Courage in Crisis | Robotic Thoracic Surgery at Cone Health
Doctor and Patient Reunite: Watch the reunion of Donna Brannock and Dr. Lightfoot and hear more about her story as well as the possibilities robotic thoracic surgery brings to Cone Health.
Last year, Donna Brannock had the kind of moment we all fear. She found a growth on her chest.
“At first, I kind of shook it off as nothing to be too concerned about,” she says, “but it was growing bigger, so I decided to have somebody check it out.”
That someone was Harrell Lightfoot, MD, a thoracic and cardiovascular surgeon at The Moses H. Cone Memorial Hospital. When Donna went in for her appointment, they discovered it was cancer that had spread to her lungs. Dr. Lightfoot walked Donna through her initial shock and assured her he had a plan.
His solution was to remove her cancer with robotic thoracic surgery — a revolutionary advancement in minimally invasive surgery.
“We have our patients at the center of our thinking when we recommend robotic-assisted surgery, because the outcomes are better, the surgery is more precise and less invasive, and the recovery is quicker with a substantially reduced amount and duration of pain after the procedure,” Dr. Lightfoot says.
“Rather than making a large incision to create access and room to manipulate instruments, we’re able to do it through incisions about a half an inch in length,” explains cardiothoracic surgeon Steven Hendrickson, MD, one of Dr. Lightfoot’s colleagues and surgical coleader of Cone Health’s Multidisciplinary Thoracic Oncology Clinic (MTOC). “The robot gives us the reach and dexterity inside where the procedure is done.”
In these procedures, the surgeon controls all the movements of the robot, which is why they’re called robotic-assisted surgeries. While the patient is asleep under general anesthesia, the surgeon makes the incisions and places ports for the robotic instruments. Then the surgeon moves 10 feet to the console to conduct the surgery with robotic arms. These arms move with the surgeon’s hands while a specialized camera bends and rotates within the surgical field, giving the surgeon a full view inside the rib cage.
“You have better vision and dexterity and can see and reach around corners that you were not able to do with older technology,” says Dr. Hendrickson.
Dr. Lightfoot adds, “When you’re operating in an area that’s surrounded by a boney cage, it really makes the operations a lot easier and a lot safer.”
Doctors are now able to do highly complex operations in more patients.
The Patient's Perspective
Donna Brannock is a cancer survivor.
While Brannock was still processing her diagnosis, she liked the idea of Dr. Lightfoot using the robotic technology. “I thought, ‘Well, this sounds really good,’ ” she says. “‘How could it be any better?’”
To her surprise and delight, Brannock soon discovered things could in fact be better. Today, she is cancer free. She has some small scars around her chest but recovered quickly. That, according to doctors who use this technology, is one of the major benefits to this type of procedure.
Dr. Lightfoot says he has had some patients go home one or two days after surgery compared to four or five days after more invasive surgery.
“We’ve had several people go back to work two or three weeks after major lung surgery, which is really unheard of,” says Dr. Hendrickson.
Brannock credits her quick recovery to her positive attitude and the minimally invasive robotic surgery. She knew other people in her church group who had more- invasive procedures done and were not recovering as quickly. Brannock is certain she made the right decision.
“I just felt like I could breathe again,” she says. “It was like a new me. I was back to me.”
Life today has gone back to normal for Brannock. After major lung surgery, she walks an hour a day, rides her bicycle and spends time at the beach with her husband.
“We have a good life. We go, go, go,” she says.
Doctors are also seeing less pain in recovering patients.
“People are requiring much less in the way of narcotics and getting off narcotics quicker,” says Dr. Hendrickson. He says there are exceptions to every rule, but by and large, people are doing better with less pain.
They’re also sending fewer patients to the ICU after surgery. According to Dr. Lightfoot, patients have all been sent to the step-down unit with less bleeding and more tolerable pain. “That’s really a big change, a big improvement that’s important to us and our patients.”
Physicians With Precision
Dr. Lightfoot with the thoracic surgery robot.
Robotic technology is helping surgeons in the operating room. “The 3D imaging and stability is far better than previous minimally invasive equipment,” says thoracic and cardiovascular surgeon Edward Gerhardt, MD, former Chief of Surgery at Cone Health. He adds that the instruments needed for each case may seem more complicated, but in reality, less instrumentation than conventional procedures is needed.
Surgeons at Moses Cone Hospital began doing this robotic surgery in January 2021, and they’re on track to complete about 150 procedures before the end of the year. “Most programs may do 75 to 100 cases a year,” Dr. Lightfoot says. “Our volume of cases is going to continue to deepen our experience in providing this care.”
Dr. Hendrickson says they’re turning to robotic technology in about 90% of their thoracic operations.
“Our experience has been nothing but positive,” he says. “I was a little bit skeptical that it would make a huge difference, but it does. It’s very straightforward to use, very intuitive, and it really does allow you to do a better job than without the robot.”
The doctors agree that one benefit outweighs them all.
“It’s all about the patient outcomes,” says Dr. Hendrickson. “The latest technology gives patients the best chance of doing well. It makes it easier for me to do a good job for the patient and that patient’s outcome is likely to be better.”
Their patient focus made a big difference to Brannock.
“They kept my mind at ease from the beginning,” she says. “They were right there to talk to me and explain everything that was going on. That meant a lot to me.”
She continues, “Dr. Lightfoot’s whole staff was so kind and knowledgeable. When you go through something like this, you have so many questions — sometimes you don’t even know the questions to ask, and the answers are hard to hear. I know he saved my life. I know it without a doubt.”