Alicia’s Patient Story
3D Imaging Contributes to Successful Robotic Kidney-Sparing Surgery During COVID-19
Iris technology allows urological surgeon to plan and perform high-risk tumor surgery for grandmother, age 67, with single kidney
Alicia Morris, age 67, of South Orange, New Jersey, is a married mother of five adult children and grandmother to a three-year-old grandson. She also is no stranger to kidney surgery.
After being diagnosed with kidney cancer in 2007, Alicia had a procedure called a radical nephrectomy to remove her entire right kidney. And although the traditional open surgery involved a large incision and a lengthy recovery, it rendered her cancer-free.
But 13 years later, in December 2019, Alicia began to experience severe abdominal pain and was diagnosed with enteritis, or inflammation of her small intestine. A CT scan taken to diagnose her condition revealed a density on her remaining left kidney, and a follow-up MRI showed a large cancerous tumor measuring 4 cm in diameter.
Looking for a Sign
Alicia’s kidney surgeon told her that she had three options — watch the tumor to see if it grows or spreads, have a procedure called cryoablation to destroy tumor tissue, or have surgery to remove the tumor while preserving the rest of her kidney.
“My doctor told me that my tumor was a tough one to remove because it was very deep,” said Alicia. “And, the fact that I only had one kidney made it a very high-risk procedure.”
Alicia’s doctor recommended that she seek a second opinion from the urological surgeon he trained under, Michael D. Stifelman, M.D., chair of Urology and director of Robotic Surgery at Hackensack Meridian Hackensack University Medical Center and professor and founding chair of Urology at Hackensack Meridian School of Medicine at Seton Hall University.
“I was told that Dr. Stifelman was one of the best kidney surgeons around, and he was the guy to see for really tough cases,” said Alicia.
So Alicia, who describes herself as a spiritual person, made an appointment with Dr. Stifelman and began praying for healing.
“As my husband and I were driving to my appointment, I prayed that I would receive a sign that would let me know if Dr. Stifelman was the right person to help me,” said Alicia.
And sure enough, Alicia received the sign she was seeking.
“Dr. Stifelman was sincere and encouraging while being personable, kind and professional,” said Alicia. “When I told Dr. Stifelman that I was from South Orange, he said that he also grew up in South Orange — and I thought, ‘This is the sign. I know I can trust this man’.”
Iris Surgical Technology
As a retired nurse, Alicia wanted to learn as much as possible about her condition and the procedure that Dr. Stifelman was planning for her. Dr. Stifelman told Alicia that he would perform a robotic partial nephrectomy, meaning that he would use a robotic surgical system to remove the cancerous portion of her kidney while sparing as much healthy kidney tissue as possible.
“Being a nurse, I like to be taught,” said Alicia. “And Dr. Stifelman was willing to teach.”
Dr. Stifelman explained that he would control the robotic surgical system — which includes four robotic arms with small surgical instruments and a camera that allows him to see inside Alicia’s body — from a console in the operating room. Since Alicia’s surgery would be performed using robotic technology, Dr. Stifelman said it would only require a few small incisions of about a half-inch in length — a welcome change from Alicia’s previous kidney surgery, which required a large incision.
And, Dr. Stifelman was able to show Alicia exactly how he planned to approach the procedure using an innovative 3D imaging tool called Iris.
Based on images of Alicia’s blood vessels obtained through magnetic resonance angiography (MRA), Dr. Stifelman used Iris to create a 3D imaging model of Alicia’s unique anatomy.
“Because Alicia only had one kidney, it was critical to see her tumor and her anatomy before the surgery to lower the risk that she would lose her kidney. We only have about 20 minutes to clamp the renal artery and perform the procedure, so Iris allowed me to visualize Alicia’s anatomical structures so I could plan my surgical approach before setting foot in the operating room,” said Dr. Stifelman. “During surgery, I could view Alicia’s Iris images through the Da Vinci Surgeon Console, which is a significant surgical advantage that promotes increased patient safety and improved outcomes — especially in a high-risk procedure like Alicia’s.”
“Years ago, surgeons had to open you up before they could see what was going on inside,” said Alicia. “I didn’t want to lose my kidney and be on dialysis for the rest of my life, so I felt reassured that Dr. Stifelman was able to use the 3D image to map my anatomy and plan my surgery ahead of time.”
Surgical Safety during COVID-19
Alicia’s appointment with Dr. Stifelman occurred as the COVID-19 pandemic hit northern New Jersey. With her surgery scheduled for April 1, Dr. Stifelman felt it would be best to postpone.
“Even though we postponed my surgery, I still had to go get lab work and my MRA test during COVID-19,” said Alicia. “However, I felt very safe and assured that everything would be OK.”
After waiting a few weeks, Dr. Stifelman believed that it was safe to go ahead with Alicia’s surgery. Because Alicia’s tumor was large, and he did not want to delay care any longer. So, Alicia’s procedure was rescheduled for May 6.
Two weeks before surgery, Alicia — who lives with her husband, son, and grandson — went into quarantine with her daughter, who lives in Jersey City, New Jersey.
And when the day of her surgery arrived, Alicia had a safe, successful procedure.
“It was a great surgery using great technology, and it was performed under very safe conditions,” said Dr. Stifelman. “We were able to remove the tumor and spare Alicia’s kidney, safely providing her with the treatment she needed, even during COVID-19.”
An Easier Recovery
After an overnight hospital stay, Alicia was discharged and returned to her daughter’s home in Jersey City to recover.
“I was in the hospital for four days after my first kidney surgery and came home in a lot of pain. The recovery was slow, and I was much more tired,” Alicia said. “This time, I stayed in the hospital one night, took one pain pill, and was up and walking within a few days.”
Alicia said she felt like herself about two weeks into her recovery, around the time when she had her post-op virtual visit.
“The recovery has been amazing,” Alicia said. “It’s almost like I didn’t have surgery.”
Alicia said she was very impressed by Dr. Stifelman and the entire Department of Urology team, who made her feel like someone from the office was with her during the entire experience.
“I am so grateful that Dr. Stifelman had the technology to remove the tumor and that I now have more time,” Alicia said. “I can’t wait to get back home and see my grandson, and I hope my story can help others who might be in a similar situation.”
Hackensack University Medical Center
Our urologists are fully accredited and highly trained. They are here to provide with the advanced care you need to achieve a good quality of life.
Meet Our Team
Hackensack University Medical Group
The urologists of Hackensack University Medical Group (HUMG) are a subgroup within the Department of Urology at Hackensack University Medical Center. This faculty practice forms the backbone of academics, research, and education for the Department of Urology.