Multicare surgeon using robot for chest surgeries

Dr. Jon Boyum of MultiCare’s Pulse Heart Institute in Spokane has the distinction of being the only surgeon in the area to perform thoracic surgery with the assistance of a robot.

The large da Vinci Xi surgical robot stands about 6 feet high and looks something like an octopus even though it has four arms instead of eight. Boyum sits at a control station a few feet away, using his hands and feet to control the camera and surgical instruments attached to the robot’s arms.

“It’s not autonomous,” he said. “I’m doing the surgery. It’s just a tool. It’s an instrument that we use.”

Boyum said he’s been using the robot for several years. “The latest model has been specially designed for thoracic surgery,” he said. “It made everything easier to do. I have free range of motion inside.”

MultiCare Deaconess Hospital has two of the robots, and Boyum shares them with other surgeons. “Other specialties use them, too,” he said. “I’m the only one who uses it for thoracic surgery.”

Boyum does heart surgery without the robot. He uses the robot mostly on patients who need treatment for esophageal or lung cancer. The key feature is that it is minimally invasive, requiring only four small incisions.

He previously performed video-assisted thoracoscopic surgery, which is also minimally invasive. “It’s basically using an instrument on a stick,” he said. “That takes a lot of work. This allows better movement.”

Boyum also likes that he has control over the camera when he uses the robot. “If someone else is holding the camera I’m always having to direct them,” he said.

Using a robot is also far better for the patient, Boyum said. “I’ve seen benefits,” he said. “Patients have less pain. People are probably going home a day earlier with the robot.”

Boyum, a Gonzaga University alum who graduated from the University of Washington Medical School, said he thinks many doctors don’t use robots for thoracic surgery because it simply wasn’t a part of medical school training. “It wasn’t available in my training,” he said. “It was something I had to take on myself after.”

But Boyum expects he won’t be the only robotic thoracic surgeon for long since medical schools are beginning to incorporate robotic surgery.

Boyum said he’s known since he was a young boy that he wanted to be a doctor. His grandmother’s death from lung cancer when he was in the fifth grade helped propel him toward thoracic surgery, as did a mentor during surgical training who was a cardiothoracic surgeon. An aunt also died of lung cancer several years ago.

“Everything pushed me in this direction,” he said.

Boyum said most of his lung cancer patients are current or former smokers. If lung cancer is caught early enough the affected lobe can be removed, he said. “Early lung cancer is treatable and highly curable,” he said. “If you have early stage lung cancer, surgery is all that you need.”

The medical profession has begun doing lung cancer screenings on high risk patients, mostly those who are long-term smokers, Boyum said. Those screenings have allowed doctors to increase the rate of early lung cancer detection.

“The symptoms of early lung cancer are nothing,” he said.

It used to be that people would come in complaining of chronic coughing or coughing up blood, but by then the lung cancer had spread and it was too late for surgical intervention, Boyum said.

“It kills more people than breast, colon and pancreatic cancer combined every year,” he said. “Once you start showing symptoms, it’s too late for surgery.”

Boyum said most of his thoracic surgery patients come to him because they’ve heard about the benefits of robotic surgery and the lessened pain that comes with it.

“Surgery on the chest hurts,” he said. “There’s no getting around it. You certainly get better a lot faster.”