Photo: Epworth Dr Nick Wilsmore (left) and Dr Jazmin Eckhaus (right)
For the first time in Australia, an Epworth physician and surgeon have used two high-tech robots to mark and remove a lung cancer in a single minimally invasive operation.
Pulmonologist and respiratory physician Dr Nick Wilsmore and thoracic surgeon Dr Jazmin Eckhaus teamed up to perform the robotic-assisted operation at Epworth Eastern.
First, Dr Wilsmore located and marked the tiny 6mm lesion with a coil dipped in fluorescent dye using the Ion robotic bronchoscopy platform, which has a built-in navigation system to help specialists precisely navigate to access hard-to-reach nodules in the peripheral lung.
Like a relay, Dr Eckhaus then moved into theatre to excise the identified lesion from the lung using the da Vinci Xi multi-port robotic-assisted surgical system. This platform enables complex procedures to be performed in a minimally invasive way via four tiny incisions.
This is the first time in Australia that both stages have been completed in one single operation using robotic-assisted diagnostic and surgical technology.
"The fact that it's now possible to do everything in the one procedure, from diagnosis to marking and resection, is astounding," Dr Wilsmore said.
The single procedure avoids the need for a patient to return to hospital within days for a second procedure and removes the requirement for a second anaesthetic.
"Using the Ion robotic bronchoscope and the da Vinci robotic-assisted surgical systems within the same procedure allows us to coordinate care efficiently while supporting a safe and precise approach for patients," said Dr Eckhaus, the only female thoracic surgeon practising in Australia.
The first patient to have this surgery, a 78-year-old Melbourne woman, had a small lesion in her lung that had started to grow after more than two years or monitoring. The options were to continue to monitor for further growth, or to have it removed.
"I decided to have it removed. I thought I'm only 78, with very young grandchildren so I need to stick around a bit longer," she said.
"I was a bit nervous to be the first person to have this surgery, but I really trusted the doctors, and I felt it was better to have one surgery."
The early-stage lung cancer, precisely marked with the glowing coil by Dr Wilsmore, was entirely removed by Dr Eckhaus.
"It was a very early finding, and I don't need chemotherapy or radiation, which is a blessing," she said.
The avid walker was back hitting the pavement within two weeks of her surgery. She is now looking forward to a trip of a lifetime with her husband - a European river cruise - later this year.
New bronchoscope technology
Epworth is the only hospital in Victoria with an Ion robotic bronchoscope, a system 'like Google Maps for your lungs' that enables specialists to navigate through a complex maze of airways with accuracy and stability.
"This new technology means I can rely on the robot to help navigate to the right position inside the lung, and once it's pointed towards the nodule or tumour, it stays perfectly steady as we take a sample or mark it for surgery," Dr Wilsmore said.
The precise localisation and excision of the lesion with the two robotic systems may also allow a smaller segment of the lung to be removed during surgery, preserving more of the healthy tissue.
"The Ion bronchoscope enables us to localise lesions in the lung that we were previously unable to mark for surgery because they were so small. To remove them, we would sometimes need to take out a larger section of the lung, or the patient might need a second procedure to ensure we have removed it completely," Dr Eckhaus said.
Lung screening assessment service
Epworth is committed to improving outcomes for lung cancer patients, launching one of Australia's first Priority Lung Screening Assessment Services last year.
This service supports the Australian Government's National Lung Cancer Screening Program by providing fast access to specialists and advanced diagnostic tools when scans show the need for further investigation.
"Through the national program, asymptomatic people can now undertake scans that will identify any abnormalities. Patients who might be at risk can now access the Epworth priority service ensuring they receive the right follow-up care quickly," Dr Wilsmore said.
