CHOOSING LAPAROSCOPY

This entry was posted by Thursday, 29 July, 2010
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ANGELO'S TRAINER-BOX KEEPS SURGEONS SHARP AS A SCALPEL

A KIDNEY HAS TO GO

My brother-in-law’s still a handsome guy in his mid seventies. He’s fiercely loyal to my sister and his kids, a “drivin’ fool” who runs his magnificent RV across country at the drop of a beanie, and he’s the “go to guy” in the family when it comes to automotive questions.

But for several years, he’s been battling cancers acquired (probably) during his military service.

R’s been in remission for seven years thanks to the remarkable work of Dr. Shimon Slavin (International Center for Cell Therapy & Cancer),  a pioneer in immunological therapy. Recently, however,  a mass was discovered on one of R’s kidneys.

The kidney has to go.

A DECISION HAS TO BE MADE

R had to decide between an open incision or laparoscopy, the new “modern” approach, which involves manipulating tiny tools inside the abdominal cavity while observing with a tiny video camera. Laparoscopy is all done through small holes in the abdomen rather than through a large incision and can mean faster recovery and less scarring.

“You’re the science guy, R said.  What do you think? Should I take a chance on laparoscopy?”

“Well, the recovery’s easier with laparoscopy,” I said. “What’s not to like?”

“Here’s the thing,” he said. “I’m afraid they’ll have to chop up the kidney to remove it. I wouldn’t want all that cancer juice sloshing around in me.  Who knows what other organs could be affected.”

R’s fears certainly seemed reasonable. In fact, surgeons do worry about “spills”, cells that drip from an instrument during surgery.  So I called Angelo Tortola (Venture Technologies) who designs the tools used in these procedures. He also makes the training simulators that surgeons use to perfect their techniques.

After explaining a little about my brother-in-law’s background and describing the problem, I asked him if he could help.

“You called the right guy,” he said. “I had to give up one of my own kidneys about two years ago.”

Since Angelo had never mentioned this to me, I was very surprised.

“You’re OK now, right?”

“Completely. The cancer was fully contained. But I have a story.”

“Don’t let me stop you.”

“My doctor was ‘old school’. He was determined to go with an open incision.  Even after I asked about laparoscopy, he stuck to his position. Safer. Best result.

“But the more I read, the more I wondered.  Finally, I set up an appointment at Mass General Hospital in Boston with a leading surgeon – one who I happened to know did a lot of laparoscopic procedures.

“After reviewing my situation, he said I would be a good candidate for laparoscopy but I could choose an open procedure if I wished.

“I asked him about the relative advantages. He said that laparoscopic removal of a kidney was just as safe as an open procedure with lower risk of certain complications during recovery.

“So, I asked, how do I decide?

“Well, he said, with the open procedure it’ll take you longer to get back on your feet.

“How much longer? I asked.

“With the open procedure, it could be up to a year till you are fully normal, he said. With laproscopy, you should be functional within a few days.”

“Now THAT,” Angelo said, “is an amazing difference. And, you know what? He was right.  A couple of weeks later, I was on an airplane, on the way to a meeting.”

I asked Angelo about R’s concern. Does the kidney get chopped up before it is removed?

“Not to worry,” Angelo said. “That’s not how they do it. The organ is removed in one piece. And everything’s placed in a plastic bag before removal.

“You tell your brother-in-law that either choice is safe. It’s up to him.”


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