{"id":10579,"date":"2017-05-26T08:44:00","date_gmt":"2017-05-26T14:44:00","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=10579"},"modified":"2023-04-20T14:26:04","modified_gmt":"2023-04-20T20:26:04","slug":"cancer-surgery-through-keyholes-came-after-a-very-long-road","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/cancer-surgery-through-keyholes-came-after-a-very-long-road\/","title":{"rendered":"Cancer surgery through \u201ckeyholes\u201d came after a very long road"},"content":{"rendered":"<div style=\"margin-top: 0px; margin-bottom: 0px;\" class=\"sharethis-inline-share-buttons\" ><\/div><p>&nbsp;<\/p>\n<figure id=\"attachment_10580\" aria-describedby=\"caption-attachment-10580\" style=\"width: 300px\" class=\"wp-caption alignleft\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-10580 size-medium\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/05\/26023654\/EXT_05XX17-AnaGleisner.webp\" alt=\"Headshot of Dr. Ana Gleisner.\" width=\"300\" height=\"214\" srcset=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/05\/26023654\/EXT_05XX17-AnaGleisner.webp 1200w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/05\/26023654\/EXT_05XX17-AnaGleisner-300x214.webp 300w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/05\/26023654\/EXT_05XX17-AnaGleisner-1024x731.webp 1024w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/05\/26023654\/EXT_05XX17-AnaGleisner-768x548.webp 768w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/05\/26023654\/EXT_05XX17-AnaGleisner-150x107.webp 150w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/05\/26023654\/EXT_05XX17-AnaGleisner-200x143.webp 200w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-10580\" class=\"wp-caption-text\">Ana Gleisner, MD. A passion for cancer treatment and medical research fueled her transition transplant surgery in her native Brazil to oncological surgery at UCHealth University of Colorado Hospital.<\/figcaption><\/figure>\n<p>That Ken Littrell\u2019s six-hour surgery to remove more than half his liver was done via a minimally invasive laparoscopic procedure is a remarkable thing. The fortitude it took the UCHealth University of Colorado Hospital\u00a0surgeon to attain the skills to pull off such a feat makes it more amazing yet.<\/p>\n<p>Littrell, 59, had already noted flagging energy levels when, walking out of the gym one day in September 2016, he couldn\u2019t keep up with his wife Teresa, \u201cand she had just had her knee replaced,\u201d he said. The Parker resident soon had a stage 4 colon cancer diagnosis.<\/p>\n<p>In early October, Littrell had his ascending colon removed at a community hospital. But there was more work to be done. On a friend\u2019s recommendation, he touched base with <a href=\"https:\/\/www.cudoctors.com\/Find_A_Doctor\/Profile\/4227\" target=\"_blank\" rel=\"noopener noreferrer\">Christopher Lieu, MD<\/a>, who directs the University of Colorado School of Medicine\u2019s Colorectal Medical Oncology Program. Littrell\u2019s case channeled into the GI Oncology Multidisciplinary Clinic, where a team of CU School of Medicine medical, radiation and surgical oncologists as well as radiologists and pathologists team up to craft care plans for tough cases like Littrell\u2019s. <a href=\"https:\/\/www.cudoctors.com\/Find_A_Doctor\/Profile\/18069\" target=\"_blank\" rel=\"noopener noreferrer\">Wells Messersmith, MD<\/a>, took the lead, prescribing\u00a0four rounds of chemotherapy, the goal being to shrink a threatening liver tumor to the point that surgeon Ana Gleisner, MD, PhD, could remove it.<\/p>\n<p><strong>Career change<\/strong><\/p>\n<p>That Gleisner is a GI oncology surgeon at UCH \u2013 or anywhere else, for that matter \u2013 is a testament to just how much can change when talent meets drive. Gleisner had already gone through medical school, a three-year surgery residency, a year of transplant-surgery fellowship and a PhD program. She was a practicing surgeon in her native Brazil. Her interest in medical research brought her to Johns Hopkins University, where she focused on surgical outcomes, co-authoring papers with, among others, <a href=\"https:\/\/www.uchealth.org\/provider\/richard-schulick-md-mba-surgery\/\" target=\"_blank\" rel=\"noopener noreferrer\">Richard Schulick, MD, MBA<\/a>, now chair of the CU School of Medicine\u2019s Department of Surgery.<\/p>\n<p>\u201cI really fell in love with the oncology field,\u201d Gleisner said. \u201cIt\u2019s a team approach. That\u2019s the only way you can get people to have the best outcomes \u2013 they\u2019re complex decisions, and they require knowledge coming from several different fields, and I just loved having that kind of challenge and perspective.\u201d<\/p>\n<p>She has continued her surgical-outcomes research here, spearheading the development of a database detailing hundreds of surgery cases, the aim being to spot ways to improve patient care.<\/p>\n<p><strong>Into the lap<\/strong><\/p>\n<p>You might think a transplant surgeon could transition quickly to cancer surgery. In fact, it would take eight years. Gleisner would have to do a six-year surgical residency in the United States, then a two-year complex surgical\u00a0oncology fellowship. She knew she would be again subjected to the grueling workloads such training involves. She did it anyway: the residency at Saint Louis University, the fellowship at the University of Pittsburgh Medical Center. When she finished\u00a0in 2015, Schulick and Barish Edil, MD, helped bring her to Colorado, and, ultimately, to Ken Littrell.<\/p>\n<figure id=\"attachment_10581\" aria-describedby=\"caption-attachment-10581\" style=\"width: 300px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-10581 size-medium\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/05\/26024225\/EXT_05XX17-KenTeresaLittrell.webp\" alt=\"Ken Littrell with wife, Teresa.\" width=\"300\" height=\"225\" srcset=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/05\/26024225\/EXT_05XX17-KenTeresaLittrell.webp 1280w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/05\/26024225\/EXT_05XX17-KenTeresaLittrell-300x225.webp 300w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/05\/26024225\/EXT_05XX17-KenTeresaLittrell-1024x768.webp 1024w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/05\/26024225\/EXT_05XX17-KenTeresaLittrell-768x576.webp 768w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/05\/26024225\/EXT_05XX17-KenTeresaLittrell-150x113.webp 150w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/05\/26024225\/EXT_05XX17-KenTeresaLittrell-200x150.webp 200w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-10581\" class=\"wp-caption-text\">Ken Littrell with wife, Teresa.<\/figcaption><\/figure>\n<p>In Pittsburgh, Gleisner had honed rare skills in major laparoscopic cancer surgery on the liver. Having been involved with many liver transplants and other open liver surgeries was an advantage, she said. Successful laparoscopy \u2013 in which the work is done through small incisions, guided by a camera on one probe and surgical instruments on others \u2013 demands a deep understanding of the underlying anatomy and experience with open procedures, she said. You might liken it to preparing dinner though a couple of keyholes in the kitchen door. Some cases are too complex to do this way, but if it\u2019s possible, there are big benefits: on average, there\u2019s 50 percent less morbidity, 30 percent less blood loss, and two days less time in the hospital, among others, Gleisner said.<\/p>\n<p>In Littrell\u2019s case, it was soon clear that one of the metastases was, as he put it, \u201creally close to a major blood supply in the liver.\u201d The team would have to remove 60 percent of the liver, Gleisner concluded. They would start laparoscopically, reserving the option of switching to open surgery midstream if she deemed it necessary.<\/p>\n<p>\u201cShe made me feel real comfortable and was a real straight shooter. She laid out all the options and said, \u2018This surgery is the best chance for a cure,\u2019\u201d Littrell said. \u201cNobody had ever used the word \u2018cure\u2019 with me.\u201d<\/p>\n<p>Gleisner is careful to balance the benefits of minimally invasive surgery with the overarching goal of removing any visible hint of cancer, she said, \u201cbecause you can\u2019t compromise the oncologic safety and outcomes because of the approach.\u201d In simple terms, just because you can wield the hammer of laparoscopy does not make every GI cancer surgery a nail.<\/p>\n<p>\u201cHaving the ability to do any procedure laparoscopic, open, or a combination of the two gives patients the most options,\u201d Schulick explained.<\/p>\n<p><strong>Back in business<\/strong><\/p>\n<p>She performed the surgery on Feb. 8. It went well, Littrell said. Gleisner visited him daily in the surgical intensive care unit and then the inpatient oncology unit at UCH. He was back home eight days later. Two-and-a-half weeks after the surgery, Littrell was working part-time from home as a senior software engineer. A few days after that, he was in the office part-time \u2013 a quick return made possible in part, he said, by the small incisions involved in laparoscopy. His energy was slow in returning \u2013 not because of the cancer this time, but because his body was preoccupied with re-growing the bulk of his liver, which took about two months.<\/p>\n<p>Edil, himself a surgeon with rare laparoscopic expertise and one of few in the United States capable of doing a laparoscopic Whipple procedure for pancreatic cancer patients, called the surgery, \u201cone of the toughest liver operations to be done laparoscopically. It\u2019s a huge feat for our program and our hospital.\u201d<\/p>\n<p>Littrell\u2019s cancer care continues under Messersmith\u2019s watch, in the form of follow-on chemotherapy to take out remnant cancer cells no surgeon can see. Both are hopeful that the term \u201ccure\u201d will indeed apply.<\/p>\n<p>In addition to Gleisner\u2019s surgical skills, Littrell said he appreciates how invested she was in his well-being.<\/p>\n<p>\u201cShe\u2019s just so caring and really took the time to engage with me on how I was feeling,\u201d he said. \u201cShe was really great, and I think she\u2019s a wonderful person.\u201d<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>&nbsp; That Ken Littrell\u2019s six-hour surgery to remove more than half his liver was done via a minimally invasive laparoscopic procedure is a remarkable thing. The fortitude it took the UCHealth University of Colorado Hospital\u00a0surgeon to attain the skills to pull off such a feat makes it more amazing yet. Littrell, 59, had already noted [&hellip;]<\/p>\n","protected":false},"author":23,"featured_media":10581,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[5],"tags":[28,702,9179],"class_list":["post-10579","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-innovative-care","tag-cancer-care-oncology","tag-surgical-care","tag-urologic-cancer-treatment-2"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.7 (Yoast SEO v27.7) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Cancer surgery through \u201ckeyholes\u201d came after a very long road - UCHealth Today<\/title>\n<meta name=\"description\" content=\"&nbsp; That Ken Littrell\u2019s six-hour surgery to remove more than half his liver was done via a minimally invasive laparoscopic procedure is a remarkable thing. The fortitude it took the UCHealth University of Colorado Hospital\u00a0surgeon to attain the skills to pull off such a fea...\" \/>\n<meta name=\"robots\" content=\"noindex, follow\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Cancer surgery through \u201ckeyholes\u201d came after a very long road\" \/>\n<meta property=\"og:description\" content=\"&nbsp; That Ken Littrell\u2019s six-hour surgery to remove more than half his liver was done via a minimally invasive laparoscopic procedure is a remarkable thing. The fortitude it took the UCHealth University of Colorado Hospital\u00a0surgeon to attain the skills to pull off such a feat makes it more amazing yet. 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