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precision through tiny incisions. To ensure our patients receive the best robotic surgery possible, our surgeons receive extensive robotic surgery training. Training and approval is required to use robotic tools. We rank second in efficiency among top cancer centers in the country, with approximately 325 cases per robot each year. “Even with the complexity of surgery required for our patients’ diagnoses, we do more cases per robot than most hospitals, and our program is still growing,” says George Chang, M.D., professor of Surgical Oncology. We sponsor multiple initiatives to help bolster the use of robotic surgery and technology within the division, including an innovation subcommittee and MINTOS. MD Anderson established the MINTOS — Minimally Invasive New Technology in Oncology Surgery program — 11 years ago. In MINTOS, we implemented a robotics curriculum for both fellows and faculty so they can strengthen their experience and expertise. Some areas in which our surgeons conduct robotic surgery in include: • Head and Neck Surgery: Transoral robotic operations, a minimally invasive approach, is a significant change since traditional surgeries for human papillomavirus (HPV)-associated oropharyngeal cancers require opening the jaw. • Plastic Surgery: All MD Anderson plastic surgeons are trained microsurgeons. In addition to performing reconstructive surgery, our plastic surgeons can help patients overcome lymphedema, a debilitating and common cancer treatment side effect in which the lymph nodes fail to move fluid throughout the lymphatic system properly. Fluid builds up causing swelling and pain. Our plastic surgeons can perform two surgeries to ease lymphedema. The first is a lymphatic bypass surgery in which surgeons disconnect and reconnect the lymph nodes so fluid moves properly. 6 MD Anderson Cancer Center The second is the lymphatic transfer in which surgeons take lymph nodes from other parts of the body and use them to fix the spot where the lymphatic system is clogged, like a plumber replacing pipes. This allows the patient’s lymphatic system to drain fluid. While the procedure can’t completely reverse lymphedema, nearly 100% of patients saw a positive change. • Rectal cancer: Robotics are enabling surgeons to perform surgery on complex cases of rectal cancer traditionally treated by an open surgical approach. As a result, patients experience improved recovery and a quicker return to their normal routines or to their next phases of multidisciplinary treatment. Urologic surgeons also are able to perform robotic retroperitoneal lymphadenectomy with equal quality as open surgery. This procedure removes retroperitoneal lymph nodes in patients with testicular cancer. A robotic approach is advantageous for patients because it reduces hospital length of stay and postoperative pain. • Thoracic: Nearly 70% of lobectomies – surgically removing a lobe of the lung to treat lung cancer – at MD Anderson are performed robotically. This allows our patients to experience shorter hospital stays and lower side effects. • Urology: The most common procedure is a robotic prostatectomy for prostate cancer. MD Anderson urologic surgeons are skilled at nerve-sparing techniques that may help men keep urinary and sexual function. Robotic prostatectomy results in fewer complications and less blood loss and urinary tract scarring. MD Anderson urologic surgeons are skilled at nerve-sparing techniques designed to help men keep urinary and sexual function. Division of Surgery | Surgical Outcomes FY18 7 Surgery supports 16 surgical fellowships at MD Anderson, which have graduated nearly 1,000 skilled surgeons. The following fellowships are offered through our departments: Breast Surgical Oncology: In 2002, MD Anderson created a multidisciplinary Breast Surgical Oncology fellowship directed by Henry Kuerer, M.D., Ph.D., professor of Breast Surgical Oncology. Since the commencement of this internationally renowned training program, over 50 graduates have matriculated, and Mediget Teshome, M.D., became the associate program director in 2015. The program admits four top trainees per year, making it the largest of 55 programs in the nation. It is one of the most sought after training programs, with an average of 85 applicants per year. Clinical Fellowship in Microvascular Reconstructive Surgery: Run by Plastic Surgery, this one-year fellowship exposes nine trainees to a range of ablative and reconstructive surgeries for cancer patients. Matthew Hanasono, M.D., professor of Plastic Surgery, is the director of the program, which graduated 168 fellows since 1988. Gynecologic Oncology Fellowship: The four-year fellowship in Gynecologic Oncology is an ACGME approved fellowship and the largest such program in the United States. Since its inception in the 1950s, it has graduated 179 fellows. Michael Frumovitz, M.D., professor of Gynecologic Oncology and Reproductive Medicine, directs the program. The department has a T32 grant from the National Cancer Institute (NCI) to support the research and training during the first two years of the fellowship, which is completed by three fellows each year. The department also has the Felix Rutledge Fellowship, a one-month elective rotation for third-year obstetrics and gynecology residents. Musculoskeletal Oncology Fellowship: Directed by Valerae O. Lewis, M.D., this fellowship allows
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