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The Journal Gazette

  • Chad Ryan | The Journal Gazette Dr. Neil Sharma, president of Parkview Cancer Institute, explains how new technologies will allow Parkview surgeons to use less invasive procedures, which allow for faster recovery times for patients.

Thursday, June 22, 2017 1:00 am

Scope of 'new tools' helps patients

SHERRY SLATER | The Journal Gazette

At a glance

Technology: Cutting-edge surgical scopes equipped with more than cameras

What it does: Allows doctors to perform some surgical procedures, including removing cancerous tissue, without making incisions

Benefits: Faster recoveries and lower medical costs

Doctors wondered why Robert Mabee kept landing back in the hospital with double pneumonia.

The 61-year-old Huntertown man's lungs filled with fluid every couple of months last year. When it happened, he had no energy and was plagued by high fever and chills.

In September, Dr. Neil Sharma performed an exploratory procedure to find out whether more was going on. Looking back, Mabee believes God kept sending him to the hospital until doctors could find the stage 4 growth on his esophagus.

“When I was first told I had cancer, it scared the hell out of me. I went through all the emotions,” Mabee said, adding that he assumed he'd need chemotherapy and radiation. But those treatments weren't necessary.

Sharma discovered the tumor, snipped off a portion for biopsy and in October removed it completely. Each procedure was done by placing an endoscope down Mabee's throat. Before the cutting-edge technology was available, a patient with an esophageal tumor would have to be cut open – a process that is more expensive and requires a longer recovery.

By incorporating a camera and surgical tools into the scope, no exterior cuts are required, Sharma said. A surgeon can cut out just the affected piece of inner lining from the inside to remove early-stage cancer of the esophagus, for example.

“It's really new tools that let us do that,” he said. “It's just pushed the boundaries a little bit.”

The previous method involved sawing through rib bones and removing an entire section of esophagus, as Sharma explained to Mabee. 

“The procedure they used on me now is so much different, so … patient friendly,” said Mabee, who acknowledged feeling sluggish for two days after the outpatient procedure. But on the third day, “I wake up feeling like a million bucks.”

The new technique typically allows patients to be released the same day or spend just one night in the hospital. Not only is the recovery faster, but the cost is lower. That's good for the patient and providers, Sharma said. Although situations can vary greatly, he guessed the cost of scope procedures could be half of traditional surgery and recovery time could be half – or even a third.

Parkview collaborates with various universities, including Harvard, and with other providers, including Mount Sinai Hospital in New York City. This allows researchers to compile enough quality data to judge whether a device or a procedure is effective.

Procedures are offered at Parkview only after they've been tested and proved elsewhere.

Dr. Maurits Wiersema, a gastroenterologist with Lutheran Medical Group, also treats local patients with esophageal cancer – and other select conditions – with outpatient endoscopic procedures.

When Dr. Sharma arrived at Parkview in 2013, the system didn't offer any of these cutting-edge procedures. Patients who wanted them had to go to Indianapolis or other larger markets.

Sharma and his colleagues wait until they have developed proficiency in new techniques before offering them locally.

Sharma did fellowship training in advanced interventional endoscopy and endoscopic oncology. He flies out to work in university research labs every few months to maintain his skills in those areas. He needs to understand potential benefits and complications before recommending a procedure to patients.

Different types of scopes are used to access different organs.

The latest scopes can: cut (remove tissue), suture (sew tissue together), take an image (sonogram), cauterize (burn tissue to stop bleeding) and freeze tissue (to treat cancers that can't be completely removed).

Sharma cautioned that this technique isn't appropriate for every patient, especially if cancer is more advanced. The National Comprehensive Cancer Network establishes guidelines for using new methods to treat cancer.

When a patient isn't a candidate for a scope procedure, Sharma implants gold seed, which are used to guide cyberknife procedures. A cyber knife doesn't cut but actually uses high-intensity radiation focused at a specific area without affecting surrounding tissue.

Having advanced scopes as an option makes some procedures much safer for older patients, who are often on blood thinners, Sharma said.

“(The patient) walks out of the hospital without a scar on his body,” he said.

Mabee, who is teaching himself to play guitar, is on disability following an unrelated diagnosis of chronic obstructive pulmonary disease – or COPD. 

He now walks five to 10 miles a day to improve his overall health, making it easier for his body to fight off illness and to keep up with his puppy, an Australian shepherd-blue heeler mix named Banjo.

Mabee hopes his story will inspire others to seek advanced medical care when necessary.

“Thanks to Dr. Sharma and the new procedure he used on me, I have a new chance at life,” he said. “If you're not feeling right, get yourself checked out.”