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Lbelle78

Lobectomy robotically??

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Okay, my visit with the surgeon today left me feeling scared and confused. He was a nice guy, but really blunt about how painful it was all going to be and what a long recovery I would have with the upper right lobe being removed. He stated he does not do VATS for lobectomies and would make standard incisions between ribs. He said I would probably have to go out of state to get a Dr. who would do VATS. I asked him about robotic surgery done locally, and he said that I would probably be a candidate, but he would not recommend it. That is really what I want, but with his opinion on the robotic surgery and him alluding to a questionable opinion of the doctor who would be performing it, I'm torn. 

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Hi Lbelle,

Wow! I'd look for a second opinion, even if you have to go out of state, if you can in any way manage to do that. I don't know where in Alabama you are. I can imagine that there might not be somebody local to do VATS or robotic is you're in a small community, but it's hard to believe that there's nobody in Alabama. Can you ask your primary doctor to refer you to someone for a second opinion? Can you contact your nearest cancer center and if it's far from you ask whether they know somebody nearer to you? From my experience with VATs and what I've heard about open surgery, I'd go to great lenghts to get VATS. With VATs, there is always the possiblity that they would have to do open surgery anyway if there is some complication, but I don't think it's that common.  Hang in there! 

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Thanks BridgetO, I'm in a small town in Alabama but about 55 minutes from UAB where they offer a robotically assisted Lobectomy for potential candidates, which is where I really want to try next. I'm having a hard time with the idea of an open surgery. My family is so worried about waiting too long that they want to schedule right away with our first doctor because he was so highly recommended by the pulmonologist. This surgeon did not offer why he would not personally use the doctor who offers the robotic approach. Maybe because he is a younger less experienced surgeon, but at a well respected medical center. Thanks so much for the good ideas!

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Lbelle,

I've heard about some thoracic surgeons express concern about upper right lobes resection using VATS. Trying to recall where I heard it and in what context. I think there was an anatomical reason but can't recall. 

Nevertheless, by all means seek a second opinion. And, I'd have this surgery in a hospital that does hundreds of them a year, not a local hospital. I don't know anything about UAB's medical system. Ask your surgeon if there is an anatomical risk to an upper right lobe resection using VATS. If there is risk, I'd use the standard method. You've already got enough on your plate with adding surgical risk. 

Stay the course.

Tom

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Lbelle,  

   I was fortunate to have a surgeon in my area that did the Vats robotic surgery . I agree with the others get a second opinion . Someone you are comfortable with . And check patient reviews as well . Mine was a right upper lobectomy and I don't remember him mentioning any increased risk . But that seems like a lifetime ago.

       Prayers Suepm

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I had open lobectomy to my right middle lobe last year. My surgeon is AMAZING. He does VATS, but was unable to do it in my case--I can't quite remember why (anatomy, lymph nodes, my previous treatment--I can't recall). 

Nothing wrong with with getting a second opinion. Studies show better outcomes when we see surgeons who specialize in these surgeries, and do LOTS of them. 

Meloni

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Hi Lbelle,

I'm new to this site, and just found your thread, so I'm sorry I'm late to the game. 

How are you? What surgery did you finally get, and how have you been since? I've found very little discussion of robotics on this site yet, but it's early days. My husband is scheduled for a robotic lobectomy next week, so of course I'm interested to hear from others and to learn of any personal stories, pros and/or cons!

I do hope your recovery has gone well.

Best wishes,
Louise

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Hi LouiseB

Thanks for responding to my post. It has honestly been a very long time since I have been on the forum, although I read comments periodically. I did decide to go ahead with a robotic lobectomy April 22, 2017. Unfortunately as they began the surgery they realized that the cancer had metastasized and only took a wedge resection of the lower part of my lung and closed. I went to Stage IV immediately, where as before they believed that I was Stage 1A. They had reported that my PET and CT scans revealed no further spread of cancer initially, but were mistaken, and that's why we went ahead with the surgery. I was given few options for treatment following the attempted surgery. I was thought to be ALK positive at the time, but later tests revealed that I was not. I was given the option of beginning a drug to block the ALK gene, and that is the direction we took, along with immunotherapy later, as the ALK drug failed (my current doctor believes the initial test was botched, and that I was not truly ALK positive, as later testing revealed). I have since had Foundation One testing and have a rare Exon 20 mutation. We opted for some out of the box treatments, including 2 cryotherapy procedures followed by intratumoral injections of immunotherapy drugs. I had my most recent procedure March 2018. If I had clear indications that the cancer had not spread, would I opt for a robotic lobectomy again? Probably so. The robotic surgery itself was fairly easy to heal from, and my pain was managed very well. The only difficulty I had following was a pneumothorax, which required 2 additional days in the hospital with my chest tube (the bane of my existence, lol, the least fun part of the whole deal). I was sore following the procedure, but was on my feet fairly quickly. My story is complex, and has taken a lot of twists and turns. I'm thankful to be here today, having just celebrated my 40th birthday a little over a year following diagnosis. I anticipate that your husband will do well, and pray that they will be able to get him on the road to health quickly! Blessings!

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Oh my goodness, Lbelle, what a journey!! I'm so sorry to learn that you had to deal with such a turn of events, having expected a relatively easy road after the initial diagnosis. This is precisely the kind of thing I am concerned about for my husband, but I am grateful for all your details and to at least be prepared to deal with the unexpected, even though we are naturally thinking positively and hoping for the best.

I'm glad to hear that at least the robotic surgery was easy to heal from. I was relieved when the surgeon said that was the route he was taking, and was quite surprised not to find more 'robotic' stories on this site. I did some searching but didn't turn up many posts at all, so thank you so much for your comments, and heads up about the pneumothorax too.

Wishing you many lots better days ahead. My 40s are way behind me now, but I do still remember it was a great decade and I certainly wish the same for you!!

😎

 

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Guest Lbelle78

Thank you LouiseB for your kind words! I had a hard time also finding stories of those who had chosen to go through robotic surgeries. I believe if you are a candidate for one it is the easiest way to go. Last week a young coworker of mine was diagnosed and although she did not have the more minimally invasive robotic but VATS, she was in surgery Tuesday and home by Friday afternoon with very little pain. They were able to remove just a lobe and she had no sign of cancer in her lymph nodes. So be encouraged that your husband's story will be similar. Blessings to you!

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For what it's worth, my own surgeon said VATS and robotic are essentially the same (or were for my case--upper left lobectomy).  He said it's really a matter of the surgeon's preference and the availability of the robotic operating room, if that's the preference.  He said he, personally, preferred to do VATS, but his colleague did almost all robotic, just because he liked it better.  Both were well-qualified to do both.  Since I wanted the type my surgeon was most comfortable with, we went with the VATS.  Minor post-surgical complication had me re-admitted for a couple of days (air leak causing crepitus, or bubbles under the skin), but other than that it was simple with little pain and quick recovery.

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I’m beginning to realize VATS and robotic are closer cousins than I thought. My husband goes into surgery early Monday morning, so we’re hoping for a smooth operation and no complications!

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Hoping all goes well with the surgery. Don't worry about what kind of surgery ends up being necessary, just focus on helping him recover afterwards. Sending positive vibes your way!

I have had both VATS (lower left lobe removed) and thoracotomy (upper right lobe removed), and its all okay. Focus on breathing, healing, and good health in the future!! 

 

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