The day of Joan Cranmore’s preoperative visit with her gallbladder surgeon, Andrew Parsons, MD, she brought her sister June Bryan with her to the appointment.
Soon after the two arrived, Dr. Parsons, chief of surgery at Spectrum Health Pennock Surgical Services, stepped into the exam room to greet his patient—and did a double take.
“I walked in the room and I looked at them like—wait a minute, what’s going on here?” the doctor said, laughing. “It took me a minute, I will admit.”
Cranmore and Bryan—Joan and June—aren’t just sisters. They’re identical twins.
And Cranmore wasn’t the only one with gallbladder trouble. Just four months earlier, her twin sister underwent the very same outpatient surgery she was about to have. With the same doctor. Using the same robotic surgical system.
Dr. Parsons quickly got up to speed—“Oh, now I get it!”—and jumped into a conversation with the 68-year-old pair. (The two just attended their 50th high school class reunion and found that even today their classmates can’t tell them apart.)
Bryan explained that her January gallbladder removal had gone so well—“just one little incision in my navel”—that her sister decided to drive from her home in Lake City, Michigan, nearly three hours away, to have Dr. Parsons perform the operation she also needed.
“June had such a great outcome with Dr. Parsons that I thought, why not come down here,” Cranmore said.
Plus, the sisters have a soft spot for this place.
“We were born at Pennock, our kids were born at Pennock”— and a few grandchildren, too, Bryan said. “We love Pennock Hospital.”
When Cranmore’s surgery day came, in mid-May, things went even better than she had expected.
“It was so much easier and so much less pain than I was anticipating,” she said. “Even that first day I had no trouble getting out of a chair or anything. … I’d have done it a long time ago if I’d realized it was gonna be that easy, really.”
“Easy peasy,” Bryan agreed.
Three days post-surgery, Cranmore was ready to leave her sister’s home outside of Hastings, Michigan, and drive herself back up north.
“She’s pretty much done everything herself,” Bryan said. “She’s just been here with me, and I enjoy the company because I’m a widow, but she’s taking care of herself.”
No argument from Cranmore: “I feel great,” she said. “Robotic is the way to go, my goodness.”
When Bryan was referred to Dr. Parsons for her gallbladder issues—intermittent pain and discomfort in her upper abdomen—she expected him to recommend laparoscopic surgery. And though this was one of the options she could choose, the surgeon also told her about robot-assisted surgery.
“I never knew that we could get robotic surgery at Pennock,” Bryan said. “Who knew?”
Dr. Parsons is one of a handful of surgeons at Pennock Hospital with the credentials to use the da Vinci Surgical System, introduced at the hospital in 2014. Patients are fans of the system because they like having a single incision and a nearly invisible scar, he said.
“And then from my perspective as an operating surgeon, working on the robot is a lot easier physically,” Dr. Parsons said. “You’re in a much better ergonomic position.”
He’s quick to caution that the risks to patients are the same for laparoscopic and robot-assisted surgeries. Studies say that recovery times are also the same, though in his experience the scale tips in favor of robotic surgery.
“My experience with my patients has been that they seem to be returning to activity … a little bit faster (after robotic surgery),” he said. “When they come back in for their post-operative visits, they seem to be a little more energetic and ready to return to normal.”
Robotic and laparoscopic surgeries are both vast improvements over the traditional open surgery, which involves a large incision and longer recover times.
Surgeons today perform an open gallbladder surgery only when necessary, Dr. Parsons said—typically if they encounter complications while using a minimally invasive technique.
The robotic process
With a robotic system, the surgical process starts and ends just like a traditional surgery—at the bedside.
Before making the 3-centimeter incision in the belly button, Dr. Parsons gives a local anesthetic, which eases the pain after surgery. Once he’s made the incision, he inserts a silicone port through it and into the patient’s belly.
All surgical devices and instruments, including a 3D camera, pass through this silicone port. Once the doctor has the devices where he wants them, he rolls the robotic cart up to the table and attaches the robotic arms. Then, seated at the console a few feet away, he uses hand controls to move the instruments remotely.
The crux of the surgery is to detach the gallbladder from the liver. Once this is done, he puts the gallbladder in a grasper, begins removing the surgical tools and disconnects the robot. He’s left with the grasper, the gallbladder and the silicone port—which he pulls out all at once.
He then scrubs, puts on a fresh gown and gloves, and closes the incision.
The patient is moved to a recovery room and then a regular room. In Cranmore’s case, her sister said, “we were out of there by noon” on the day of the surgery.
Ties that bind
Family ties are strong for the sisters. When they were both raising their children, Cranmore lived down the road from the house where Bryan still lives. Now they spend a week together each summer on the shores of Lake Superior, something they love more than anything, Bryan said.
Once a month, on a Monday, they get together with their younger sister and their female cousins for food and crafting. Though Cranmore lives up north, she’s happy to make the drive to Hastings.
“Gotta see them grandbabies,” she said.
That’s why driving 150 miles for a surgery wasn’t a big deal for her. She’s used to the trip.
For Dr. Parsons, however, having a patient come from hours away is far from typical.
“It’s very unusual and, quite honestly, quite touching,” he said.
“We try really hard at smaller hospitals like this to make it a place people want to come, so that’s a great thing to have happen,” he said. “And I’m just happy that they did really well with the surgery and that they were happy with how it went.”