A Teenager's Landmark Robotic Rescue

Jonathan Muniz was registering for an accelerated high school program last summer when he doubled over, gasping for air. “I couldn’t get a breath in or out,” said the 16-year-old Coconut Creek resident.

Elizabeth Muniz rushed her son to his pediatrician, who sent them straight to the hospital. “He could barely hear any breath from the right lung,” Ms. Muniz said.

After diagnostic tests at Broward General Medical Center, Jonathan was airlifted to Miami Children’s Hospital with a breathing tube in place. The diagnosis: a large cancerous mass in his right lung, which had collapsed. “My heart dropped,” his mother said. “He’s just a kid. Kids don’t get lung cancer. It was really, really scary.”

The rare carcinoid tumor, especially unusual in children, needed to be removed to save Jonathan’s life. But it was located in a very tricky area and normally would require a large surgical incision to remove it. His doctors recommended a minimally invasive, robot-assisted approach to reduce the complications, pain and prolonged recovery typical of traditional open chest surgery. However, no surgeons at Miami Children’s had the expertise and experience to perform this procedure.

“They said it was a very high-tech, high-risk operation and they were going to try to look for the best surgeon,” Ms. Muniz said. “They told us we might have to travel out of the state. I said, ‘We’ll go wherever we have to go.’ ”

In the end, they only had to travel a few miles, to the Center for Robotic Surgery at South Miami Hospital, to find an international pioneer in robot-assisted chest surgery. The Muniz family was referred to Mark Dylewski, M.D., Baptist Health’s director of thoracic robotic surgery, after a Miami Children’s doctor sought advice from a New York specialist who, it turned out, had been trained by Dr. Dylewski. “The doctors were very excited. They said, ‘This is the surgeon who writes the books on these types of surgeries,’ ” Ms. Muniz said.

Within a few days, Jonathan was transferred to South Miami Hospital, where Dr. Dylewski performed what is believed to be the first fully robotic lung cancer surgery of its type in the world. The Broward teenager was both his youngest robotic surgery patient and youngest lung cancer patient. “It’s a challenge to do through an open approach and even more challenging through a robotic approach,” Dr. Dylewski said.

On June 19, Dr. Dylewski successfully removed Jonathan’s “huge” tumor, which involved the upper lobe and main bronchus, using four eight-millimeter incisions to create a port to hold the robotic arms. To perform the surgery, Dr. Dylewski sat at a console, looking at a magni ed internal view of the chest, and used his hands to control the robotic arms. “We were able to spare two-thirds of his right lung,” Dr. Dylewski said. “If his entire right lung had been removed, he wouldn’t be able to run or play sports.”

Jonathan awoke able to breathe on his own for the first time in over a week. All the tubes were gone. “I couldn’t believe it,” his mother said. “He had no pain medication, no nothing. It was amazing.”

The high school junior needs no further treatment, and there’s a 95 percent chance that the cancer is gone for good.

“It’s extremely rare but very curable,” Dr. Dylewski said. Within weeks, Jonathan was playing the saxophone again. “I feel fine,” he said. And the hospital experience wasn’t bad, either: “I pretty much slept through the whole thing.”

Just weeks after a robot-assisted procedure got him breathing again, Jonathan Muniz was back playing his sax.

Tags: health & technology, surviving cancer