New medical procedure makes it easier to remove large tumors

Imagine being told you have a five pound tumor growing inside you. Now imagine getting that news, when you're 13 years-old. That's exactly what happened to one girl.

But a minimally invasive option, usually reserved for adults, helped the talented teen, not just survive, but recover quickly.

She can work the keys of a piano, light up the strings of a violin, and perform in unison with her siblings. For, Anna Cole, music is a way of life. It's also the reason Anna's mom knew something was wrong with her daughter.

Chee-Hwa Cole, Anna's mom, explains how she knew something was wrong, "I'm a musician, and I notice posture, and I noticed that she had a little curvature, a little hump."

Scans showed the 13 year-old had a five-pound tumor the size of a volleyball growing in her chest.

Anna Cole, 13 years-old, explains what her first reactions to the news were, "I just started crying because I was kind of scared."

Doctor Steven Rothenberg says removing tumors with a minimally-invasive approach is the best way, but Anna's tumor was different.

Steven Rothenberg, Chief of pediatric surgery RMHC, Clinical Professor of surgery, Columbia University college of physicians and surgeons, explains how most doctors would not have acted on the tumor due to the size, "The size of it made most physicians feel that there was no way they could do it using these small incisions."

The standard procedure involves making a 14-inch incision across the chest, and a long, painful recovery. Instead, Doctor Rothenberg tried a minimally invasive technique. Using tiny instruments, he extracted Anna's tumor from her chest, dodging blood vessels, her lung and spine.

Doctor Rothenberg, MD, explains what he had to do to remove the tumor, "I had to keep trying to circle the tumor to get all the aspects."

Then, he chopped up the tumor and used a bag to pull it out, piece by piece. The entire surgery was performed through four tiny incisions. Anna's tumor was not cancerous, and she felt good enough to play at a piano recital just a week after her surgery.

Anna Cole explains how much she looked forward to the recital, "I had been looking forward to it, and I didn't want to miss it just because of my surgery."

A dedicated musician who won't let anything interfere with a performance.

In addition to offering shorter recovery and less pain, minimally-invasive approaches also lower the risk of scarring and chest deformities like scoliosis.

Doctor Rothenberg says he can always fall back on an open, traditional surgery if he needs to when performing a minimally-invasive procedure.


REPORT: MB #3396

BACKGROUND: A tumor is an abnormal mass of tissue. Tumors are a classic sign of inflammation, and can be benign or malignant (cancerous). In general, tumors occur when cells divide excessively in the body. Typically, cell division is strictly controlled. New cells are created to replace older ones or to perform new functions. Cells that are damaged or no longer needed die to make room for healthy replacements. If the balance of cell division and death is disturbed, a tumor may form.There are dozens of different types of tumors. Their names usually reflect the kind of tissue they arise in, and may also tell you something about their shape or how they grow. For example, a medulloblastoma is a tumor that arises from embryonic cells (a blastoma) in the inner part of the brain (the medulla). Diagnosis depends on the type and location of the tumor. Tumor marker tests and imaging may be used; some tumors can be seen or felt. (

MINIMALLY INVASIVE SURGERY: Traditional open surgical techniques are being replaced by new technology in which a small incision is made and a rigid or flexible endoscope is inserted, enabling internal video imaging. Endoscopic procedures are commonly performed on nasal sinuses, intervertebral disks, fallopian tubes, shoulders, and knee joints, as well as on the gall bladder, appendix, and uterus. In minimally invasive procedures, the doctor makes one or more incisions, each about a half-inch long, to insert a tube. The number of incisions depends on the type of surgery. The tube or tubes let the doctor slip in tiny video cameras and specially designed surgical instruments to perform the procedure. When minimally invasive surgery is performed, the patient is likely to lose less blood and have less postoperative pain, fewer and smaller scars, and a faster recovery than open surgery. (,

DR. STEVEN S. ROTHENBERG: A world leader in the field of endoscopic surgery in infants and children, he has pioneered many of the procedures using minimally invasive techniques. He has authored over 100 publications on minimally invasive surgery in children and has given over 200 lectures on the subject nationally and internationally. He is also an editor for the Journal of Laparoendoscopic and Advanced Surgical Techniques. Rothenberg is Chief of Pediatric Surgery and Chairman of the Department of Pediatrics at the Rocky Mountain Hospital for Children in Denver, Co. He is also an Associate Clinical Professor of Surgery at the University of Colorado. Dr. Rothenberg completed medical school and general surgery residency at the University of Colorado in Denver. He then spent a year in England doing a fellowship in General Thoracic Surgery, returning to complete a two year Pediatric Surgery fellowship at Texas Children's Hospital in Houston. He returned to Colorado in 1992 where he has been in private practice for the last 15 years. (

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