Tulane Health System chief endocrine surgeon Dr. Emad Kandil recently performed the first-ever robotic thymectomy in the world that used a single incision under the armpit, a revolutionary technique that gave one young patient something to cheer about.

A few years ago, 14-year-old Alexis Resendez started complaining of a sore neck. Her mother, Brandi Resendez, thought it might be a pulled muscle from the extra work Alexis was putting into preparing for high school cheerleading tryouts. When Alexis’ pain continued to get worse, Brandi new something was wrong.

“Alexis started to lose weight because it hurt to swallow – at times she would even choke on water,” Brandi said. “She would tell me she was exhausted all the time, which was completely unlike her.”

A trip to the emergency room revealed a mass in Alexis' neck and chest near her thyroid gland, and she was referred to Dr. Kandil, a specialist in robotic endocrine surgery and a teaching faculty member at Tulane University School of Medicine.

“Alexis needed to have a tumor surgically removed from her thymus, a gland located in the base of the neck that produces T cells,” Dr. Kandil said. “Traditionally, surgeons have to split the breastbone to remove the thymus, requiring a long incision in the chest and leading to more recovery time for the patient. But here at Tulane, we perform the surgery through one tiny incision.”

Dr. Kandil is a pioneer in performing thyroidectomy and thymectomy using a robotic surgical system that provides a detailed 3-D magnified view of the anatomy around the glands, enabling him to perform precise surgery through a single incision. Using this minimally invasive approach, patients heal faster, and many are able to go home the same day. 

In Alexis' case, Kandil was able to use robotic thymectomy to remove the tumor from her thymus gland. He removed the mass through a hidden incision under the armpit.

“This is the first time that a robotic thymectomy was performed using a single hidden incision under the arm,” said Kandil. Other robotic thymectomies are performed through incisions through the chest between the ribs which can be painful and requires special care of the lungs during the surgery.

“Here we didn't go through the chest; we performed the operation through a single hidden incision in the armpit without any chest wall incisions resulting in lessening of symptoms, less risk of infection and faster recovery. The patient can be discharged after an overnight stay," said Kandil.

 “When Dr. Kandil came in that waiting area and told me he was able to remove the whole mass, I remember jumping up and hugging him," Brandi said. Alexis went home the following day, quickly showing signs of improvement. A month later, the teen was back to tumbling and, shortly after that, she tried out for the cheerleading squad.

She made the team.

"Alexis is like a whole different kid," Brandi said. "She is doing so well, she does not complain about pain, she has so much energy. Her cut under her arm is getting lighter and lighter, and it healed very well.

"I hope that every hospital will be able to get a robotic machine, but I know that Dr. Kandil is the best using the machine," she said. "He can't be at 10 hospitals at the same time, but if you are lucky enough to have him teach people how to accomplish what he did on my daughter, people will recover so quickly from surgery.”