April 26, 2013
Urologist uses da Vinci robot to remove tumor, reconstruct kidney
Tom Woistman has avoided dialysis thanks to Dr. Michael Hayyeri's surgery to reconstruct his kidney.
Tom Woistman was a lot more concerned about being on dialysis for the rest of his life than receiving an innovative kidney surgical reconstruction procedure his doctor had never done before.
At age 72, the idea of being chained to a dialysis machine for four hours, three times a week, just wasn't appealing to the Phoenix native.
"Although I'm retired from a career as an air conditioning and plumbing project manager in the engineering field, I still have a full-time job as bus driver for my grandkids — which I love," he said. "Dialysis would cut into that.
"Also, my wife and I are active," he continued. "We love to travel. You can make arrangements to get dialysis on the road, but it's a hassle."
Tom's doctor, Michael Hayyeri, MD, is a partner at Central Arizona Urologists in Glendale; he has been practicing urological surgery for 14 years. He's enthusiastic about his creative approach to his patient's situation.
"I hadn't done a procedure like this before, but I thought about it, and it seemed like it could be accomplished successfully," Dr. Hayyeri said. "That would certainly be a better outcome for the patient than the traditional treatment."
Tom was diagnosed with an early stage of an unusual kidney cancer known as transitional carcinoma of the kidney. That's different from the more common renal cell carcinoma of the kidney, Dr. Hayyeri said.
"Typically in this kind of kidney cancer, we remove the kidney and the ureter along with the tumor," Dr. Hayyeri said. "But if the patient's other kidney cannot handle all the body's needs, then we have to do additional surgery to implant a port so the patient can be on dialysis."
While dialysis is lifesaving and not painful, it can be harsh on patients, Dr. Hayyeri said. It can affect the heart and shorten lifespan. Diet and activities may be restricted.
"I'm already diabetic with high blood pressure and liver problems," Tom said. "I just didn't want the hassle of dialysis on top of all that, and, mentally, I just didn't want my kidney removed. So when Dr. Hayyeri told me he thought he could rebuild my kidney instead of removing it, I was all for it."
The da Vinci Surgical System provides a much better view of the surgical field and much more precision in operating procedures.
da Vinci Benefits
The da Vinci Surgical System translates the surgeon's hand movements in real time to its miniaturized instruments.
Potential benefits for patients can include:
- A shorter hospital stay.
- Less pain.
- Less risk of infection.
- Less blood loss.
- Fewer transfusions.
- Less scarring.
- Faster recovery.
Advantages for surgeons can include:
- Greater surgical precision.
- Increased range of motion.
- Improved dexterity.
- Enhanced 3-D HD vision.
During a six-hour procedure at John C. Lincoln North Mountain Hospital, Dr. Hayyeri used the minimally invasive da Vinci Surgical System to remove Tom's cancerous tumor. Then he reattached the ureter and literally put the rest of the kidney back together.
"I've been using the da Vinci for about four years," Dr. Hayyeri said. "It provides a much better view of the surgical field and much more precision in operating procedures. I could not possibly have done this innovative procedure to save Mr. Woistman's kidney without the da Vinci.
"This surgery was really exciting," he continued. "A lot of my colleagues were amazed and want me to make a video of the procedure so they can see how it's done."
Tom was in the hospital for five days, recovering from the surgery. The first upside, he said, was losing 24 pounds. "I wouldn't recommend this process as a weight loss plan for my friends," he joked, "but it sure made my primary care doctor happy."
At 5 feet 11 inches tall, he was approaching 200 pounds before surgery. Now he's down to a svelte 170. To maintain a healthy body weight, he plans to get a bicycle.
But the best part, he said, is that his kidney function has not only been saved, it's actually better than it was before surgery. "I've had several lab tests, and they all show that my kidney function has actually improved. And I feel absolutely great."
For more information, visit JCL.com/surgery.
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