Robot helps surgeon fight lung cancer

Da Vinci technology allows minimally invasive procedures
Dr. Paul Fedalan has been performing surgery with the DaVincii robot more than two years. BY MOLLY MACMILLAN
June 25, 2014

Hands-off surgery may seem like a thing of the future, but with the advanced technology of da Vinci surgery, hospital officials confirm robots are performing an increasing number of procedures.

At Bayhealth-Kent General Hospital in Dover, cardiothoracic surgeon Paul Fedalen said he has seen successful over the past two years using the hospital's da Vinci surgical robot to perform lung surgery known as a lobectomy using a monitor nearly 10 feet away from his patients.

Fedalen has done lobectomies, removing diseased lobes in the lungs, at Kent General for the last 10 years.

More than 100 of these procedures were accomplished using a robot for eligible patients suffering from stage 1 and 2 lung cancer.  Everyone has survived, Fedalen said, and have gone on to do well with no surgery-related complications.

"It's great technology, and it really improved the outcomes of patients as far as overall well-being and recovery," he said. "With old surgeries, people would complain of pain and difficulty breathing or develop pneumonia."

The old, hands-on surgery required a 7-inch incision to crack the breastbone and manually spread a patient's ribs enough to gain access to the infected lobe. A surgeon must then fit his or her hands and equipment into the chest cavity to remove diseased tissue, Fedalen explained.

Patients typically spent the first two days of recovery in the intensive care unit and overall, recovery from the old method was prolonged and painful.

Not so with the da Vinci robot, the surgeon said.

"Now with the robot, we make three or four small incisions without having to spread the ribs," he said. "The whole purpose of the device is to allow a lung cancer operation to be a minimally invasive procedure."

Stage 3 and 4 lung cancer patients are often treated through chemotherapy and radiation, Fedalen said, and may not be eligible for robotic surgery.

The surgical robot has been criticized because of its cost – nearly $1.5 million – but at Kent General, it has been used not only for lung surgery, but also in cardiac, colorectal, gynecologic and urologic surgeries.

Many hospitals now own at least one da Vinci robot, he said, but the learning curve for a surgeon accustomed to a hands-on procedure can be steep.

Fedalen said not all patients qualify for robotic surgery, so he still performs hands-on surgeries for some patients. He said he is grateful for an assisting surgical team he has worked with most of the last decade.

For more information on da Vinci robotic surgery, go to To contact Dr. Paul Fedalen's office at Bayhealth- Kent General Hospital, call 302-744-7980.