Ninh and Thanh after her successful surgical procedure.
In 2006, Thanh Huong Tran and her husband, Ninh, left Vietnam for a new life in the United States. Having worked many years as a pharmacist in her native country, Thanh brought with her an encyclopedic knowledge of herbs and their medicinal qualities. She had prepared natural remedies for thousands of patients over the years, but with four of her five children and several grandchildren already in the United States, it was time to make the move.
Thanh and Ninh settled into retirement in Southern California, eventually moving to their current residence in Huntington Beach, but two years ago, at age 70, Thanh developed a sudden fever and abdominal pain.
In the emergency room of a local hospital, doctors pressed gently on Thanh’s lower abdomen, exposing a large, oblong mass under the skin. A computerized tomography (CT) scan revealed that the growth, which had likely taken root in Thanh’s small bowel, had invaded both her colon and bladder. Doctors performed a biopsy and reached a grim diagnosis: Stage IV gastrointestinal stromal tumor.
A gastrointestinal stromal tumor, or GIST, develops in the soft tissue of the digestive tract wall. It can start anywhere along the tract – from the esophagus to the colon – but the stomach and small intestine are the most common sites. In the early stages, these tumors can be difficult to detect, because they can grow toward the outside of the wall, instead of inside, becoming quite large before symptoms appear.
For many patients, the first symptom is blood in their vomit or stool. Other symptoms include anemia resulting from a slow-bleeding tumor, loss of appetite, nausea, difficulty swallowing and weight loss. Like Thanh, some patients suddenly experience abdominal pain or feel the growth in the abdomen.
Second opinions matter
In the hospital, Thanh was placed on an oral chemotherapy drug, but when that had little effect, she was switched to another. After three months, shrinkage of the tumor was minimal; it still affected several organs and was still about the size of a hard-boiled egg.
Thanh was referred to a colon surgeon and a urologist, who jointly recommended surgery to remove not only the growth, but also her bladder, part of her small intestine, colon and rectum. The surgery would require large incisions, lengthy recovery, and a pair of external ostomy bags to collect urine and stool for the rest of her life. Thanh was devastated.
Ninh began searching for other options. When he learned that his neighbor’s mom had recently been treated for colorectal cancer, he asked for the doctor’s name and quickly scheduled a consultation with Tam H. Le, M.D., gastrointestinal surgeon at Orange Coast Medical Center, board-certified in general, colon and rectal surgery.
Dr. Le reviewed Thanh’s CT scan and concluded that open surgery would not be necessary. He could remove the entire tumor with the help of the advanced and minimally invasive, robotic-assisted surgical system – the da Vinci Xi®. The surgeon-controlled robotic system is equipped with four arms and a high-definition 3D camera. The surgical instruments attached to each arm are small enough to fit through a half-inch or inch-long incision and the camera feeds magnified video to a large overhead screen where everyone in the surgical suite can observe the procedure.
At the same time Dr. Le removed the tumor, he would repair the affected organs and perform a temporary ileostomy that would divert the contents of her bowel to an ostomy bag while the surgery site healed. Thanks to the expertise and experience Dr. Le brought to her case, he would be able to reverse the ileostomy in just a few months so that Thanh would not have to use stool and urine bags for the rest of her life.
“I think this illustrates how complex surgeries can be more accurately and safely performed using robotic-assisted surgery,” says Dr. Le. “Without this technology, Thanh’s surgery would have been an open surgery with a long recovery period.”
The precision that the da Vinci® robotic system brings allows surgeons like Dr. Le to perform complex procedures with greater accuracy. For patients like Thanh, that means less blood loss, less pain, fewer complications and a faster recovery.
Following surgery, Thanh spent five days in the hospital, then went home to recover. Though she continues her chemotherapy, the healer, now 73, is healing.