Fitness Files: Taking the cutting out of surgery
My friend Laurie got me out to UC Irvine’s medical lecture series on April 20 for a sexy subject: urology.
We heard Dr. Jaime Landman, the darling young chairman of UCI’s Department of Urology and Radiology. A compact, dark-haired dynamo of rigorous research and wonky humor, Landman promised to make skin-slicing surgery as extinct as bloodletting.
Just 15 years ago, Landman graduated from the prestigious residency program at the Icahn School of Medicine at Mount Sinai in New York. Today he uses none of the specialized surgical training learned there because surgery is changing so quickly.
“I left Columbia, recognized as one of the best medical schools in the world, to be part of the amazing innovation going on at UC Irvine,” he said.
Landman’s all consuming interest? With his former mentor, Dr. Ralph Clayman, he’s a pioneer in minimally invasive surgery — urology’s tantalizing future.
What virile man with an elevated PSA reading wouldn’t welcome replacing the biopsy with something like a camera pill and scan? If the scan found cancer, wouldn’t that man prefer non-surgical ablation of the growth, leaving his prostate intact? (Current surgical practice removes the entire prostate gland.)
How about making the colonoscopy tool a thing of the past? Instead of a scope, a swallowed pill steered by a magnet would illuminate the intestinal “tunnel” far more clearly.
Think of transforming a competent surgeon into Superman with the aid of a robotic arm, already proved to be more precise than the superbly trained human hand. Now visualize this through telesurgery, with miles separating doctor and patient.
At UCI, the Surgical Education Center laboratory joins the computer chip with radiological innovation, the laser and robot design. The desired goal is to see clearly inside the array of human organs, identify potential and actual disease and eradicate a problem without the need of a stitch.
Surgery, which changed little for hundreds of years, is accelerating at breakneck speed because of technology. UCI’s collaboration with the tech industry makes Landman’s department the place to jet through to innovations with tremendous human, economic and environmental benefit.
For example, 3-D printers figure into medicine, economics and environmental cleanup. Landman described “6,600 tons of medical waste” generated daily, and “one-third of this is produced in operating rooms. This is not a sustainable model.” A particularly delicate surgical tool costing tens of thousands of dollars breaks after a few surgeries, he said.
The 3-D printer innovation would work like this: A technician would design and print a flexible surgical tool, made precisely to fit the individual patient’s anatomy. After performing its task, it would be tossed back into the 3-D printer’s plastic vat, heated at germ-killing temperatures and ready to form an instrument for the next procedure.
No medical waste, no cleaning challenges, no expensive discards.
“Technologies are developing fast to make the operating room the location of tailored technology and green technology,” Landman said.
The bright future of treatment is less treatment.
“We are working to learn the biology of disease and to understand that every occurrence does not have to be treated,” Landman said. “Biopsy readings will be so much more precise. We will use implants to monitor functions and determine what needs medical attention, finding problems early.”
“My goal is to make surgery dead,” Landman said.
But then Landman’s technical talk took a u-turn. “Cancer treatment is improving, but there are more cancers,” he said. “Today’s air and water are a little more contaminated.” He said he sees the results of “bad food habits” every day.
So Landman’s talk ended with the Fitness Files mantra.
“My family eats locally grown fruit and vegetables in season,” he said, adding that he eats salmon in season as well.
Unexpectedly, this stellar UCI physician and researcher turned out to be my healthy-eating ally.
Newport Beach resident CARRIE LUGER SLAYBACK is a retired teacher who ran the Los Angeles Marathon at age 70, winning first place in her age group. Her blog is email@example.com.