New UW Surgeon Offers Robotic Option for Esophageal Cancer Patients
The two most common types of esophageal cancer, adenocarcinoma (AC) and squamous cell carcinoma (SCC), will affect nearly 18,000 Americans this year. According to the National Cancer Institute, two-thirds of them will be treated for AC, the most frequently diagnosed esophageal cancer in the U.S. AC tumors are typically found near the stomach, in the lower end of the esophagus. Squamous cell carcinoma is generally seen in the upper part of the esophagus.
There is often a correlation between AC and acid reflux, Barrett esophagus or being obese. SCC is frequently associated with tobacco use or heavy alcohol consumption.
Traditionally, patients have undergone conventional surgery to treat the disease, but more recently, increasing numbers of patients are turning to robotic esophageal surgery.
In the procedure, robotic arms are inserted into small incisions to remove the cancerous portion of the esophagus. The shortened esophagus is then reattached to the stomach, which is pulled into the chest cavity. Most patients had chemotherapy and radiation before surgery to shrink the tumor.
Traditional surgery would involve breaking one of the patient's ribs, two large incisions, a greater chance of infection and weeks of recovery. With the robotic surgery, patients are left with a three-inch chest incision and spend just over a week in the hospital.
"There are a handful of surgeons who have the appropriate skills to perform this operation, and I have the largest experience with this surgery to date," says Dr. Meredith, who rarely recommends using open surgery to remove cancer from the esophagus. He estimates he has done about 170 of the surgeries.
Dr. Meredith, who practiced in Florida before joining the University of Wisconsin surgery faculty in October, is fellowship trained in surgical oncology and board certified in surgery.
A study published in the Journal of Clinical Oncology last year followed 89 patients from Dr. Meredith's Florida practice who had a robotic esophagectomy following chemotherapy or radiation and found that it was safe and effective. As abstract of the study is available at: http://meetinglibrary.asco.org/content/105560-133
Dr. Meredith is also an expert in robotic approaches to pancreatic cancer surgery and other gastrointestinal malignancies. He recently performed UW Hospital’s first robotic removal of the adrenal gland on a patient from Florida who traveled specifically for Dr. Meredith's robotic expertise.
A graduate of the University of Louisville School of Medicine, Dr. Meredith did a residency in general surgery at the University of Wisconsin Hospital and Clinics.