NEW YORK, NY — Lenox Hill Hospital surgeons are the first in the world to repair a collapsed trachea using a fully robotic, minimally-invasive technique. Tracheobronchomalacia (TBM), a debilitating condition that weakens the airway walls, has been treated historically through open, invasive surgery.
Under the direction of Richard Lazzaro, MD, the hospital’s chief of thoracic surgery, the Lenox Hill team utilized robot-assisted surgery to treat 42 patients in a trial designed to examine the safety and efficacy of the new technique. The results demonstrated fewer postoperative complications, improved outcomes and quicker recovery when compared to traditional surgery. Dr. Lazzaro will present his findings at the American Association of Thoracic Surgeons conference in San Diego, CA on April 30.
“While open surgery for a collapsed trachea has been successful for certain patients in the past, our first-of-its-kind study has shown that the minimally-invasive robotic procedure is unequivocally the superior option,” said Dr. Lazzaro, who has specialized in minimally-invasive surgery for more than 20 years. “Our findings indicate a significant improvement in breathing capacity and a faster, less-painful recovery when compared to traditional surgery for this complex, high-risk population.”
One of those patients, Richard McGurk, 64, of Farmingdale, NY, is breathing easier after undergoing the robotic procedure in August 2017. He first noticed that something was wrong three years ago when he developed a persistent cough that prevented him from sleeping. He wasn’t able to lie down for more than 15 minutes without having a coughing fit and began sitting up in a chair to sleep. Shortly thereafter, he started developing monthly sinus infections, and then acquired bronchitis and pneumonia. Though Mr. McGurk visited numerous specialists and underwent a variety of tests, no one was able to diagnose him.
Eventually, Mr. McGurk was sent for a dynamic computed tomography (CT) scan, which showed that his trachea had significantly deteriorated and would close up during breathing. He was referred to Dr. Lazzaro, who determined that Mr. McGurk would be a good candidate for the robotic tracheobronchoplasty, which entails using highly-advanced robotic arms to place mesh stenting around the trachea to stabilize it and restore proper functionality. Unlike traditional invasive surgery, the entire procedure is done through several tiny incisions, substantially improving the overall patient experience during and after surgery.
“From the day I came home, I couldn’t believe the difference. I was able to lie down and go to sleep,” said Mr. McGurk. “I couldn’t be happier. It’s amazing, it’s a game-changer.”
TBM, a condition once considered rare but now believed to be considerably under-diagnosed, is a progressive disorder in which the back wall of the trachea and the bronchi are significantly weakened. Those plagued by TBM are unable to cough up their secretions, making them more prone to bronchitis, pneumonia and other respiratory ailments.
While open surgery is an adequate treatment for the condition, the major incision and associated pain involved in the procedure make recovery more difficult and lengthy. Typically, patients stay at the hospital for one to two weeks, spending up to six days in intensive care. There is also a three percent mortality rate associated with the procedure. By comparison, patients undergoing the robotic approach typically spend three to four days in the hospital, with minimal time spent in intensive care and no reported mortality.
“No other institution has our depth of experience using this type of minimally-invasive approach to treat TBM. Dr. Lazzaro is a master at robotic surgery involving the respiratory system,” said S. Jacob Scheinerman, MD, chair of cardiothoracic surgery at Lenox Hill Hospital. “This is a perfect example of how our surgeons are using cutting-edge medicine, innovation and research to deliver the best care to our patients.