July 6, 2009 | Two surgeons at the University of Arkansas for Medical Sciences (UAMS) teamed up recently to perform the first two robotic parathyroid surgeries in Arkansas.
After head and neck surgeon Brendan C. Stack Jr., M.D., diagnosed each patient’s condition and found the faulty parathyroid glands in each patient’s chest, heart surgeon Gareth Tobler, M.D., and Stack used the da Vinci Surgical System robot to remove the glands.
“This is really cutting-edge; to the best of our knowledge these were only the third and fourth such robotic cases done in the United States, and the first in Arkansas,” said Stack, chief of Head and Neck Surgery in the Department of Otolaryngology-Head and Neck Surgery and the UAMS Thyroid Center.
The parathyroid glands are normally in the neck, but in rare cases people are born with a parathyroid gland elsewhere in the body, such as in the chest. In these two cases, the patients’ glands within the chest had developed benign tumors that were secreting excessive hormones. The hormones were leaching calcium from the patients’ bones and would have caused osteoporosis if left untreated.
Tobler and Stack removed the defective glands in surgeries one week apart. “We actually use the “c” word – cured; these procedures have a 97 percent cure rate,” Stack said. Removing one parathyroid gland leaves patients with three other parathyroid glands to regulate the amount of calcium in the blood and in the bones, Stack said.
The defective parathyroid was deep in the chest of each patient, so the only way to get to it was either by cutting through the breastbone or endoscopically, a common minimally invasive approach at UAMS, said Stack. “In this case, we chose the minimally invasive approach with the added advantages of the robot.”
The robot gives surgeons a magnified, high-resolution 3D view inside the body and more precise control of surgical instruments. Surgeons operate the robot while sitting a few feet from the patient.
Several UAMS surgeons have become first or among the first nationally to use the robot for various surgical procedures since it was purchased in September 2007. The robot requires only small incisions, which heal quickly, allowing patients to resume normal activities weeks and even months sooner than after more traditional surgeries.
Less than a week after her robotic surgery, Kelli Murphy, 32, of Little Rock, said she was recovering quickly and already looking forward to running again, even training for the Little Rock Marathon next spring.
“I feel more refreshed and I have more energy,” Murphy said.
Murphy said she had considered some alternative medicinal options, but she opted for surgery. “At 32, I didn’t want to take any chances and be hunched over with osteoporosis – that’s why I chose to have it removed.”
She said she was impressed that she could receive such sophisticated treatment so close to home.
“I was amazed to know that in Little Rock, just down the street, that there were these world-renowned doctors using such a machine,” said Murphy, who read about the da Vinci before surgery. “I was really grateful.”
Stack and the other physicians at the UAMS Thyroid Center see about 3,000 patients every year. Of those, about 350 will have either thyroid or parathyroid surgery.
The Thyroid Center provides patients a single place for diagnosis and treatment and long-term disease management of thyroid and parathyroid disorders by a team of fellowship-trained surgeons, endocrinologists, pathologists, radiologists and nuclear medicine doctors using the very latest equipment.
UAMS is the state’s only comprehensive academic health center, with five colleges, a graduate school, a new 540,000-square-foot hospital, six centers of excellence and a statewide network of regional centers. UAMS has 2,652 students and 733 medical residents. Its centers of excellence include the Winthrop P. Rockefeller Cancer Institute, the Jackson T. Stephens Spine & Neurosciences Institute, the Myeloma Institute for Research and Therapy, the Harvey & Bernice Jones Eye Institute, the Psychiatric Research Institute and the Donald W. Reynolds Institute on Aging. It is the state’s largest public employer with more than 10,000 employees, including nearly 1,150 physicians who provide medical care to patients at UAMS, Arkansas Children’s Hospital, the VA Medical Center and UAMS’ Area Health Education Centers throughout the state. Visit www.uams.edu or uamshealth.com.