A local surgeon performed a unique liver surgery in San Antonio recently, the first of its kind in Texas and perhaps the nation. He was able to remove a liver tumor through a single tiny incision.
Last fall, C.B. Slabaugh of San Antonio had a pain in his chest that worried him. His wife thought he might be having a heart attack and rushed him to the emergency room.
“They did a CT scan,” Slabaugh recalled. “They said ‘your heart’s fine but you have a mass on your liver.’”
That mass turned out to be a benign tumor the size of an orange.
“His tumor is called hemangioma,” said Dr. Juan Palma, a liver surgeon who specializes in transplants and laparoscopic procedures. “It’s a benign tumor made out of blood vessels that normally grow in the liver. These vessels are just abnormally large.”
During a February 16, 2010 surgery at Methodist Specialty and Transplant Hospital, Palma tried something new. Using a spongy port inserted through a cut in the belly button, he was able to insert cameras and instruments to extract the tumor.
Angled instruments with bendable parts like wrists gave him the flexibility he needed. “So with these bendable instruments,” Palma explained, “you can manipulate them inside the abdomen in a more comfortable way and be able to reach any angle of their structure that you are trying to remove.”
“When you look at my belly button, it’s just almost like it was before,” Slabaugh said. “I have virtually no scar at all.”
All of the work was performed through a 1¼” incision. Slabaugh was out of the hospital the next day.
Palma says patients have less pain, a shorter recovery and a better cosmetic result. He said it’s a particularly good approach for older, frailer patients.
Single incision laparoscopic surgery is widely used for appendectomies, gall bladder removal, even colon surgery. Palma believes it will be an important advancement for liver tumor surgery, too.
