I’m consistently surprised about how new techniques are adopted in medicine before they’re proven to be more effective, or even safe.
As a Houston, Texas, medical malpractice attorney, I’ve seen this problem many times.
Are laparoscopic surgeries safe for treating cervical cancer?
NBC News recently covered new research that suggests that laparoscopic, or keyhole, surgery may be riskier for cervical cancer treatment.
NBC shared the story of a patient with recurrent cervical cancer who received treatment at Houston’s MD Anderson Cancer Center.
The patient, Jeanine Andersson, is an orthopedic surgeon. Her medical providers and friends recommended a minimally-invasive (laparoscopic or keyhole) robotic surgery, rather than the traditional approach.
These days, so-called keyhole surgeries are a big trend. Previously, patients only had one option, open surgery—in the case of cervical cancer, it’s called a laparotomy. Dr. Andersson described the open surgery as one where they “kind of slice you vertically down the front, take everything out, and set you back up and it’s a six to eight-week recovery.”
The appeal of the robotic keyhole surgery is clear. Instead of a huge incision, the surgeon makes a handful of small cuts and uses them to insert small robotic surgical equipment and a camera into the body. Dr. Andersson explained why she chose this approach: “Recovery was two, maybe three weeks. I would be back to work and to me it was a no-brainer.”
Unfortunately, this 45-year-old patient’s cervical cancer returned a year and a half after her minimally-invasive robotic surgery at MD Anderson. This time, the tumor was so large that it couldn’t be removed surgically. She’s now facing radiation and chemotherapy.
Since then, medical researchers have concluded that women who had laparoscopic/keyhole/minimally-invasive hysterectomies, including those that use Da Vinci and other robotic devices, were more likely to have their cancer come back and kill them then women who had traditional surgery.
What terrible and frightening news! It got so much attention at MD Anderson that they stopped offering minimally invasive surgery for most women with early stage cervical cancer. Other hospitals are advising patients against it.
No one is sure why the recurrence and death rates are different between the two types of surgery. There will certainly be more studies. In the meantime, I believe that surgical oncologists and physicians should fully discuss with their patients the relative risks between traditional open surgeries and laparoscopic surgeries. Under Texas law, doctors are required to have this candid conversation and then document it as part of the informed consent process.
What about other types of minimally-invasive surgeries?
Even beyond this disturbing news about treating cervical cancer with laparoscopic procedures, I’ve seen other complications and risks that I believe patients should know about.
I’ve represented several patients in medical malpractice lawsuits where surgeons performed different types of laparoscopic procedures and didn’t recognize when something went wrong. Common problems that I’ve seen include surgeons nicking or perforating organs, like the stomach, bowel, or spleen. From experience, I believe that surgeons notice these errors less frequently in minimally-invasive robotic procedures than in open surgeries, where the bleeding and other complications may be more obvious.
The stakes are high. I’m working on a medical malpractice wrongful death lawsuit now where a patient had a laparoscopic appendectomy at a College Station hospital and the surgeon unwittingly perforated her bowel. By the time he put two and two together regarding her grossly abnormal post-operative symptoms, she was in septic shock and it was too late to save her.
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Robert Painter is a medical malpractice attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits against hospitals, physicians, surgeons, anesthesiologists, and other healthcare providers. A member of the board of directors of the Houston Bar Association, he was honored, in 2018, by H Texas as one of Houston’s top lawyers. Also, in 2018, the Better Business Bureau recognized Painter Law Firm PLLC with its Award of Distinction.