Doctors Austin DeRosa and Garry Sandhu, Blessing Physician Services, are the area’s only fellowship-trained urologists.
What does that mean? It means the doctors invested two additional years after medical school and residency to focus on the minimally invasive treatment of urologic cancers.
What does that mean to you? It means access to the latest care without leaving the area.
Helping the doctors change the lives of their patients is the daVinci surgical system at Blessing Hospital. The daVinci has four arms — one holds a tiny camera, and the other arms hold surgical instruments. Instead of the large incision required with traditional open surgery, the daVinci arms work through small incisions — about the size of a dime — with the arms of daVinci controlled by the surgeon from a console in the operating room.
Not every patient or condition is a candidate for daVinci-assisted surgery. However, patients who are daVinci candidates experience less pain, less blood loss, a shorter hospital stay and quicker recovery time. The technology also provides outstanding visualization, featuring a camera that displays the surgical area magnified up to 10 times in high definition.
Changing family history
Randal Brewer has lived with chronic kidney disease for years. When his doctor told him he had kidney cancer, it was not a surprise, yet the diagnosis hit him particularly hard.
“My mother died of kidney cancer,” Brewer said. “I was really scared.”
“A lot of patients are offered a radical nephrectomy (removal of the entire kidney) when they have a small renal mass, which is not good for the patient’s renal function and life expectancy,” DeRosa said.
He suggested Brewer undergo a partial nephrectomy using the daVinci system.
“Partial nephrectomy preserves renal function as best as possible,” the doctor said. “That’s very important in the older population prone to diabetes or high blood pressure. They need as many nephrons (cells of the kidney) as possible.”
Nephrons are the filtering structure in the kidney. Each kidney contains more than a million tiny filtering nephrons that help clean the blood — removing excess water, wastes and other substances — and return other elements, such as sodium, potassium or phosphorus, when they run low in the body.
“Nephron-sparing surgery means removing only the tumor and not the entire kidney,” DeRosa said.
Brewer was the first Blessing patient to undergo a robotic-assisted partial nephrectomy.
“After surgery, he came up to my room and said, ‘We got it,’ ” Brewer recalled of his encounter with DeRosa after the procedure. “I was relieved to hear that.”
Brewer continued: “I love Dr. DeRosa. He was patient with me, explained things so I could understand and was quick to answer questions. I would recommend him to anyone.”
‘One very sick man’
Lee Roy Crider says a headache brought him to see his primary care doctor. It also led him to become a “first” at Blessing Hospital.
“My husband was one very sick man,” said Lee Roy’s wife, Cathy. In addition to the headache, she said, her husband’s blood pressure exploded, he felt nauseated, his appetite disappeared, he alternated between exhaustion and sleeplessness, experienced pain in the right side of his body in the abdomen and back and his personality changed.
“You didn’t know what each day was going to bring,” Cathy Crider recalled.
Medical tests indicated the adrenal gland on Lee Roy’s right kidney was enlarged and growing.
The adrenal glands sit on top of each kidney, producing hormones a person cannot live without, including epinephrine and norepinephrine, hormones responsible for the “fight or flight” response when the body is stressed.
The diseased gland was pumping out an excessive amount of epinephrine and norepinephrine, leading to Crider’s debilitating symptoms. He needed surgery to remove the suspicious gland and was a candidate for the daVinci procedure. Sandhu joined Blessing from Washington University in St. Louis, where he frequently had performed the procedure.
“It’s a unique case because when this is a concern, you also have to be very delicate during surgery to not manipulate the mass too much, otherwise the patient’s blood pressure could spike because of the release of the excessive amount of hormones it is producing,” Sandhu said.
“Because daVinci offers better visualization, the diseased gland is manipulated less than it would be during open surgery,” he said.
Three days after surgery, Crider was home.
“I was surprised. I thought it would take longer,” he said. “I am grateful.”
One more piece of good news — Crider’s tumor was noncancerous.
“He had a smile on his face from ear-to-ear,” said Crider when Sandhu gave him the news.