Surgeons at MedStar Georgetown University Hospital completed three notable procedures within a single week in late June using the da Vinci SP, or Single-Port, robotic surgical system made by Intuitive — performing breast, colorectal and thoracic surgeries each through just one incision.
The most novel of the three was a robotic bilateral nipple-sparing mastectomy performed June 25 by Dr. Lucy De La Cruz, chief of the Breast Surgery program at MedStar Georgetown and system chief of Breast Surgery at MedStar Health, for a 50-year-old patient with breast cancer. Working with plastic surgeon Dr. Kenneth Fan, De La Cruz created a single 4-centimeter incision hidden in the natural fold beneath the breast, rather than the armpit or side-of-chest incision used at most U.S. hospitals offering robotic nipple-sparing mastectomies. Through that opening, the team combined immediate breast reconstruction with a permanent implant and no supporting mesh, a sentinel lymph node biopsy, and a nerve-sparing technique intended to help preserve breast sensation — a combination not typically performed together in robotic breast surgery.
“One incision. One surgery. My patient woke up with her cancer treated and a scar she’ll barely see,” De La Cruz said. “For too long, women have had to choose between treating their cancer and preserving sensation… This new approach is designed to address both.”
MedStar Health says the technique is best suited to patients with small to moderate-sized breasts, a healthy body weight and appropriately positioned nipples, and is not recommended for patients with larger or sagging breasts or inflammatory breast cancer. The health system says MedStar Georgetown is one of 10 hospitals nationwide performing nipple-sparing mastectomy with the Single-Port system, and the only hospital in the Washington, D.C. region offering it.
The following day, June 26, colorectal surgeon Dr. Tushar Samdani performed two of the region’s first Single-Port robotic colorectal procedures — a partial bowel resection and a colostomy for obstructive rectal cancer — using the patient’s stoma site as the robot’s sole entry point, avoiding additional abdominal incisions. “This technology allows us to perform certain abdominal procedures for patients with both cancerous and non-cancerous conditions using an even less invasive approach,” Samdani said.
Three days after that, on June 29, Dr. Marc Margolis, chief of Thoracic Surgery, performed what MedStar says was the Mid-Atlantic region’s first Single-Port robotic thoracic lobectomy, removing part of a patient’s lung through a single incision made below the rib cage rather than between the ribs, as traditional minimally invasive lung procedures require. Margolis said his team has since performed four lobectomies and two thymectomies using the approach. “Patients have had less pain, most have not needed narcotics, and they have been doing very well,” he said.
Dr. Thomas Fishbein, chair of Surgery at MedStar Georgetown, called the three procedures part of a broader pattern of surgical firsts at the hospital, adding that surgeons are also expanding use of the Single-Port platform into urologic and head and neck procedures.
