Thoracic Surgeon Brings First-Ever Robotic Lobectomy to Region

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In the fall of 2011, when Red Bank resident Rosanne Pingitore experienced a diverticulitis attack, she had no idea the episode would end up saving her life.

During her hospitalization, doctors recommended the 75-year-old undergo a colon resection to remove the affected part of the colon. In preparation for surgery, Rosanne was required to have a number of medical tests, including a chest X-ray that showed troublesome results.

“They saw some abnormalities, including a nodule in my lung,” says Rosanne

Thoracic surgeon Loki Skylizard, M.D., with patient Rosanne Pignatore and her husband, Jack, in the Surgical Intensive Care Unit following her robotic lobectomy, and then, just two weeks later, at Monmouth Medical Center's Ladies Night Out community health event at the Holiday Inn in Hazlet, featuring Dr. Skylizard.

Thoracic surgeon Loki Skylizard, M.D., with patient Rosanne Pignatore and her husband, Jack, in the Surgical Intensive Care Unit following her robotic lobectomy, and then, just two weeks later, at Monmouth Medical Center’s Ladies Night Out community health event at the Holiday Inn in Hazlet, featuring Dr. Skylizard.

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Soon after, Rosanne began being treated by pulmonologist Douglas Scott Livornese, M.D., FACP, FCCP, DABSM, who sent Rosanne for periodic CT scans to monitor the size of the nodule. In March 2013, a PET scan revealed the nodule had grown.

Dr. Livornese referred Rosanne to new Monmouth Medical Center thoracic surgeon Loki Skylizard, Chief of Thoracic Surgery, Director of Minimally Invasive and Robotic Thoracic Surgery and Director of the Thoracic Surgical Oncology Program.  Together Dr. Livornese and Dr. Skylizard lead the Lung Cancer Screening Program at Monmouth Medical Center as, respectively, medical director and surgical director.

Upon meeting with Rosanne and determining that the nodule in her lung required removal, Dr. Skylizard recommended a robotic lobectomy – a minimally invasive surgery that uses very small incisions, about the size of a dime, to remove the tissue – a first for the region. Dr. Skylizard received nearly two years of training in this procedure during residency and subsequent fellowship in Thoracic Surgery and Cardiovascular Surgery at the University of Alabama in Birmingham. He was the first physician to complete a 12-month fellowship in Minimally Invasive and Advanced Robotic Thoracic Surgery at the University of Alabama under the mentorship of Dr. Robert Cerfolio.

“The small, metabolically active lesion in Rosanne’s lung, coupled with the fact that she was overall healthy, very active and motivated to get better, made her an excellent candidate for a completely portal robotic lobectomy,” said Dr. Skylizard.

The robotic system allows surgeons better visualization and improved fine motor skills in a very small space, whereas traditional surgery to treat lung cancer – thoracotomy or Video-Assisted Throcoscopic Surgery – requires one large incision or several incisions and exposes a large portion of the lung. The robotic lobectomy may result in significantly less pain and trauma for patients.

“Typically, with traditional surgery, many surgeons may not get the lymph nodes, making the staging of cancer difficult,” said Dr. Skylizard. “Using the robotic system, we were able to remove Rosanne’s lymph nodes, in addition to the lesion on her lung, and confirm that they were clear of cancer. This was a very early stage cancer – our hope is that this is a curative surgery and Rosanne will never require chemotherapy, radiation or any additional treatment.  She really is a shining example of what an early lung cancer screening and comprehensive lung nodule surveillance program can provide.”

After only a three-night hospital stay, Rosanne was discharged from the hospital with minimal pain. Two weeks after surgery, Rosanne was back to her normal activities and credits Dr. Skylizard and his staff for it all.

“I’m so glad things progressed the way they did and I know I’m very fortunate as this type of procedure usually takes much longer to recover from. In the time Dr. Livornese first found the nodule, Dr. Skylizard joined MMC and brought this new technique, which is marvelous. He took time with my husband and me to thoroughly explain the procedure, to have someone call my husband every so often from the operating room to update him – his bedside manner was wonderful,” Rosanne says. “Dr. Skylizard and the staff at MMC made my entire experience as pleasant as possible.”

For more information on the Lung Cancer Screening Program at Monmouth Medical Center, call 732-923-7966.