Peter Ellman, M.D. poses with robotic lung surgery
patient Brenda Lee and her daughter Rhonda Lee during a
follow-up appointment at Reid Heart Center earlier this year.
PINEHURST - Lucy the dog turned around several times before curling up on the sofa beside Brenda Lee. “I was never really a dog person,” Brenda confided. “But I don’t think I have a choice now. She’s not too happy when I’m not here.”
Fortunately for Lucy and Brenda, the 69-year-old Sanford resident wasn’t away from home for long after a robotic lobectomy to treat her lung cancer. Surgeon Peter Ellman, M.D. performed the procedure at FirstHealth Moore Regional Hospital in Pinehurst on Feb. 4, 2020, and she was home with Lucy the next day.
“We had never heard of robotic surgery,” said Rhonda Lee, Brenda’s daughter. “But Dr. Ellman explained it to us and it really seemed like the best approach for Mama.”
Offered at FirstHealth since 2015, a robotic lobectomy — a procedure that removes one of five lobes in the lungs — is one of many robot-assisted surgeries performed at Moore Regional Hospital. The first robotic surgery at FirstHealth was completed in 2006 and since then, doctors have performed more than 3,600 robotic surgeries to address issues in the fields of cardiovascular/thoracic, gynecologic oncology, gynecology, urology, colorectal and more.
A common misconception with robotic surgery is that the robot is doing the surgery when in fact, it is a sophisticated instrument that helps the surgeon perform the operation. Using small incisions, specialized instruments, and high-definition imaging, robotic surgery is a state-of-the-art alternative to traditional open surgery that is less invasive and allows patients to recover faster with much less pain and usually less blood loss.
Dr. Ellman explained that with Brenda’s lobectomy, “around the chest and back, we made four small incisions about the diameter of a pencil and one the length of a paperclip. Through the small incisions, we placed special instruments and a tiny camera. These were connected to a robot. From a console beside Ms. Lee, I controlled the robot’s movements with my hands and feet while looking into a binocular monitor that allows three-dimensional viewing. The visualization is incredibly vivid and I have absolute pinpoint control of the machine’s instruments. The technology is remarkable.”
Rhonda reported that fewer than four hours elapsed from the time her mother went back to the operating room until the time Dr. Ellman returned to her family reporting that the procedure was complete. Shortly afterward, Brenda was up and walking. “The nurses were so proud of me,” said Brenda. “I was proud of myself, too!”
After a night in the hospital, Brenda was back home with Lucy. Rhonda had scheduled several days off from work to care for her mother but reported that “she didn’t need me at all. I didn’t even have to give her a Tylenol.”
Before robotic surgery was available, Dr. Ellman said the standard procedure to remove lung cancer was a thoracotomy, in which surgeons make an incision about the length of a small football in the chest between two ribs. Surgeons must cut through muscle and spread the ribs apart to get to the affected areas, leaving patients with a long scar and long recovery time. A standard hospital stay for this procedure is four days and recovery time can be six to eight weeks. Dr. Ellman said this procedure is still performed at hospitals in North Carolina that do not offer a minimally invasive approach.
“The pain patients experience from a thoracotomy is the primary reason I wanted to learn how to do robotic surgery,” said Dr. Ellman. “While some people can have a bit of discomfort after robotic surgery, we know they have less pain than with the conventional incision. The other benefits are less blood loss in the operating room, shorter hospital stays and a much more rapid recovery. In Mrs. Lee’s case, going home the day after her lung cancer operation was unthinkable before we had this approach.”
Another aspect of robotic surgery that Dr. Ellman and his fellow physicians appreciate is the ability to see and diagnose cancers and other diseases in their early stages. Dr. Ellman explained that his colleagues, pulmonologists Michael Pritchett, D.O., David Thornton, M.D. and Scott Johnson, M.D. are “all experienced in advanced bronchoscopic techniques to help us diagnose cancers earlier than ever before. Dr. Pritchett has been a world expert in pioneering some of these techniques and performed the first robotic bronchoscopic biopsy in the U.S. a few months ago. It has been truly inspiring to be with physicians like my pulmonology colleagues who are committed to these kinds of advancements. With these techniques, we can diagnose and treat cancers that are still extremely small before they have a chance to get bigger and spread.”
For Brenda, her future looks bright. “I hope to go to a family reunion in Orlando this summer and to my Pinckney High School reunion in Carthage this fall,” she said. “I might even go to California to see my grandson who makes movies. And I have to keep up with Lucy. She needs me.”