The new procedure for removing lung tumours uses robotic arms, which are controlled by a surgeon using handles on a remote console. --PHOTO: NATIONAL HEART CENTRE SINGAPORE
A NEW procedure that uses robot-assisted technology will enable surgeons to remove tumours from early stage lung cancer patients more accurately.
Two lobectomies using the technology have been carried out at the National Heart Centre Singapore (NHCS) since August, and both have been successful.
They were the first times robot-assisted lobectomies have been performed in South-east Asia.
Four small keyhole incisions are made on the side of the body, each measuring between 1cm and 4cm. Probes are then inserted into the incisions to remove the tumour.
Previously, the probes were held manually by the surgeon and the procedure was known as video-assisted thoracoscopic surgery (VATS).
It limited the manoeuvrability of the instrument to the range of motion of the human hand.
The new procedure uses robotic arms, which can be controlled by the surgeon using handles on a remote console.
The robotic arms can perform complex manoeuvres that exceed the range of motion of a human hand, and without any tremors that a human hand might have.
In addition, VATS requires the insertion of a camera into the patient to transmit the image of the lung to a computer screen.
This could result in difficulty gauging depth of field, as the resulting view is two-dimensional.
The advanced technology in the new procedure allows the surgeon a three-dimensional view of the chest cavity from the remote console.
'The precision of the procedure means enhanced safety for the patient,' said Dr Su Jang Wen, consultant at the department of cardiothoracic surgery in NHCS, who performed the two operations.
A possible disadvantage of the procedure, however, is that it is difficult for the surgeon to gauge the amount of pressure to use when he cuts into the lung, as he will not actually be holding the probe.
This is an important part of the learning process for new surgeons, he said.
The NHCS estimates that it should be able to offer the procedure to between 50 and 100 patients a year.
The operation costs about $12,000, 30 per cent more than the older VATS procedure, which costs about $9,000.
The surgery is currently available only for patients with early-stage lung cancer. This is because the keyhole incisions allow the removal of only fairly small tumours.
Later-stage lung cancer patients require a long incision of about 10 to 15cm to remove larger tumours.
The first patient to receive the surgery here was Madam Goh Geck Khin, 71, who had a 3cm tumour in her right lung removed. She was discharged five days after her operation on Aug 25 and has since recovered.
'I am happy to have only four small wounds and felt very little pain,' she said in a statement issued by NHCS.
The hospital said it would train another two to three surgeons over the next five years to carry out the procedure.
Dr Su is the only surgeon trained for this operation here at present.
There are currently only about 25 centres offering this procedure worldwide, and about 3,000 operations have been performed.
Source: The Straits Times © Singapore Press Holdings Limited. Permission required for reproduction.
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