First Robotic Esophagectomy Performed at Northwestern Memorial Hospital

Northwestern Medicine
Pulmonology November 13, 2019

Each year, approximately 572,000 people are diagnosed with esophageal cancer, globally resulting in more than 508,000 deaths; making esophageal cancer the seventh most frequently diagnosed cancer and the sixth-leading cause of cancer-related deaths in the world. It is typically treated with a complex surgical procedure called an esophagectomy, which involves a large incision on the abdomen and chest, breaking a rib and spreading the rib cage open. For the first time at Northwestern Memorial Hospital, a robotic esophagectomy has been successfully performed on a patient with esophageal cancer, resulting in smaller incisions, less pain and a shorter recovery.

“This is a very important milestone for Northwestern Medicine and a key development towards our mission to provide the most cutting-edge cancer treatment to patients with cancer,” says Ankit Bharat, MD, chief of thoracic surgery at Northwestern Memorial. “Only a handful of medical centers in the world can offer robotic esophagectomies safely to their patients since it requires a highly specialized multidisciplinary care team. This feat brings a new paradigm for the treatment of esophageal cancer to the patients in our community.”

On October 14, Samuel Kim, MD, thoracic surgeon and director of robotic thoracic surgery, led the team who performed the robotic esophagectomy on 67-year-old Denis Frankenfield at Robert H. Lurie Comprehensive Cancer Center of Northwestern University at Northwestern Memorial Hospital. Dr. Kim joined Northwestern Medicine in August, bringing a national level of expertise in minimally invasive thoracic surgery. Dr. Kim has completed more than 600 robotic thoracic operations and maintains one of the best surgery outcomes in the country.

Frankenfield, who retired from the Shedd Aquarium after nearly 30 years, lost his father to stage IV esophageal cancer in 2008. Shortly after, Frankenfield started receiving regularly scheduled endoscopies and colonoscopies, which revealed a diagnosis of Barrett’s esophagus. The condition is caused by recurrent gastroesophageal reflux disease and increases the chances of esophageal cancer. About one percent of adults in the United States have Barrett’s esophagus.

“During my latest round of testing in September, they found something suspicious – which turned out to be stage II esophageal cancer,” says Frankenfield. “I was referred to Dr. Kim, who quickly scheduled surgery. I was really impressed with the way everything was handled.”

Frankenfield’s treatment plan called for a robotic esophagectomy, followed by chemotherapy. Robotic esophagectomies are best suited for patients with stage I, II or III esophageal cancer.

“The esophagectomy is one of the most technically demanding and complex operations in surgery,” explains Dr. Kim. “Most of the time, the operation is performed using an open technique and patients tend to have a longer recovery, with higher risk for wound infections and respiratory complications, such as pneumonia. A minimally invasive procedure decreases the chances of pulmonary complications and shortens the recovery. When the patient needs adjuvant chemotherapy, they’re likely to receive it because their recovery is quicker.”

Dr. Kim performed the robotic esophagectomy by making small incisions in Frankenfield’s abdomen and chest. He cut out the esophageal cancer and connected the stomach conduit with the cut end of the esophagus.

“I have better visualization with the robot, which allows me to operate more precisely. Plus, the patient experiences less blood loss and less pain,” says Dr. Kim. “Esophageal cancer is one of the deadliest cancers, and survival rates are much better if we can catch and treat the disease early.”

Frankenfield will soon start chemotherapy and has a strong support system. His husband of 39 years also battled and beat cancer, which gives Frankenfield hope for the future. 

“I feel really good right now,” says Frankenfield. “I have more good days than bad days. I’m lucky to be alive because many patients discover they have esophageal cancer in the later stages, and thanks to my routine screenings, I was able to catch it early. I can’t say enough good things about my entire team at Northwestern Medicine.”

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