"The Whipple is among the most complex surgeries performed by general surgeons"
When Joseph told friends he needed a Whipple procedure to treat his pancreatic cancer (the pancreas helps control blood sugar levels), some of them became visibly upset. “Anyone who knew anything about the procedure was a little shocked,” recalls Joseph, 62, a retired science teacher from suburban Homewood. “It became clear my condition was more serious than I realized.”
The Whipple, he learned, is among the most complex surgeries performed by general surgeons, necessitating a large abdominal opening to remove benign or cancerous tumors in the head of the pancreas and adjacent ducts and blood vessels. Patients are left with a long scar, a lengthy hospital stay, significant pain, months of recuperation and risk for infection. Luckily for Joseph, not only was his cancer detected early, but it was removed using a noninvasive robotic Whipple, pioneering technology available at the University of Illinois Medical Center at Chicago.
Another stroke of luck: His surgeon was Dr. Giulianotti, MD, chief of the center’s division of minimally invasive general and robotic surgery, who has performed more than 2,000 minimally invasive surgeries which includes nearly 1,000 robotic procedures.
Giulianotti says the robotic Whipple requires about the same amount of time as traditional methods, though the result is less blood loss and pain, minimal scarring and a much shorter recovery time. While robotic surgery is routine for certain conditions, Giulianotti, a general surgeon, has expanded its use to treat life-threatening diseases of the lungs, esophagus, colon, stomach, liver, gall-bladder, kidneys, and pancreas. The center, which performs more than 300 such procedures per year, is a world leader in robotic-assisted surgery.
Surgery performed by Giulianotti to remove a cancerous lung lobe illustrates why. Giulianotti is seated at a console resembling those found in road race video games, his forehead pressed against the instrument so he could access a binocular viewer. Robotic arms translated his gestures via hand and foot controls.
“I can see the patient better than if I were at the operating table,” he says, noting that high-resolution, three-dimensional views are magnified nearly 30-fold. Gripping the hand controls, he explains that the jointed-wrist instruments replicate the surgeon’s motions but allow 360-degree rotation, twice the range of the human hand. To operate the third hand, Giulianotti removes his shoes to increase his sensitivity while pumping pedals.
As surgery proceeded, Giulianotti employed a cauterizing instrument to excise tissue, isolate the cancer and remove it. Joseph underwent Whipple surgery in January 2009 and left the hospital just 10 days later. “By that point, patients who undergo a traditional Whipple only feel well enough to rise from bed,” he says.
Once home, Joseph resumed normal activity after two months, long before a traditional Whipple would have allowed. “I really feel good,” he says, “and my prognosis is excellent.”
Dr. Giulianotti performed this remarkable surgery.