University of Iowa News Release
University of Iowa Children's Hospital Performs Pioneering
Surgery
Release: March 21, 2003
Pediatric surgeons at University of Iowa Children's Hospital
recently used a surgical robot to assist their removal of a
tumor in the right adrenal gland of a 22-month-old Iowa girl
- the first time the advanced technology was used for such a
case.
Emanuel and Leona Troyer of Moulton, Iowa first noticed
something was wrong when their young daughter, Loretta,
developed a rash on her cheeks and a swollen face. When she
began sprouting facial and body hair, they consulted their
physician in Bloomfield. They next received a referral to
the Ottumwa Regional Medical Center, and were in turn
referred to specialists at University of Iowa Children's Hospital.
John Meehan, MD University of Iowa assistant professor
of surgery at University of Iowa Children's Hospital, determined that
Loretta was an ideal candidate for minimally invasive
surgery with the advanced technology that uses a surgical
robot to assist the surgeon.
"Lab tests and our examination showed that Loretta had
abnormally high steroid levels and a mass in her right
adrenal gland," Meehan said. "Because the lesion was
isolated to the right adrenal gland, we felt that using the
robot would better enable us to remove the gland without
damaging the right adrenal vein, which is very fragile,
especially in such a young child."
In the four-hour procedure, Meehan made several very
small incisions and then inserted a special camera and
instruments to remove the tumor, all with the assistance of
the computer-controlled precision of the robotic surgical
system.
"Using the robot made it much easier to dissect and tie
off the very short right adrenal gland vein," Meehan said.
"We removed the entire tumor. We did not see any residual
disease, and Loretta is doing very well."
Another key benefit of the minimally invasive surgical
technique in such cases is a faster recovery. Patients who
do not receive minimally invasive surgery to remove an
adrenal gland instead receive a large incision and must stay
in the hospital up to a week to recover. By contrast,
Loretta's parents took her home just one day after her
surgery.
"We are looking forward to getting back home," Emanuel
Troyer said.
"Loretta has had great care, and her outlook is good."
The robotic surgical system allows a surgeon to operate
with instrument movements that can simulate hand and wrist
movements. After the surgeon establishes access into the
body cavity, the physician sits at a computer console that
offers a three-dimensional view of the area to be treated
with magnification up to 12 times that of normal vision. The
surgeon uses joystick-like controls to manipulate long,
narrow, specially hinged surgical instruments that are
inserted through small incisions in the patient. The
remote-controlled instruments can be used in hard-to-reach
areas and turned in ways that would be impossible with
normal wrist dexterity. Altogether, these advantages allow
the surgeon to work on a smaller scale and more precisely
than traditional surgery.
Information about the system can be viewed online at
www.uihealthcare.com/daVinci.
The technology is currently approved for use in surgeries
in the abdomen, pelvis and chest. In addition, UI Hospitals
and Clinics was the first medical center in Iowa to use the
da Vinci® system to perform urological procedures such as
radical prostatectomy for removing a cancerous prostate.
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