By: Natalie Akoorie

Dr Diego Gonzalez spent time at Waikato Hospital teaching a highly specialised surgery technique that will make lung surgery quicker and less painful and invasive for patients. Photo / Waikato DHB

Surgeons at Waikato Hospital are the first in New Zealand to learn a less invasive lung surgery technique that is quicker, not as painful, and enables patients to recover faster.

The pioneer of the technique, Dr Diego Gonzalez, spent several days last week teaching cardiothoracic specialists at Waikato Hospital how to conduct major lung surgery through one small incision in the chest.

Gonzalez is considered a “global megastar” in the world of uniportal video-assisted thoracic surgery [VATS], and runs the international training programme at the biggest thoracic centre in the world at Shanghai Pulmonary Hospital in China.

Usually doctors must travel to Shanghai to learn the technique but Gonzalez, who works as a thoracic surgeon at Coruna University Center in Spain, brought uniportal VATS lobectomy training to Hamilton in his first visit to New Zealand.

“We just use one incision, of two or three centimetres, depends on the tumour. We basically avoid spreading the ribs, we avoid the big incisions, we avoid thoracotomy,” Gonzalez said.

“That means the patient has less pain, and better process of recovery. Since we started the technique in 2010, we have improved it a lot and we can do everything.”

Gonzalez, who is the creator of the Minimally Invasive Thoracic Surgery Unit at Quiron Hospital in San Rafael, California, and shares his knowledge on Facebook and YouTube, said there were no limitations for the technique.

Traditional lung surgery, largely undertaken to diagnose and treat lung cancers up until the 1990s, involved cracking open the side of the chest up to 20cm and spreading the ribs to reach the lungs.

It took several hours of operating time, a week of recovery in hospital, left a large scar, was more painful and traumatic and there was more risk of further treatment.

In the 1990s the VATS technique, similar to keyhole surgery, revolutionised lung surgery but until Gonzalez it required two or three incisions, known as the multi-port technique.

“This creates portional angles inside the chest and it’s difficult to orientate your view inside,” Gonzalez said.

In June 2010 Gonzalez performed the first single incision video-assisted lobectomy, where the camera is on the tool being inserted into the chest.

He was invited to Waikato Hospital by local specialist Dr David McCormack after the pair connected on the social media site for professionals, LinkedIn.

Gonzalez, who needed Medical Council registration, took surgeons through the procedure and then assisted on more surgeries over three days.

The former Spanish national surfing team doctor had ulterior motives for visiting Hamilton – Raglan’s famous left-hand break was high on his list of waves to surf.

“I’m an amateur surfer. Tomorrow I have fun. I heard that there’s the best coffee in the world here in New Zealand, after Italian of course.”

Waikato Hospital cardiothoracic surgeon Dr Paul Conaglen can now perform a single incision video-assisted lung surgery. Photo / Waikato DHB

Waikato Hospital cardiothoracic specialist Dr Paul Conaglen said having Gonzalez bring a masterclass to Hamilton was a major coup for the Waikato District Health Board and New Zealand.

“We’re incredibly grateful that Diego could come and do this, and this is a huge thing for thoracic surgery in New Zealand.

“It’s actually a big thing for the thoracic community, not only for surgery but the different communities that look after lung cancer in particular.

“Because if we can do an operation that’s a lot less morbid for the patient, they get out of hospital quicker, they recover quicker, they can tolerate a lot of other treatments such as chemotherapy better, it makes a huge difference.”

Conaglen, who learned the technique, said not only was the uniportal method less invasive and painful for patients, it was often a more thorough surgery.

He said if the technique can be routinely performed at Waikato Hospital it means more patients getting the surgery.

“We’re talking about a third of the time [in theatre].”

It’s hoped the surgeons will attend another class in Shanghai to undertake further training in the future.

Source: NZ Herald

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