ASSISTED SURGICALSYSTEM OFFERSLESS PAIN, FASTERRECOVERY

Roy Frizzell was able to take advantage of St. Luke’s new robotic surgical systemto help him get back on his feet more quickly after prostate cancer surgery6

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DA VINCI ROBOTIC

A few years ago many surgeons began performinglaparoscopic operations instead. Laparoscopic surgeryinvolves a few tiny incisions instead of one large one,which results in less blood loss and scarring – not tomention a much faster recovery for patients. And atSt. Luke’s Hospital, surgeons are now performinglaparoscopic prostatectomies with the latest cutting-edge technology.

Recently, St. Luke’s purchased a state-of-the-art daVinci robotic-assisted surgical system. The da Vincitranslates the surgeon’s hand movements into precisemovements by microinstruments.

“It is honestly a remarkable piece of equipment,”says John McCarthy, MD, a urologic surgeon at St. Luke’s. “The more I use it, the more amazed I amby it.” According to Asim Razzaq, MD, also a urolog-ic surgeon at St. Luke’s, the da Vinci has three featuresthat give surgeons more precise control than they’veever had. “First, the surgeon has a 3-D view,” he says.“You also have more magnification, and the robotgives you your hands and wrists back – meaning youhave more range of motion.”

The benefits for patients are just as important.“We have found that men need much less pain

medicine after this procedure,” says David Bryan, MD,another urologic surgeon at St. Luke’s. “They clearlyhave less pain and blood loss and get on their feetmore quickly.”

‘IT’S A GODSEND’Roy Frizzell should know.Roy, 65, was diagnosed with prostate cancer in July

2007. He knew he had decisions to make – Radiation

or surgery? An open or laparoscopic operation? – buthe put them off. He and his wife were building a newhome, and he was doing much of the work himself.He knew that if he chose an open radical prostatecto-my, he would be off his feet for several weeks. Andthe possible side effects of radiation frightened him.

So he opted for a temporary solution: He got a shotof Lupron Depot, which can slow the growth of can-cerous cells. And he put off his decision even longer.Then his wife read about the da Vinci surgical system.Roy had never heard of it, so he did some research.

“I got on the Internet and looked up the proce-dure,” he says. “It looked good. And now I can tellyou for a fact: It’s a godsend – a miracle.”

On March 12, Drs. Razzaq and Bryan performed ada Vinci prostatectomy on Roy. The next day he wasup and walking – well enough to go home. The doc-tors didn’t even prescribe pain medication for him totake once he was discharged because he wasn’t inpain.

“With the robotic surgery, patients feel normal farmore quickly,” Dr. McCarthy says. “That’s worth alot.”

And Roy had to deal with a catheter for only abouta week – half the time required with a traditionalopen prostatectomy.

“I consider this a miracle process, plain and sim-ple,” he says. “I would recommend it to anyone whohas this condition and tell them plainly, ‘If you’redelaying over indecision, stop and get it done.’”

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l7Roy and his wife will be able to enjoy their new home,

knowing Roy is cancer-free

FB Y A N D R E A M O N G L E R

For years, when a prostate cancer patientchose to have his prostate removed, italmost certainly meant he would undergoan open radical prostatectomy. This pro-cedure involves a 6- to 8-inch abdominalincision. Patients lose a lot of blood, endup with a sizable scar and take a coupleof months to recover.

FOR A FULL LISTING OF ST. LUKE’S CLASSES AND SPECIAL EVENTS, PLEASE VISIT WWW.STLUKES-STL.COM OR CALL 314-542-4848.

Dr. Razzaq says Roy did “exceptionally well. Hehad minimal to no pain afterward. The procedurewent as smoothly as one could expect.”

Roy is grateful he won’t be off his feet this spring –the prime time for working on his new house.

He says he couldn’t have asked for a better experi-ence than what he had at St. Luke’s. “Those guys aresomething else.”

DA VINCI DETAILSWith the da Vinci surgical system, the surgeon

operates while seated at an ergonomic console andviewing a 3-D image of the operating site. He or shegrasps master controls, and the system translates thesurgeon’s hand, wrist and finger movements into pre-cise real-time movements of surgical instrumentsheld by robotic arms.

“It’s a totally different way to approach the prostateanatomically, and I like it,” Dr. Bryan says.“Ergonomically it makes it easier on the surgeon –just by the fact that magnification, instrumentationand visualization are so precise and so much better.”

A da Vinci prostatectomy involves five tiny inci-sions. Three of them measure 5 millimeters, and theremaining two are 10 and 12 millimeters.

“The ports don’t cut the muscle,” Dr. Bryan says.“There’s really no hole – just a nick in the skin.”

One of the ports is enlarged to 1.5 to 2 inches sothe surgeon can pull out the prostate – which hasbeen enclosed in a plastic Endo Catch bag.

According to Dr. Bryan, a surgeon hopes to achievethree things with prostate surgery:• Get rid of the cancer.• Leave the patient continent.• Maintain the patient’s ability to have an erection.

“The data is too imma-ture for us to know forsure, but the da Vinciprostatectomy seems equiv-alent, if not better than,other types of prostatecto-my when it comes toachieving these threegoals,” Dr. Bryan says.

“If I had prostate cancer,I’m quite sure that first, Iwould want surgery andsecond, I would want myprostate removed robotical-ly,” Dr. Razzaq says.“Having seen it all – radia-tion and other types of sur-gery – this is what I recom-mend to my patients.”

FOR A FULL LISTING OF ST. LUKE’S CLASSES AND SPECIAL EVENTS, PLEASE VISIT WWW.STLUKES-STL.COM OR CALL 314-542-4848.

The DaVinci Robotic SurgicalSystem allows surgeons amore precise and scalableexperience.

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FOR A FULL LISTING OF ST. LUKE’S CLASSES AND SPECIAL EVENTS, PLEASE VISIT WWW.STLUKES-STL.COM OR CALL 314-542-4848.

When Raylene Hollrahwas 33, she and her hus-band decided to have asecond child. So shescheduled an appoint-ment with her obstetri-cian-gynecologist, DanielWagner, MD, of St. Luke’sHospital.

Raylene expected a routine appoint-ment. Little did she know it would beher first step in a sometimes-terrifyingjourney.

Dr. Wagner found a lump inRaylene’s right breast.

Neither a mammogram nor an ultra-sound showed cancer. “But Dr. Wagner– being the wonderful physician he is– referred me to Dr. Fahrner,” Raylenesays. “Dr. Wagner provided an amaz-ing level of personal care.”

So on April 10, 2007, Raylene metwith Mari Anne Fahrner, MD, a gener-al surgeon at St. Luke’s Breast CareCenter. She underwent a needle biop-sy that same day.

“The Breast Center can provide adiagnosis rapidly," Dr. Fahrner says.“Usually we have the results to thepatient within 24 hours – sometimeswithin eight hours.”

YOUNG CANCERPATIENT FINDSSUPPORT ATBREAST CARECENTER

The Hollrahs are taking steps on the next journey of theirlives together.

On April 11, Dr. Fahrner calledRaylene with the news: She hadStage 2 breast cancer.

“Often when young women havelumps, they are benign,” Dr. Fahrnersays. “But in Raylene’s case it wasinfiltrating ductal carcinoma. Shehad a medium-sized tumor with nonodal involvement.”

The very next day Raylene cameto the Breast Care Center to meetwith Dr. Fahrner again.

“It’s so important to go to a doc-tor and a hospital you feel comfort-able with. There’s no question I wasat the right place,” Raylene says. “Iwas greeted warmly by the nursesto start my journey, and then Dr.Fahrner and I discussed ouroptions – I say ‘our’ because shewas very much a part of my jour-ney. My husband, mom and bestfriend were with me, and Dr. Fahrnerspent an hour and a half with us.”

Raylene decided to have a bilater-al mastectomy. On April 20 – justnine days after Raylene’s diagnosis –Dr. Fahrner performed the surgery.She removed all the cancerous cellsin Raylene’s right breast and precan-cerous cells in her left breast.

“I had such a wonderful doctorand team at the Breast CareCenter,” Raylene says. “And I’vealso completely changed my lifesince my diagnosis. I’ve changedmy eating habits and exercise rou-tine and have a lot of faith. It’s aholistic approach, and today I’m liv-ing at 100 percent.”

The Breast Care Center offers afull range of diagnostic and treat-ment options, including screeningand diagnostic mammography,physical exams, ultrasounds, biop-sies, MRIs and PET scans. It alsoprovides genetic and supportive

counseling. In addition, theAmerican College of Radiology'sCommission on Quality and Safetyand the Commission on BreastImaging have designated St. Luke'sHospital's Department of Radiologya Breast Imaging Center ofExcellence – one of only three inMissouri.

“Several departments are consoli-dated right here in our building,and we all work very closelytogether,” says Sally Rappold, nursemanager at the Breast Care Center.“Patients only need to come to oneplace, and we can coordinate alltheir appointments. We have radia-tion oncology on the first floor andmedical oncology on the thirdfloor.”

The building is also home to St. Luke’s Cancer Resource Center,which provides educational materi-als to cancer patients.

After Raylene had surgery, shewent through four months ofchemotherapy with Julie Gill, MD,at St. Luke’s.

“Dr. Gill was another addition tomy wonderful St. Luke’s team,”Raylene says. “She was incredible –she explained everything andanswered my questions. When Ihad concerns, I would call theoffice, and I always got a call back.”

From Day One, the staff mem-bers at the Breast Care Center werejust as impressed with Raylene asshe was with them.

“Everyone here was amazed byher,” Dr. Fahrner says. “She alwayshad such a positive, upbeat attitude.She not only handled her own situ-ation with courage and grace butreached out to others.”

Specifically, Raylene bonded withInga, another young breast cancer

patient she met at the Breast CareCenter. Inga, a 31-year-old motherof five, and Raylene traded storiesabout their disease and their chil-dren. Raylene even traveled toHouston to visit Inga, who hadbeen sent there for treatment.

Raylene, who sells insurance, alsoserved as a source of comfort andinspiration for Rhonda, one of herclients who was diagnosed withbreast cancer, and for her daughter’spediatrician, whose wife hadreceived her own diagnosis.

“Just as much as chemo was partof my treatment, so was talking toand helping others,” Raylene says.

But it wasn’t always easy for herto stay positive and upbeat. Whilesitting in the waiting room at theBreast Care Center before learningthe results of her surgery, she wasscared and distraught – to the pointof tears. That’s when she met Cindy,an 11-year breast cancer survivor.

“Cindy told me: ‘I never stoppedliving because of cancer. I don’twant to say that I just wasted 11years.’ That became my theme,”Raylene says.

This September, Raylene had herfinal reconstructive surgery. It wasthe last stage of the most difficultjourney of her life. She says herdoctors and nurses gave her thesupport she needed every step ofthe way.

“I felt so good about being at St. Luke’s. It really sets itself apart,”she says. “You can be standing inthe hall, looking at a directory, andeven doctors stop to see if they canhelp you. People at St. Luke’s areincredible.”

Shirley Bowling owes her newly pain-free days to St. Luke’s Brain andSpine Center and Dr. Anne Christopher

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