UIC surgeons first to use robot for living-donor kidney-pancreas transplant and for boy with rare swallowing disorder

Chicago 24 January 2006Surgeons at the University of Illinois Medical Center at Chicago (UIC) are the first in the world to use robotic surgery to successfully remove a kidney and pancreas from a living donor as part of a successful transplantation. UIC is one of only two centres in the United States to perform living-donor kidney-pancreas transplants, and the only centre to use robotic technology for the removal of these two organs. In addition, UIC surgeons performed robotic-assisted surgery on a 12-year-old Chicago boy with a rare swallowing disorder called achalasia. The disorder, in which the sphincter muscle between the esophagus and stomach does not properly relax, affects only about 100 children in the United States each year and is often misdiagnosed.

Advertisement

The recipient of the kidney and pancreas organ transplants, a 34-year-old man with Type 1 diabetes, suffered kidney failure as a result of the disease. His wife donated her left kidney and approximately 50 percent of her pancreas to her husband.

During the January 12 surgery, physicians inserted the laparoscope and robotic arms of the da Vinci Surgical System through half-inch incisions in the donor's abdomen to precisely control the real-time movements of the surgical instruments inside the patient.

Both organs were removed through a 2 3/4-inch incision and then transplanted into the recipient during traditional open surgery. The kidney and pancreas are functioning normally and the patient no longer requires insulin to control his diabetes.

The donor and recipient, who do not wish to be identified, are doing well. The donor was discharged from the hospital January 17 and her husband will be discharged on January 19.

"The robot allows us to perform complex surgeries laparoscopically and spares the donor from open abdominal surgery, a large scar and a prolonged recovery", stated Dr. Enrico Benedetti, professor of surgery at UIC and division chief of transplantation surgery. "In this case, it allowed us to more delicately preserve the splenic artery and vein and maintain the viability of the spleen."

According to Dr. Santiago Horgan, director of minimally invasive surgery at UIC, robotic-assisted minimally invasive surgery vastly expands laparoscopic capabilities by allowing surgeons to view the operating field in 3D using a tiny camera to manipulate instruments more precisely. The robotic system also provides a 360-degree range of motion, using instruments modelled after the human wrist. This dexterity is not possible with traditional laparoscopic instruments, which are suitable for only a narrow range of surgical procedures.

Nathaniel O'Donnell would often complain about pain in his chest when he ate, according his mother, Weslene O'Donnell, a Chicago police officer. His parents and paediatrician attributed the 150-pound boy's complaints to heartburn. "When he drank, he could feel the temperature of the hot or cold liquids just sitting there in his chest", stated his mother.

Nathaniel lost nearly 28 pounds in a short time, and his worried parents became determined to find out what was wrong with their son. Specialists diagnosed Nathaniel with achalasia, a disorder which occurs in only 2000 people in the United States each year, 95 percent of them adults. There is no cure for the disorder, but surgery provides the greatest hope for improving symptoms, which include difficulty swallowing liquid and solid food, chest pain and weight loss.

Traditionally, surgery for achalasia has been performed as an "open" procedure. Only recently have minimally invasive techniques like laparoscopy been used. UIC surgeons were the first in the world to perform robotic myotomy for achalasia in adults and in children. They were also the first to publish the benefits of robotic myotomy over laparoscopic myotomy for this rare disorder.

During a one-hour procedure on January 24, surgeons used the da Vinci Surgical System to cut the sphincter muscle, which will allow Nathaniel to eat and drink food that will empty directly into his stomach. Nathaniel, an active boy who plays baseball, football and hockey, is expected to be discharged from the hospital very soon.

Experienced minimally invasive surgeons are continually pushing the envelope to use robotic-assisted surgery for more complex surgeries. Procedures that were once performed through open abdominal surgery or conventional laparoscopic surgery are now being adapted using the robot, which allows surgeons to operate more precisely.

UIC surgeons performed the first robotic-assisted surgery in Illinois in 2000. Since then, more than 500 robotic surgeries have been performed at UIC for a variety of procedures including kidney donation, gall bladder removal, gastric bypass and Lap-Band for treatment of obesity, and esophageal repair.

UIC ranks among the nation's top 50 universities in federal research funding and is Chicago's largest university with 25.000 students, 12.000 faculty and staff, 15 colleges and the state's major public medical centre. A hallmark of the campus is the Great Cities Commitment, through which UIC faculty, students and staff engage with community, corporate, foundation and government partners in hundreds of programmes to improve the quality of life in metropolitan areas around the world.

More da Vinci news is available in this VMW issue's article Saint Joseph's Hospital acquires most advanced robotic surgical system.


Leslie Versweyveld

[Medical IT News][Calendar][Virtual Medical Worlds Community][News on Advanced IT]