Skip to contents
In This Issue:
This spring, a BWH Thoracic Surgery team completed the first minimally invasive esophagectomies in Israel and taught their Israeli counterparts how to perform these surgeries themselves.
“We showed them everything, step by step, and explained every nuance,” said Raphael Bueno, MD, associate chief of the Division of Thoracic Surgery. “These are long, complex operations with hundreds of steps.”
Bueno led the five-member BWH team that included surgeon Abraham Lebenthal, MD; anesthesiologist/intensivist David A. Silver, MD; Operating Room nurse in-charge Chris Sears, RN; and surgical technologist Carol Belle King. They helped carry out the operations at Rabin Medical Center outside Tel Aviv, one of Israel’s leading hospitals, at the invitation of Professor Hanoch Kashtan, chair of surgery at Rabin.
During their week-long visit, the team performed two minimally invasive esophagectomies, which involve removing most of the esophagus and rebuilding it with tissue from the patient’s stomach. The BWH Division of Thoracic Surgery performs almost 100 esophagectomies a year—30 to 40 of which are minimally invasive—as treatment for esophageal cancer. But this was the first time that BWH thoracic surgeons took the innovative operation “on the road.”
Minimally invasive esophagectomy, which uses small incisions and videoscopes, has many benefits over its open-surgery version: faster recoveries, shorter ICU and hospital stays, less pain and blood loss and higher survival rates.
In two other minimally invasive operations in Israel, the BWH team removed a cancerous lobe from a patient’s lung and a large bronchial cyst from another patient. As BWH and Israeli teams worked side-by-side in the OR (mainly speaking English), surgeons from across Israel watched on closed circuit televisions in the hospital and were able to pose questions. The patients ranged from age 22 to 72, and all did well, Bueno said.
“Now that the procedure has been introduced to Rabin Medical Center, the Israeli surgeons plan to perform their first one alone very soon,” Bueno said. “They now have contacts at BWH, should they have questions about the procedure.”
“The Israeli anesthesiologists had very modern, sophisticated techniques and tools. I was able to offer guidance and teaching, both during the surgeries and for postoperative care in the ICU,” said Silver.
The trip was a homecoming of sorts for Silver, who worked on an Israeli kibbutz (a communal industrial and agricultural community) one fall during college, and for Bueno and Lebenthal, who grew up in Israel. But it was a novel experience for Belle King and Sears.
The surgical team worked three long days but also explored some sights, including ancient ruins in Caesarea and Jerusalem. They witnessed the country’s rich religious diversity and remarkable economic growth, and enjoyed plenty of fresh Mediterranean food. “It was the opportunity of a lifetime,” Sears reflected. “I hope to have the chance to visit again.”