Why One South Bay Teen is Breathing a Little Easier
Robotic technology for precise and less painful surgery
Written by Laura Roe Stevens | Photographed by Philicia Endelman
By all appearances, 19-year-old Tyler Higa is a healthy South Bay teen who plays baseball and enjoys hanging out with his friends. The North Torrance High graduate and current El Camino College student only had one health issue in his young life: recurrent bouts of pneumonia. This was odd, as Higa doesn't have asthma or allergies, which often trigger bronchitis and pneumonia. Yet Higa contracted the dangerous lung illness in February of both his junior and senior years of high school.
Higa explains that his family physician prescribed a round of antibiotics for both high school episodes, which made him better, so the two incidents were deemed a coincidence. When he came down with pneumonia yet again in the month of February of his freshman year in college, it was his third strike. Another round of antibiotics and steroids just wasn't enough. He felt a little better for a few months, but by May the persistent pneumonia was back.
"After four times (of having pneumonia) in two and a half years, my doctor referred me to a pulmonologist. I had a CT scan, and he found something in my left lung, so he referred me to Dr. Mahfoozi," explains Higa.
While Higa's journey to a diagnosis and a treatment solution was circuitous, he landed in good hands. Amirhossein Paymon Mahfoozi, MD is a Cedars-Sinai thoracic surgeon who specializes in utilizing the latest robotic technology to remove tumors. Luckily for Higa, this type of surgery, which was performed at Torrance Memorial, results in better surgical precision, reduced hospital stays, less post-operative pain and a quicker recovery.
Dr. Mahfoozi explains Higa's tumor was "endobronchial inflammatory myofibroblastic," which is a benign tumor in young patients. That's the good news. This type of tumor causes the "obstruction of the airway resulting in post-obstructive bronchitis and pneumonia." Removing it stops the pneumonia from recurring.
"The treatment is removal of the involved segment or lobe of the lung. Unfortunately, due to the long period between the start of the symptoms [when he was first contracted pneumonia] until diagnosis when Dr. Rasic, the pulmonologist, and I saw the patient, there was a lot of inflammation and scar tissue [in Higa's lung]," Dr. Mahfoozi says.
Because of the inflammation and scar tissue, Higa needed the entire upper lobe of his left lung removed, rather than just a segment. Finding Dr. Mahfoozi, who uses cutting-edge technology for the procedure, meant the teen would be able to work out at his local gym within three weeks of surgery. That would not be possible if Higa had a traditional open thoracotomy, requiring a longer hospital stay and causing more pain and a harder road to recovery.
"The robotic surgery is completely minimally-invasive and increases the accuracy and precision of the dissection," says Dr. Mahfoozi. "The precision of dissection in a very tight space with robots and three-dimensional optic allows this difficult procedure to be performed in a true, complete minimally-invasive fashion with the same or sometimes even better results. With open procedures, (thoracotomy) patients usually stay five to seven days in the hospital and require and epidural for pain control. Their total recovery time is also extended, and the pain of cutting the muscles and removing the ribs lasts for months to a year."
Three weeks after his operation, Higa has been exercising daily for a week, was back at work and excited to return to college. "Yeah, I can exercise now," he shares. "Every day I breathe into the breathing machine to monitor my level of breath. I'm at a 70% (lung capacity) and am getting used to that, but I'm a lot better."
The teen was only in the hospital for two days. "Dr. M thought I'd be in the hospital for three to five days, but I went home the second day. The hardest part was just after surgery when the anesthesia wore off. And being bored in the hospital," he says with a laugh. "I'm glad I didn't have to stay longer! The doctor cleared me to go back to work, go to the gym. Everything is starting to feel back to normal, week by week."
Traditional surgery might have caused pain for six months or longer - maybe even delaying the start of his sophomore year in college. As it is, the busy teen hasn't skipped a beat. And that helps Higa and his family breathe a little easier.
To perform the minimally-invasive surgery that reduced Tyler Higa's hospital stay and recovery time, Dr. Mahfoozi used the da Vinci Xi Surgical System, developed by Intuitive Surgical Inc. Torrance Memorial was the first hospital in the South Bay to use this technology and is the only hospital to use it for thoracic surgery procedures.
Surgery performed using the da Vinci Xi system is often called robotic surgery, but that's a bit of a misnomer: The system doesn't perform the surgery; a surgeon does. Traditional open thoracic (chest) surgery requires a long incision through skin and muscle (sometimes the breastbone needs to be cracked or ribs separated or removed, as well) for the surgeon to be able to see and operate on the area of concern.
The da Vinci system is a set of instruments that allows the surgeon to perform surgery using small, remotely controlled surgical tools requiring similarly small incisions in the patient. These tools include a videoscope, allowing the surgeon to see what's going on in high-definition 3-D while controlling the tools to perform the surgery. So more accurately, procedures performed using the da Vinci and similar systems are termed robotic-assisted minimally-invasive surgery. Torrance Memorial is the only hospital in the South Bay performing this type of thoracic surgery.
In addition to thoracic surgery, the da Vinci Surgical System can be used to assist in general surgery (including bariatric and other abdominal procedures) and in cardiac, colorectal, head and neck, gynecological and urological surgeries. In all procedures, the benefits or robotic-assisted minimally-invasive surgery are clear: reduced hospital stays, speedier recoveries, less scarring and fewer complications.
Dr. Amirhossein Paymon Mahfoozi is a Cedars-Sinai thoracic surgeon on staff at Torrance Memorial and can be reached through his office at 310-784-6946.
