Lung: Laser Surgery
Lung: Laser Surgery
Discuss laser lung surgery here.
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Charity
laser lung resection
After discussing with patients who have gone through the procedure, I chose laser lung resection to remove my lung tumors. I think this is an important option patients who have mets to the lungs should consider. Especially someone with multiple mets in all lobes like I had. Here in Canada I was told when I had 20 mets in 2003 that they were not resectable. Well finally in 2006 after learning about laser lung resction in Germany I went in March and had my right lung resected. The surgeon Dr. Axel Rolle removed 34 tumors largest just under 3 cm. Then in June I went back and removed 31 tumors the largest 5cm. I admit the first surgery was surprisingly easy duea very good anesthesiologist I felt next to no pain post-op. My breathing and energy went back to normal quite quickly so I was ready for the second surgery. This recovery has been more difficult, however it is to be expected.The bottom line is I had 64 tumors surgically removed which is a complete resection. Previous Chemotherapy never killed any of my lung mets. So its definately a procedure worth looking into for those who are looking for options.
Ivan's laser surgery and Dr.Rolle's contact info
Ivan has had two laser assisted surgeries done by Dr.Rolle to remove his multiple lung metastases, for the right lung in Feb.2005 and for the left lung in May 2005. We needed to travel to Germany as there is no laser assisted surgeries done in Canada at the moment and other types of surgeries were not feasible due to the high number and wide spread of the metastases. Ivan has had about 100 mets removed from the right lung and about 80 removed from the left lung although in the CT scan before of the surgery were seen only about 20 each side - about 40 at all. CT scan can not see the lung mets smaller then 1-2 mm and most of the mets were such a small size - about 0.5 mm as a sugar on the surface of the lungs. Using Dr.Rolle's laser the loss of the lung tissue was minimal as he doesn't need to cut wedges to remove the met but burns it on the spot. Now Ivan's lung volume is even bigger then before as he keeps training - runs and other sports. It was not easy but tolerable. There are cases when Dr.Rolle is not able to help to the people - when the number of the mets visible on the CT scan is very big and they mostly in the size range more then 1-2 mm so he can not use the burning mode. To be evaluated you need to contact him:
http://www.ctsnet.org/home/arolle
he lives in Germany his English is very good so no language problem here.
This is the latest statistic using his method:
Laser resection technique and results of multiple lung metastasectomies using a new 1,318 nm Nd:YAG laser system
http://www.ncbi.nlm.nih.gov/entrez/quer ... med_docsum
or search for the abstract # 16444696 on the PubMed.gov inserting the number in the search field.
http://www.ctsnet.org/home/arolle
he lives in Germany his English is very good so no language problem here.
This is the latest statistic using his method:
Laser resection technique and results of multiple lung metastasectomies using a new 1,318 nm Nd:YAG laser system
http://www.ncbi.nlm.nih.gov/entrez/quer ... med_docsum
or search for the abstract # 16444696 on the PubMed.gov inserting the number in the search field.
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amanda macdonald
previous radiation and laser surgery?
hi there...
i'm facing treatment decisions for my lung mets. wondering if anyone knows if previous radiation of any sort is detrimental for laser surgery?
thanks
amanda macdonald
i'm facing treatment decisions for my lung mets. wondering if anyone knows if previous radiation of any sort is detrimental for laser surgery?
thanks
amanda macdonald
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amanda macdonald
laser in north america?
has anyone had laser surgery for lung mets in north america? (this wouldn't be the YAG technology of course... although it's supposedly on it's way to FDA approval)
laser surgery in North Am.
Hi Amanda, there is a laser of the lower emittance approved by FDA in North Am. which is used by some of the surgeons (not widely spread as it is very specific tool with the steep learning curve). The most experienced is Dr.Lo Cicero from South Alabama - he had been one of the first to start it in 80-ties and to get it approved, since then he is now the head of the technology comitee of the FDA, one of the people who is to decide to approve Dr.Rolle's laser here. Dr.LoCicero is a very experienced surgeon and the author of the most used book Thoracic surgery for the medical students, but the sealing property of this old laser is weaker then the new one which limit the number of the mets which could be resected. That's him: http://www.ctsnet.org/home/jlocicero
I contacted him at the point we were deciding on the surgery and he was ready to work with us and overall my experience was good with Dr.Lo Cicero, but I found no advantage in using him instead of Dr.Rolle - the cost of the surgery was 2.5 higher then in Germany and the clinical stay is 6 days there with all additional days if required billed almost a 1000 dollars a day, and in Germany the stay is up to 14 days which was always enough and the care and rehabilitation procedures were excellent there (not to mention that with the technology based surgeries the experience adds 20-30 % of the success and Dr.Rolle's specific experience is unique). The flight there is easy - Frankfurt and then to Dresden - a beautiful old European town worth visiting anyway.
I have a strong opinion that the laser surgery if ever planned has to be done before of any other interventions as the clear field with no cut adhesions from the previous surgeries enable the surgeon to see and resect much more smaller mets then if the lung is bleeding and there are scars, so you get to use all of the advantages of the laser surgery at it best state. How was your brain mets treatment, may be you are willing to share the experience and the point of having no WBRT but only radiosurgery in the brain mets treatments topics?
I contacted him at the point we were deciding on the surgery and he was ready to work with us and overall my experience was good with Dr.Lo Cicero, but I found no advantage in using him instead of Dr.Rolle - the cost of the surgery was 2.5 higher then in Germany and the clinical stay is 6 days there with all additional days if required billed almost a 1000 dollars a day, and in Germany the stay is up to 14 days which was always enough and the care and rehabilitation procedures were excellent there (not to mention that with the technology based surgeries the experience adds 20-30 % of the success and Dr.Rolle's specific experience is unique). The flight there is easy - Frankfurt and then to Dresden - a beautiful old European town worth visiting anyway.
I have a strong opinion that the laser surgery if ever planned has to be done before of any other interventions as the clear field with no cut adhesions from the previous surgeries enable the surgeon to see and resect much more smaller mets then if the lung is bleeding and there are scars, so you get to use all of the advantages of the laser surgery at it best state. How was your brain mets treatment, may be you are willing to share the experience and the point of having no WBRT but only radiosurgery in the brain mets treatments topics?
Laser Lung Surgery
My husband and I are making the arrangments to go to Germany. His scans show about 30 mets right now. We continue to pray that this is the dr. that can help us. We have been to Dana Farber, Fox Chase, Hillman, and Sloan Kettering, but nothing any Dr. had to offer seemed as good as what Dr. Rolle is doing. This site and your stories have given us hope. Thank you so much. I must say we are nervous and excited as well.
It looks like we will be flying out of Philly on the 11th - wish us luck. And please tell us anything you feel would be helpful to know.
thanks,
Kathy
It looks like we will be flying out of Philly on the 11th - wish us luck. And please tell us anything you feel would be helpful to know.
thanks,
Kathy
additional info reg. Dr.Rolle's surgery
Katy, hi, Do you have a ticket through Fra to Dresden directly? Make a sure that you can change the date of the return flight. Also you can request an assistance to meet you at the Fra airport and drive inside on the small car, at no charge (we did it once).
The taxi from Coswig hospital to the airport is about 25 Euro and can be arranged by hospital. There are a few people who speak very good English and the rest is so-so but it is OK, Dr.Rolle is always there for you.
They have very strict rules for after surgery ward (2 or 3 days) but you can ask to be allowed there you have to buzz and tell the name of the patient, just bring your slippers. Have you arranged a stay there for yourself already?
If you have a notebook take it and have some movies on a CD to watch as there is no English channel at the hospital (at least they didn't have it 3 years ago).
Can you post your husband's story and the current situation on the Personal updates topic? Just create a new topic for him, please? We need to share all the info even when it seems not to have any significance it might be needed to someone at some point.
The taxi from Coswig hospital to the airport is about 25 Euro and can be arranged by hospital. There are a few people who speak very good English and the rest is so-so but it is OK, Dr.Rolle is always there for you.
They have very strict rules for after surgery ward (2 or 3 days) but you can ask to be allowed there you have to buzz and tell the name of the patient, just bring your slippers. Have you arranged a stay there for yourself already?
If you have a notebook take it and have some movies on a CD to watch as there is no English channel at the hospital (at least they didn't have it 3 years ago).
Can you post your husband's story and the current situation on the Personal updates topic? Just create a new topic for him, please? We need to share all the info even when it seems not to have any significance it might be needed to someone at some point.
Thank you for writing back so soon. i will add T.J.'s story to the profiles. I am starting to feel really overwhelmed with planning this trip. I know how difficult it has been to deal with his previous surgeries in the states, and to not have my family and friends with us to help will be hard. I just hope we remember to schedule everything! Dr. Rolle has been amazing so far. We are just waiting for the final word from him, just to double check before we book anything. We are planning on flying right in to Dresden. I have not made arragments for myself yet. He mentioned that there is a place I could stay... my understanding is that it is at the hospital. Once I know from him I will make the arrangements.
Thank you for the advice regarding the return home flight. I am worried about how he will feel on the way home as well as recovering in another country.
There is so much to do and I am not sure we are thinking of it all.
Many thanks,
Kathy
Thank you for the advice regarding the return home flight. I am worried about how he will feel on the way home as well as recovering in another country.
There is so much to do and I am not sure we are thinking of it all.
Many thanks,
Kathy
trip to Germany
Kathy - I do not know about any direct flight to Dresden from North Am.
Do not get overwhelmed with the planning, allow more then 2 weeks between the arrival and departure, usually it is about 15-18. On both trips we went there we stayed for 2 nights in Dresden before we went to see Dr.Rolle in Coswig - first time at the very small decadent hotel Raskolnikoff and the second time at the hotel Europa both of which were very nice, the second one had the most lavish breakfast buffet - they even had caviar there although the hotel itself was simple. Dresden has a very decent historical area in the center of the city with a few huge buildings that everyone is taking pictures of - Zwinger complex - a few museums. If the pressure is to high you can arrange to go directly to the hospital from airport but usually people arrive past the admittance time. The stay in the hospital for the family member might be in the room with the patient (which is really to expensive and doesn't make that much sense as you need will need to have a good sleep too to be able to provide the better support to your husband). The other option is in the administrative building they have a small area on the last floor where are a few rooms and the common kitchen with all the utensils and a fridge. The room itself is very small but has everything you need it is a very good choice as it is right across the building where your husband will be. The big store (Kaufman) is 10 min walk from the hospital, just go by the road under the bridge and stay by the right side of it, they have everything you need there so no need to have a lot of luggage - the small stuff is not expensive in Germany and may be even cheaper at times then in North Am., esp. food. It is a little strange to carry food There might be a problem with the currency exchange - Coswig is a very small town, most banks close early and nothing works on Sunday, also make sure your credit card has a 4 digit access code, I mostly used cash to pay for everything and had taken a separate wallet for Euro currency. I prepared a bank draft to pay for the surgery and brought it with me, they do a rough estimate in the beginning and the adjustment in the end based on the days in the hospital and your stay. About 14 days of the hospital stay were included in the surgery cost when we went but it might have changed since. Do you have a direct contact with the accounting department? Ask me if you need more info.
Do not get overwhelmed with the planning, allow more then 2 weeks between the arrival and departure, usually it is about 15-18. On both trips we went there we stayed for 2 nights in Dresden before we went to see Dr.Rolle in Coswig - first time at the very small decadent hotel Raskolnikoff and the second time at the hotel Europa both of which were very nice, the second one had the most lavish breakfast buffet - they even had caviar there although the hotel itself was simple. Dresden has a very decent historical area in the center of the city with a few huge buildings that everyone is taking pictures of - Zwinger complex - a few museums. If the pressure is to high you can arrange to go directly to the hospital from airport but usually people arrive past the admittance time. The stay in the hospital for the family member might be in the room with the patient (which is really to expensive and doesn't make that much sense as you need will need to have a good sleep too to be able to provide the better support to your husband). The other option is in the administrative building they have a small area on the last floor where are a few rooms and the common kitchen with all the utensils and a fridge. The room itself is very small but has everything you need it is a very good choice as it is right across the building where your husband will be. The big store (Kaufman) is 10 min walk from the hospital, just go by the road under the bridge and stay by the right side of it, they have everything you need there so no need to have a lot of luggage - the small stuff is not expensive in Germany and may be even cheaper at times then in North Am., esp. food. It is a little strange to carry food There might be a problem with the currency exchange - Coswig is a very small town, most banks close early and nothing works on Sunday, also make sure your credit card has a 4 digit access code, I mostly used cash to pay for everything and had taken a separate wallet for Euro currency. I prepared a bank draft to pay for the surgery and brought it with me, they do a rough estimate in the beginning and the adjustment in the end based on the days in the hospital and your stay. About 14 days of the hospital stay were included in the surgery cost when we went but it might have changed since. Do you have a direct contact with the accounting department? Ask me if you need more info.
Thank you for your help Olga. They said the administration rooms are full so I have asked if they could recommend somewhere for me to stay. Tom's parents will be over for a week as well and they are looking into places to stay as well. We heard from a friend that it is not easy to use credit cards that has me a little nervous b/c with the cost of everything, well I have no idea how much extra money to bring- I am waiting to hear back from the hospital to find out more regarding how we pay and when we pay.
Do you know if we need to do anything special to be able to use our computer in the hospital?
I am sure that we will have more questions and we really appreciate your advice. Do you think your son would be willing to talk to Tom about how he felt after surgery?
Take care and thank you.
Kathy
Do you know if we need to do anything special to be able to use our computer in the hospital?
I am sure that we will have more questions and we really appreciate your advice. Do you think your son would be willing to talk to Tom about how he felt after surgery?
Take care and thank you.
Kathy
Dr.Rolle's new laser "Eraser" gets its approval in Canada
Dr.Rolle has developed a new improved laser that is more powerful then the one he used before, so it works 4 times faster to evaporate the small mets on the spot. It means that patients with the bigger number of the lung mets can expect their mets to be resected completely, as the time of the open lung surgery is limited now by the time that lung can stay exposed to the air before it turns stiff so the rest of the mets is hard to palpate, which is about 4 hours. Dr.Rolle reports that his new laser under the name Eraser is already approved in Germany and surprisingly is on the fast track in Canada, expected to be the approved soon. For Canadian patients it may mean the possibility to apply for out of country surgery to be covered by the provincial government founded insurance. If the benefit of the surgery is recognized by the surgeon/oncologist but they can not perform the surgery locally using the conventional tools as it is not feasible/takes to much lung tissue due to the centrally located/very multiple mets, then the statement of acceptance from Dr.Rolle can be obtained that with Eraiser the surgery expected to be complete.
Olga
Updated Information
Hi!
I was wondering if there is any updated information on this topic. Is there anyone in the U.S. that we could consult before going to Germany?
I was wondering if there is any updated information on this topic. Is there anyone in the U.S. that we could consult before going to Germany?
Re: Lung: Laser Surgery
I will may have to disappoint you here. Dr.Rolle does not accept patients for the surgery with the unresected primary, is it the case in Anthony situation or I didn't get you right? He accepts patients if the lungs are the only active metastatic site, if there are other mets they have to be treated and show the sign of stability, like the stable scans after the radiation therapy.
Olga
Re: Lung: Laser Surgery
Olga--you are correct. Anthony's primary has not yet been removed. They are waiting as their largest concerns has been combating the lung mets. If we were to have his primary removed or radiation, do you think they would accept Anthony? He is getting re-scanned on the 24 to determine how chemo is doing and how his brain radiation went. We will hope for the best! Thank you for your support!