Tulane advances lung cancer care with region’s first single-port robotic lobectomy

Dennis O’Neil’s lung cancer was discovered almost by accident after he went to the hospital for an injury. What happened next placed the 77-year-old at the center of a medical milestone for the region.

O’Neil became the first patient in Louisiana, Arkansas or Mississippi to undergo a single-port robotic-assisted lobectomy for lung cancer.

The breakthrough procedure was performed by Tulane thoracic surgeon Wassim Abi Jaoude at East Jefferson General Hospital, using a da Vinci Single-Port Robotic Surgical System. This technique allows surgeons to perform complex procedures through a single small incision, resulting in less pain, faster recovery and significantly shorter hospital stays, with most patients discharged within 24 hours compared to the typical two to four days following traditional robotic surgeries.

O’Neil’s case offers a glimpse of what Tulane and LCMC Health are working to build through their clinical partnership: a destination academic medical system capable of bringing highly specialized care and new treatment options to patients in New Orleans and across the Gulf South.

“This advancement represents a major step forward in thoracic oncology,” said Abi Jaoude, assistant professor of cardiothoracic surgery at Tulane University School of Medicine. “By utilizing a single incision, we can offer our patients enhanced surgical precision alongside significantly reduced pain and faster recovery times.”

The path to that operating room began months earlier with something far more ordinary: a back injury. The evaluation ultimately led to a colonoscopy, which revealed a tumor larger than a golf ball. The tumor was surgically removed, and testing showed that the cancer had not spread.

But imaging performed during his colon cancer workup also revealed something concerning in O’Neil’s right lung. A biopsy later confirmed the presence of malignant cells. O’Neil would again require surgery, this time a more advanced procedure.

Lobectomy, the removal of one lobe of the lung, has long been the standard treatment for many early-stage lung cancers. Traditional open surgery requires a larger incision through the chest, while most robotic lobectomies use four or five small incisions between the ribs.

The single-port platform allows the surgeon to complete the operation through one incision, 3 to 4 centimeters long, below the rib cage. By avoiding the spaces between the ribs, the approach may reduce irritation to the intercostal nerves and chest wall.  

“Single-port thoracic surgery is the next step in minimally invasive surgery,” Abi Jaoude said. “It preserves our ability to perform a complete oncologic resection while offering select patients the potential for less pain and an earlier recovery.”

Abi Jaoude removed the right lower lobe from O’Neil’s lung and harvested lymph nodes as part of the operation. Testing showed two small lesions on the lobe, but the cancer had not spread to O’Neil’s lymph nodes. Doctors will continue monitoring O’Neil, but he currently doesn’t need any further treatment.  

O’Neil’s chest tube was removed the day after surgery. The following morning, he returned home, just around the corner from East Jefferson.

Bringing the single-port thoracic surgery program to the hospital required months of education, simulation, laboratory training and credentialing for Abi Jaoude. Members of the cardiothoracic operating room team also completed specialized training.

“We are still pioneers and early adopters,” Abi Jaoude said. “The fact that we are able to offer this technique at East Jefferson through Tulane is a milestone in creating a center of excellence for thoracic oncology.”

Today, O’Neil has been cleared of both colon and lung cancers. He is returning to exercise, spending time with his wife, daughter and grandchildren, and considering how his experience might help others facing a frightening diagnosis.

“We have people who go to other states because they think they’ll get better care,” O’Neil said. “I don’t know how I could have gotten better care than I received here.”