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Thoracic surgeon Dr. Farid Gharagozloo is changing the way that malignant pleural mesothelioma will be treated in the future, providing new hope with his much-needed breakthrough.
Gharagozloo, medical director of thoracic surgery at Florida Hospital Celebration Health, was the first doctor in the world to successfully use robotic surgery to perform an extrapleural pneumonectomy (EPP), the most aggressive treatment a mesothelioma patient can have.
He performed it several times in 2013 at the Arizona Cancer Center in Tucson, attracting considerable acclaim. He joined Celebration Health in 2015.
“It’s not the golden ticket, but it can make a huge difference,” he said. “It could change the way we look at this disease. The use of the robot with this surgery is revolutionary.”
Robotic surgery involves tiny instruments attached to a robot that is controlled remotely by a surgeon at a computer board. It allows for better maneuverability and more precise movement during an operation. It also allows a more magnified view of the areas being worked on.
Although the chest still must be opened as with the traditional style of surgery, it’s the robot inside instead of the surgeon. An EPP involves removing an entire lung, the lining around it, the lining around the heart and parts of the diaphragm.
Robotic surgery has been used for almost 15 years for less invasive procedures. Only in the past several years have thoracic surgeons been using it in the chest. Gharagozloo was the first to use it for something as extensive as an EPP.
He believes using the robot makes for a much safer surgery and shortens the recovery time. It dramatically reduces blood loss, because the robotic hands can seal the open blood vessels almost immediately. And less blood lost leads to fewer complications.
Gharagozloo was a pioneer in robotic surgery. He joined the University of Arizona staff in 2012 after working as the chief of clinical cardiothoracic surgery at George Washington University. He also worked as the director of the Washington Institute of Thoracic Cardiovascular Surgery.
He has expertise in both minimally invasive and robot-assisted procedures. His arrival in Tucson was a boost for the multi-modal approach to lung cancer at the University of Arizona, combining upgraded screening with advanced robotics to produce an earlier diagnosis. He has created a similar program now in Central Florida.
In addition to lung cancer, Gharagozloo also specializes in a variety of thoracic disorders, including esophageal cancer. He has perfected other robotic procedures, including those for the treatment of gastroesophageal reflux disease and thoracic outlet syndrome.
He earned his medical degree from Johns Hopkins University. He did his residency in general surgery and thoracic surgery at the Mayo Clinic in Rochester, Minn. He received further training at Harvard Medical School and nearby Brigham & Women’s Hospital.
His work with robotics and mesothelioma has drawn considerable attention. Even in the medical field, there is debate over whether the EPP should be done today. The morbidity rate is high, and the risks of such a major surgery can outweigh the rewards. The robotic surgery, though, could change that perception because older patients now will have a better chance of a quicker recovery.
“This changes the post-operative course for a patient,” he said. “All the signs are pointing to the fact that, in general, this is the way to get us out of the mud with mesothelioma.”
Dr. Gharagozloo is a well-known lecturer and author. He has published more than 140 papers. He is the senior editor of the Textbook of Robotic Surgery, as well as a diplomat of the American Board of Thoracic Surgery.Among his recent papers available on PubMed are “The learning curve of robotic surgery” in 2012 and “Robotic selective postganglionic thoracic sympathectomy for the treatment of hyperhidrosis” in 2013.
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