Southeast Missouri Hospital Surgeons Use Robotic-Assisted Technology to Tackle a Physician's Complex Tumor

Martha Margreiter, MD, of Poplar Bluff Pediatric Associates, examines 3-year-old Charly Godwin. Dr. Margreiter underwent a minimally invasive procedure using Southeast Missouri Hospital's da Vinci Surgical System to remove a kidney tumor.

In summer 2007, Martha Margreiter, MD, of Poplar Bluff was riding in a boat when it violently struck a wave, causing her to fall and hit her side. When the pain in her abdomen didn't cease, she went to see a doctor and was told some news she wasn't expecting. Dr. Margreiter had a rare benign tumor growing on her kidney known as angiomyolipoma.

The good news was that it wasn't cancerous, but because of the boating accident, it was bleeding internally. To make matters even more complicated, the tumor was being fed by another blood vessel, which meant it would continue to grow unless doctors could block it. The tumor was already so large that it reached from her rib cage to her pelvic bone.

"I was in chronic pain," explains Dr. Margreiter. "Even though it was a benign tumor, I was afraid it would affect my kidney function and cause further complications."

She originally went to a hospital in St. Louis where doctors attempted to draw the blood supply away from the tumor by using a catheter. However, this provided only temporary relief and, after a couple of weeks, the chronic pain returned.

Dr. Margreiter, a physician at Poplar Bluff Pediatric Associates, says the pain was having a negative impact on both her professional and personal life.

"It's a physically demanding job working with children, so the constant pain and pressure I felt made it difficult to work," she says. "I couldn't be active with my own kids when I got home."

Finally, a medical school friend of Dr. Margreiter's, Jonathon K. Foley, MD, a surgeon on the medical staff at Southeast Missouri Hospital, referred her to Gregg S. Hallman,MD, a board-certified urologist who is also a Southeast medical staff member.

In November, four months after the initial accident, Dr. Margreiter received a second opinion from Dr. Hallman, who told her about a minimally invasive procedure using

Southeast Missouri Hospital's advanced da Vinci® Surgical System.

Southeast was the first community hospital in Missouri to invest in this robotic technology when fewer than 400 systems were installed nationwide. "The da Vinci Surgical System gives us better magnification and visualization of the surgery site, which is especially critical when

we're making small incisions and movements in tightly confined spaces," Dr. Hallman explains.

On Dec. 12, 2007, Dr. Hallman, assisted by his associate J. Russell Felker, M.D., performed the surgery on Dr. Margreiter using da Vinci. They cut off the vessel feeding the tumor, removed the tumor itself and left the rest of the kidney intact. "Using the robotic-assisted surgical system,we have precise control while performing procedures," Dr. Hallman says. "The end result is that we can isolate blood vessels and nerves and remove tumors even in the most confined spaces."

Two days after the surgery, Dr. Margreiter was able to go home and recuperate."I was wrapping Christmas presents by the following week," Dr. Margreiter says, who adds that she returned to work three weeks after surgery.

She continues to be thankful for the care she received at Southeast Missouri Hospital and for the procedure that only left a 2-centimeter scar near her navel. The same kind of surgery without da Vinci would have left a large scar that stretched across her abdomen.

"The care was exceptional--from check-in to surgical prep. I couldn't have asked for anything better," she says.

She and her husband, Dean Dye, MD, who also works as a physician at Poplar Bluff Pediatric Associates, have even purchased stock in Intuitive Surgical, the company that designs and builds the da Vinci Surgical System.

"That's how much I believe in this technology," she says. "Southeast Hospital and da Vinci have given so much to me, and I want to support them any way I can."