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Washington Hospital unveils new type of surgery

4 min read
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Marlene Wagner looks perfectly healthy sitting in her daughter’s office in Upper St. Clair. Not a spot of fatigue marks her face, and she doesn’t seem like someone who had part of her kidney removed just a few weeks ago.

Wagner, 69, of Amity, was the first person to undergo a partial nephrectomy with the assistance of a robot at Washington Hospital. Dr. Damon L. Hoffmann, the director of robotic urological surgery at Washington Health System and a member of the Washington Physicians Group, performed the surgery.

A partial nephrectomy involves the partial removal of a kidney, instead of the entire kidney, as a treatment for kidney tumors. Doctors discovered a cancerous tumor approximately 4.5 centimeters in size on Wagner’s kidney in July, and after visiting a urologist, she thought her whole kidney would have to be removed.

But when a family doctor sent her to another physicians group, she found out there was another option.

Hoffmann suggested another course of action – the partial removal of her kidney with the assistance of a robot. The surgery had never been performed at Washington Hospital before, and Wagner’s family was initially skeptical of the procedure.

“My dad was very concerned,” recalled Wagner’s daughter, Sue Shidel. Her father was concerned about the doctor’s age, but she wasn’t. She argued that the young were on the cutting edge, and after meeting Hoffmann, Shidel’s father agreed.

“During the course of my residency training, partial nephrectomy was determined to be the standard of care when feasible,” Hoffmann said. “I was not skeptical, but it is known that the surgery is very technically difficult and is most often being performed in university settings.”

In a partial nephrectomy, the large vessels that provide blood supply to the kidney are controlled. The kidneys hold approximately 20 percent of a person’s blood volume at a given time, and once the vessels are controlled, a tumor can be cut from the surrounding normal tissue. Once this is completed, if a defect is present, it must be reconstructed to stop any urine leakage or bleeding prior to finishing the procedure.

This procedure was not new to Hoffmann, who was involved in many of these cases and has scrubbed in on approximately 25 partial nephrectomies.

After meeting with Wagner, Hoffmann knew she was the perfect candidate for the procedure. “What made her a good candidate was the tumor location and tumor size … Although more complex tumors can still be approached in this manner, these characteristics are favorable for a safe operation with minimal complications,” he said.

Both Wagner and Hoffmann felt comfortable going ahead with the surgery, so Hoffmann approached Washington Hospital with the idea for the surgery. “The hospital was excited to bring cutting edge urological care to the people of Southwestern Pennsylvania,” Hoffmann continued. But there was still the matter of the cost and time needed for the surgery.

“He told (Wagner) the purchasing department must not like her too much,” Shidel laughingly recalled of Hoffmann’s interaction with Wagner.

According to Hoffmann, the procedure is definitely costly to the hospital. However, it is covered by insurance because it is the standard of care for select tumors.

After being given the OK by the hospital, Wagner went into surgery on Dec. 4, and her recovery time was less than a week. She left the hospital Dec. 7.

“(I) wasn’t very nervous,” Wagner said, “because I had faith in him. (I just) wanted to go in and get it done.”

The partial nephrectomy allowed Wagner to have a faster and a less painful recovery time. She even texted Hoffmann five days after her operation asking if she could vacuum her house or go shopping.

A month later, Wagner is again enjoying life. She credits Hoffmann for the surgery. “I’m extremely grateful,” she said.

Wagner does not have to go back for a check-up appointment for another three months, and even then, she does not require any more treatment unless the cancer has spread.

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