients view thoracic surgery (surgery on the contents of the chest, in this case the lungs) as high risk, with potentially prohibitive complication rates.  “Are you going to crack my chest open?” another common question I receive.  I usually reply “You are not a walnut.”

Just as the treatment of advanced stage lung cancer has evolved (such as molecular testing, personalized therapy, immunotherapy, etc.) so has the surgical treatment for early stage lung cancer.  In most cases of stage I lung cancer, surgery can be performed minimally invasively with small incisions and a high definition camera.  If you had a friend who had their gall bladder removed in the past 10 years, most likely it was removed in a similar manner.  With the gall bladder, it is called laparoscopic surgery.  With lung cancer it is called thorascopic surgery (scopic meaning camera, thora or thorax meaning chest: chest surgery with a camera.  As I tell my students, 90% of surgery is common sense; the other 10% is finding a pair of scrubs that actually fit.)  Thorascopic surgery, also called video-assisted thoracic surgery or VATS, results in smaller incisions, shorter stay in the hospital, less need for pain medicine and faster return to work and activities of daily living.  Moreover, VATS has the same cancer survivor results as traditional open surgery, where we have to make a larger cut and spread the ribs (again, we’re not “crackin’” anything).

On March 19th, around 10AM PT, At UC Davis we will be performing a Live Lung Cancer Surgery on Twitter (Don’t worry, we won’t be tweeting while operating, our public relations people will!).  One of our patients who has a keen interest in education was excited to volunteer and share her story.  She will undergo a right VATS lower lobectomy (removal of the bottom third of the right lung) for early stage lung cancer.  Now the focus of this Twitter project is not the surgery itself.  There are plenty of videos on YouTube that can show you how to do a VATS lobectomy (when I say “you” I mean your board certified thoracic surgeon…please leave your neighbors pets alone.).  The focus of this project is of course our patient, her story, her experiences on this important day, and the clinical care processes that will support her recovery.

Our patient’s case highlights some very important issues:

1)      Surgery for lung cancer has evolved.  Now with minimally invasive approaches, small incisions, and state of the art treatment during and after surgery, we are able to “stack the deck” in our patients favor to ensure their successful results.

2)      You only need lungs to get lung cancer.  She is a never smoker, and has no appreciable risk factors.

3)      Lung cancer is the number one cancer killer of women, yet only 1% of women when polled identify this fact (source: Lung Force Women’s Lung Health Barometer),

4)      Up to 80% of patients with stage I of lung cancer such as hers (early stage) are cured after treatment, and that is not the public perception.

The event will follow her day through the preoperative check in process, the operation, postoperative recovery, and follow her tumor through pathology processing, and whisking the tumor off to our research folks and tissue banking group.

The surgery is March 19th around 10am PT.  Please follow with the #LCSM hashtag or #UCDVATS.

Learn More About Robotic Thoracic Surgery offered at UC Davis

Posted on September 17th, 2013 in Blow Your Mind Technology | No Comments »

The section of General Thoracic Surgery at UC Davis is offering Robotic Thoracic Surgery to further enhance our top regional minimally invasive thoracic surgery program. 

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 What is robotic surgery? 

Robotic surgery is performed in much the same way that minimally invasive thoracic surgery (VATS) is performed.  It involves the use of small incisions, a video camera and a surgical robot.  The surgical robot is under the control of your surgeon at all times.  One of the many advantages of the surgical robot is the ability to have wristed articulation inside the chest, almost like having a surgeon’s hand inside your chest (without having a large incision).  The robot also provides exceptional optics, surgeon control of all instruments and is ideal for visualization in tight spaces like the middle of the chest1.  Additionally, robotic lung resection is associated with a shorter need for narcotic pain medication after surgery and an earlier return to usual activities when it is compared to traditional VATS lung resections2.  When compared to VATS, robotic surgery has been found to have similar complication and death rates, as well as similar long-term survival for cancer patients undergoing cancer resections3

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For what surgeries is the robot being used? 

We are currently using the surgical robot for:

  • mediastinal tumors (tumor in the middle of the chest)
  • lung biopsy
  • lung lobectomy (removal of parts of the lung)
  • removal of masses from the chest
  • procedures of the diaphragm

 

The UC Davis Robotic Thoracic Surgery Program offers unprecedented new value and quality to our patients

UC Davis Robotic Thoracic Surgery Team:

Dr. Elizabeth A. David

Dr. David Tom Cooke

Robin Kelly, PA-C

References

  1. Cerfolio EJ, Bryan AS, Minnich DJ.  Operative techniques in robotic thoracic surgery for inferior or posterior mediastinal pathology.  . J Thor and CV Surgery 2012; 143 (5) 1138-43.
  2. Louie BE, FarivarAS, Aye RW et al. Early Experience with Robotic Lung Resection Results in Similar Operative Outcomes and Morbiditiy When Compared with Matched Video-Assisted Thoracoscopic Surgery Cases.  Ann Thor Surg 2012 May Vol 93 (5) 1598-1605.
  3. Park BJ, Melfi F, Mussi A et al. Robotic lobectomy for non-small cell lung cancer (NSCLC): Long-term oncologic results. J Thor and CV Surgery 2012; 143 (2) 383-9.

New Point-of-Care App, PulmaCalc PPO, Predicted Post-operative Pulmonary Function Calculator

Posted on July 16th, 2013 in Blow Your Mind Technology, Cool Research, Lung Cancer | No Comments »

Brought to you by the UC Davis Section of General Thoracic Surgery: PulmaCalc PPO is a predicted post-operative pulmonary function calculator.  This unique point of care app, is ideal for health care providers, trainees and patients interested in patient centered medicine to easily calculate predicted post-operative (PPO) pulmonary function based on known pulmonary function test (PFT) values and knowledge of the extent of anatomic lung tissue removed.

The easy to use, intuitive interface allows the user to determine the PPO pulmonary function after segmentectomy, lobectomy or pneumonectomy, using known values for Forced Expiratory Volume in 1 second (FEV1) and Diffusing Capacity of the Lung for Carbon Monoxide (DLCO).

For segmentectomy and lobectomy, the user may utilize the anatomic graphic feature or the slide bar to input the number of anatomic segments removed for calculation.

For pneumonectomy a slide bar for the fraction of lung perfusion measured by quantitative radionuclide ventilation/perfusion (V/Q) scan can be used to determine PPO FEV1and DLCO.

Additional tabs describe the role for calculating PPO pulmonary function and the evidence-based medicine behind it.

This application is for informational purposes only and is not intended as a substitute for medical care, advice or professional services.

Available for the iPhone and iPad

To download PulmaCalc PPO click here:

https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewSoftware?id=670782795&mt=8

To trouble shoot or additional questions contact:

scott@fouraxisapps.com

 

PulmaCalc in iTunes