Robotic Surgery Puts Patient on the Road Again

Jim Chessare "My outcome was so incredibly positive; it couldn't have been better. I am the luckiest guy in the world," said Jim Chessare, just two months after having robotic surgery to remove a cancerous mediastinal tumor.

As soon as the weather warms up, 65-year-old Jim Chessare will get on his 1200-cc touring motorcycle and head west or south of his Beverly home for long rides in the rural areas of the far south suburbs.

"I am still a rookie rider, but I love it," said Chessare, a former bank manager. "The idea of buying a motorcycle had been rattling around in my brain for decades. It played out for me after I retired three years ago. My wife and kids fret, but I'm a careful rider."

On learning he had a potentially cancerous tumor in his chest, Chessare had two big fears: "not being able to play with my grandchildren and not being able to ride my motorcycle."

During a visit to an emergency room for a kidney stone last August, doctors noticed something suspicious on Chessare's X-ray. A supplemental CT scan revealed a mediastinal tumor located in the front of his chest. When a surgeon at his local hospital recommended open surgery (a procedure that involves splitting the breastbone) for the removal of the marble-sized tumor, Chessare and his wife, Pat, decided to contact the University of Chicago Medicine for a second opinion.

Wickii Vigneswaran Wickii Vigneswaran, MD

"If the tumor had been large, then open surgery would have been necessary," said Wickii Vigneswaran, MD, associate chief of cardiac and thoracic surgery at the University of Chicago Medicine. "But because of the small size, we were confident we could use a robotic approach to remove the entire tumor."

A Rapidly Expanding Technology

While robot-assisted surgery has been in use at the University of Chicago for other types of surgical procedures for a decade, thoracic surgeons here began using the da Vinci surgical system in January 2011.

"Patients knew about the advantages of the robotic technique and were asking for it," Vigneswaran said. "New developments in the instruments enabled us to begin applying this technology to thoracic surgery last year. We are performing thoracic procedures with more precision than ever before."

Already leaders in other minimally invasive thoracic surgical techniques, Vigneswaran and his colleague, Mark Ferguson, MD, now have the most experience in robotic surgery in the Chicago area for mediastinal tumors, resection of lung nodules and lung cancers, and esophageal surgery. The surgeons say they will continue to adapt this evolving technology to different types of thoracic procedures.

A Brief Hospital Stay and a Full Recovery

Knowing that open surgery "could mean a lot more pain, recovery and risk of infection," Chessare decided to have the robotic surgery at the University of Chicago Medicine.

In discussing this decision, Chessare said he and his wife appreciated Vigneswaran's careful and decisive approach. "He told us the tumor had to come out and there was an 80 percent chance that he would be able to complete the surgery robotically," said Chessare.

"The precise nature of the robotic technique allowed us to remove all of the cancer," said Vigneswaran.

The 3 ½-hour robot-assisted surgery took place on January 9, 2012. Before removing the tumor, the team maneuvered it into a small bag, ensuring that if any cancer cells were present, they would not spread or be left behind.

A biopsy of the extracted tumor revealed a malignant tumor. "Fortunately, the tumor was small and confined to one area," said Vigneswaran. "The precise nature of the robotic technique allowed us to remove all of the cancer."

Chessare went home a day after surgery. Within a few weeks, he was going to his part-time job at a friend's photography studio, doing his normal routine around the house, and exercising at his fitness club. He is anxious to take his motorcycle out of winter storage and start riding again.

Ravi Salgia, MD, PhD Ravi Salgia, MD, PhD

Although Vigneswaran assured his patient there was no need for serious concern, the surgeon's staff made a follow-up appointment for him with Ravi Salgia, MD, PhD, director of the thoracic oncology program at University of Chicago Medicine.

"We don't use the word 'cure' until five years out," Salgia explained to Chessare. "But in your case, it appears Dr. Vigneswaran got everything and you are going to live a nice long life."

Chessare was pleased with the thoroughness of his medical care and said the hospital staff were personable and did their job well. "My outcome was so incredibly positive; it couldn't have been better. I am the luckiest guy in the world."

March 2012


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