Her next-best friend is a robot

Not surprisingly, Dargenzio was in no hurry to remove a benign growth discovered on her thyroid in 2007. Instead, she counted on a synthetic hormone to reduce the nodule on the butterfly-shaped gland, which straddles the windpipe at the bottom of the neck.

But by fall 2009, the mass had mushroomed to about an inch in diameter. Swallowing had become uncomfortable. She asked her community endocrinologist when she should start to consider surgery. “Now,” the physician responded.

Spooked by the telltale white scars she’d begun noticing on the throats of people wherever she went, Dargenzio seized on a friend’s mention of a UC Irvine specialist possibly using a surgical robot to remove the thyroid without cutting into the throat. Her endocrinologist hadn’t heard of the procedure, nor had the staff at a south Orange County surgery center to which Dargenzio had been referred.

The determined pediatric nurse surfed the Internet and discovered that, indeed, UC Irvine Healthcare head and neck surgeon Dr. Jason H. Kim had just trained with the South Korean physician who had pioneered the procedure. Kim soon would be first on the West Coast to perform a robotic thyroidectomy. Dargenzio immediately made an appointment with him.

“I was very opposed to having the neck scar,” she admits. “I’m not totally vain, but I am a little bit. Mostly, I just didn’t want everyone to know that I had thyroid problems.”
Nodules are common on the thyroid, which controls the body’s metabolism – more so in women than in men, for reasons not entirely understood. U.S. studies suggest that about 5 percent of people develop thyroid growths large enough to feel or detect by ultrasound.

Fewer than 5 percent of them turn out to be cancerous, and even those are highly treatable if caught early. But when benign nodules impede normal swallowing or breathing, one or both lobes of the thyroid may need to be surgically removed.

When Dargenzio, of Huntington Beach, met with Kim in late spring 2010, she brought a long list of questions, each of which the doctor answered patiently and thoroughly. “He told me about the whole procedure, what it entailed, the recovery, the risks, his training, where he went to college,” she recalls. “I felt like I would be a priority to him, that he had my best interests in mind.”

For a while, it appeared that Dargenzio would be Kim’s first robotic thyroidectomy patient. But when she checked into UC Irvine Douglas Hospital on the morning of July 8, she learned that another patient had beaten her to it. Relieved, Dargenzio was wheeled into the operating room and put under general anesthesia.

Deftly and methodically, Kim made a 6-inch incision under her right armpit and inserted three robotic arms through Dargenzio’s upper chest to the right lobe of the thyroid. A fourth arm entered through a 1-inch incision low on the front of her chest.

“It’s a very complicated procedure, but we were able to remove the lobe safely,” Kim says of the five-hour surgery. The irregularly shaped growth on the right lobe measured a little more than an inch long and two-thirds of an inch deep.

Dargenzio stayed in the hospital overnight but was released the next day with little pain – and no visible neck scar. She learned later that small patches of cancer cells had been found in the excised lobe. But Kim told her those findings were incidental. He says Dargenzio’s risk of developing cancer in the remaining lobe is extremely low. Nonetheless, he has her come in for checkups every three months.

Happy to be wearing V-neck tops without telegraphing her health history to the world, Dargenzio, 39, is confident about her prognosis – and her future. She recently became engaged to longtime boyfriend R.J. Smith.

“It’s hard to find a doctor you trust,” she says. “Dr. Kim has set the bar pretty high.”

Provided by University of California, Irvine