Huntsman Cancer Institute (HCI) recently completed the first robotic surgery for a patient with primary liver cancer in the Mountain West. The surgery was led by George Rofaiel, MD, a transplant and advanced hepatobiliary surgeon at HCI and University of Utah Health. We're proud to be at the forefront of the most recent advances in cancer care.
See our live coverage of the surgery on Twitter below.
We're just beginning surgery for our patient, Abel. This is the robot that the surgeon will use to perform today's procedure. pic.twitter.com/6cVjrHuPD7
— Huntsman Cancer Inst (@huntsmancancer) February 22, 2019
Robotic (computer assisted) surgery was recently introduced to the field for primary liver cancer. A handful of centers around the country are offering robotic surgery for complex liver resections. Today’s is the first in the Mountain West.
— Huntsman Cancer Inst (@huntsmancancer) February 22, 2019
Our surgical staff is completely focused on the patient today. One of our communications staff is in the OR sharing this story without distracting the team.
— Huntsman Cancer Inst (@huntsmancancer) February 22, 2019
We will be sharing graphic content from the surgery, so viewer discretion is advised.
— Huntsman Cancer Inst (@huntsmancancer) February 22, 2019
Here is a scan showing the small tumor the surgical team will be removing today. pic.twitter.com/Gi11SPD1QK
— Huntsman Cancer Inst (@huntsmancancer) February 22, 2019
Here is our fantastic patient this morning before surgery. Thank you for sharing this surgery with us, Abel! https://t.co/SJgay9IQTi
— Huntsman Cancer Inst (@huntsmancancer) February 22, 2019
The liver is the largest internal organ, sitting on the front of your right side, just under your ribs. The liver helps break down, process, and store nutrients for your body to use.
— Huntsman Cancer Inst (@huntsmancancer) February 22, 2019
It also breaks down toxins and filters harmful substances from the blood so they can be passed from the body in stools and urine.
— Huntsman Cancer Inst (@huntsmancancer) February 22, 2019
The liver has two lobes, a right lobe and a left lobe, and each lobe is divided into two sections. Our patient’s tumor is in the left lobe. Image courtesy of @theNCI. pic.twitter.com/CW0MAb5faV
— Huntsman Cancer Inst (@huntsmancancer) February 22, 2019
Surgery has begun! Dr. Rofaiel is placing the trocars, the ends of the robotic arms he will guide. pic.twitter.com/IKqracBvh3
— Huntsman Cancer Inst (@huntsmancancer) February 22, 2019
Now the robot is being docked. pic.twitter.com/N85W5HgFau
— Huntsman Cancer Inst (@huntsmancancer) February 22, 2019
The most common type of liver cancer is called hepatocellular carcinoma but there are many types. Our patient today has hepatocellular carcinoma.
— Huntsman Cancer Inst (@huntsmancancer) February 22, 2019
The surgeon, Dr. Rofaiel, sits at this console to operate the robot. He sees a 3D view inside the patient from the camera at the end of one of the robot's four arms. pic.twitter.com/7B28eClPiU
— Huntsman Cancer Inst (@huntsmancancer) February 22, 2019
The rest of the team can see the surgery from multiple screens in the OR. pic.twitter.com/JZDyXXrPip
— Huntsman Cancer Inst (@huntsmancancer) February 22, 2019
3D, 10-40x magnification facilitates fine surgery. The tiny instruments rotate 270 degrees in all directions, where the human hand can only achieve about a 45 degree bend.
— Huntsman Cancer Inst (@huntsmancancer) February 22, 2019
This incredible precision means a minimally-invasive surgery. Recovery requires just 1 or 2 days in the hospital and the patient will be able to return to normal life in about 2 weeks. In a standard open surgery, this recovery time would be 12 weeks.
— Huntsman Cancer Inst (@huntsmancancer) February 22, 2019
The OR team is using intraoperative ultrasound to image the tumor in real time. This ensures today's surgery will be the most accurate and effective possible. pic.twitter.com/fLprU5OM5S
— Huntsman Cancer Inst (@huntsmancancer) February 22, 2019
The surgery also uses special dye that is seen with only an infra-red camera to help to decrease blood loss.
— Huntsman Cancer Inst (@huntsmancancer) February 22, 2019
Liver cancer is uncommon in the US, but is the 4th most common cancer in the world. In the US, men have a greater risk of developing liver cancer, especially Asian/Pacific Islander, American Indian/Alaska Native, and Hispanic men.
— Huntsman Cancer Inst (@huntsmancancer) February 22, 2019
It is estimated that 42,000 people in the United States will be diagnosed with liver or bile duct cancer in 2019. Learn more about primary #LiverCancer at https://t.co/4AQhG3Yj3d or contact our Cancer Learning Center at 888-424-2100 or cancerinfo@hci.utah.edu.
— Huntsman Cancer Inst (@huntsmancancer) February 22, 2019
.@UofUHealth Division of Transplantation & Advanced Hepatobiliary Surgery has 3 transplant surgeons, led by division chief @RobinKimMD, @JeffCampsenMD, & Dr. George Rofaiel. They work closely w/medical specialists, nurses, pharmacists, & social workers to provide excellent care.
— Huntsman Cancer Inst (@huntsmancancer) February 22, 2019
The transplant surgeons perform adult liver, kidney, and pancreas transplants at the @UofUHealth Hospital and pediatric liver and kidney transplants at @primarychildren’s Medical Center. They perform advanced hepatobiliary surgery at @huntsmancancer Institute.
— Huntsman Cancer Inst (@huntsmancancer) February 22, 2019
The infrared dye shows that blood flow has been preserved to the right lobe of the liver, but cut off to the left lobe. The team is ready to begin the main resection of the liver. pic.twitter.com/mxkhcKuAQo
— Huntsman Cancer Inst (@huntsmancancer) February 22, 2019
Dr. Rofaiel is lifting the liver with his instrument to see where he is operating. The robot creates the noise of surgery to give cues to the surgeon. pic.twitter.com/NZiOItEPKH
— Huntsman Cancer Inst (@huntsmancancer) February 22, 2019
Irene Zilbershteyn, NP, is the first-assistant on the surgery. She sits next to the patient and assists the surgery from there. Here's a photo of Irene before surgery began. pic.twitter.com/V9lg0OI1XZ
— Huntsman Cancer Inst (@huntsmancancer) February 22, 2019
Dr. Rofaiel received his Bachelors of Medicine and Surgery degree from Cairo University in 2001. He did research at @DukeU and completed surgery residency at @ClevelandClinic where he received world-class training in general and advanced subspecialty surgery. pic.twitter.com/XCuom9DEAg
— Huntsman Cancer Inst (@huntsmancancer) February 22, 2019
He joined @UUtah in early 2018. His focus is to provide patient-centered and compassionate care for transplant and cancer surgery, while employing the latest in surgical innovation and data-driven care.
— Huntsman Cancer Inst (@huntsmancancer) February 22, 2019
Here is the surgeon's view inside the surgical console. The 3D camera makes it feel as if the surgeon is there inside the patient. pic.twitter.com/kCY7z4jnVk
— Huntsman Cancer Inst (@huntsmancancer) February 22, 2019
The team has just done the post-resection ultrasound to see that they've gotten the entire tumor accurately. pic.twitter.com/02i75Z6aC3
— Huntsman Cancer Inst (@huntsmancancer) February 22, 2019
The robot has been un-docked from the patient and now the team is working to take out the piece of his liver with the tumor that was removed. pic.twitter.com/Qpzaxoh8gy
— Huntsman Cancer Inst (@huntsmancancer) February 22, 2019
Dr. Rofaiel has collected the tumor specimen and other surgical devices into a bag inside the patient. pic.twitter.com/Vc2j5yZTWW
— Huntsman Cancer Inst (@huntsmancancer) February 22, 2019
The specimen is out and being looked at by the HCI pathology team while the surgical team closes all the patient's incisions. pic.twitter.com/KfKdprITcA
— Huntsman Cancer Inst (@huntsmancancer) February 22, 2019
The patient's tumor can been seen here, while the pathology team is checking that the surgery got clean margins. pic.twitter.com/okA8nR136D
— Huntsman Cancer Inst (@huntsmancancer) February 22, 2019
The robot used in surgery today is nicknamed Darci, after one of Huntsman Cancer Institute's first robotic surgery nurses who recently retired. pic.twitter.com/kurTClJznM
— Huntsman Cancer Inst (@huntsmancancer) February 22, 2019
Here's the size of the incisions following surgery. In open surgery, this incision would cover the patient's whole abdomen. pic.twitter.com/kRzOX3Wn5G
— Huntsman Cancer Inst (@huntsmancancer) February 22, 2019
Dr. Rofaiel talks to the patient's wife to deliver the good news of clean margins and a successful surgery! pic.twitter.com/hNyzbUEb9V
— Huntsman Cancer Inst (@huntsmancancer) February 22, 2019
This is the first time this operation has been done for this disease in the Mountain West. We're proud to be at the forefront of the most recent advances in cancer care alongside @UofUHealth. Thanks for following along today!
— Huntsman Cancer Inst (@huntsmancancer) February 22, 2019
ICYMI: We live-tweeted Abel's surgery with Dr. Rofaiel last Friday. It was the first robotic liver cancer surgery done in the Mountain West- https://t.co/5vYxlN2pIe https://t.co/BX6gO4NC73
— Huntsman Cancer Inst (@huntsmancancer) February 25, 2019