Her next-best friend is a robot

Robot-assisted thyroid surgery at UC Irvine Medical Center spares nurse from telltale throat scar

January 27, 2012
UC Irvine thyroid cancer survivor Shannon Dargenzio and her 230-pound English mastiff, Shera

Shannon Dargenzio knew well what thyroid surgery usually entailed. When her mother’s cancerous gland was removed in the 1990s, she endured an extremely painful recovery that required months off work and left her with a scar at the base of her throat.

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 at the base of the neck.

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

Spooked by the telltale white scar she’d begun noticing on the necks of women and men wherever she went, Dargenzio seized on a friend’s mention that a UC Irvine specialist may be using a surgical robot to remove the thyroid without the need to cut into the throat. Her endocrinologist hadn’t heard of the procedure. Nor had the staff at a south Orange County surgery center where Dargenzio had been referred. 

The determined pediatric nurse surfed the Internet and discovered that indeed UCI Health head and neck surgeon Dr. Jason Kim had just trained with the South Korean physician who had pioneered the procedure. Kim soon would be the first in California and the first on the West Coast to perform a robotic thyroidectomy. She immediately made an appointment. “I was very opposed to having the neck scar,” she admits. “I’m not totally vain, but a little bit. Mostly I didn’t want everyone to know that I had thyroid problems.”

Nodules are very 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 that are large enough to feel or are detectable by ultrasound. Fewer than 5 percent of these 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 the Huntington Beach woman met with Kim in late spring 2010, she brought a long list of questions, each of which he 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. I felt like I would be a priority to him, that he had my best interests in mind.”

For awhile, it appeared that Dargenzio would be Kim’s first robotic thyroidectomy patient. When she checked into UC Irvine Douglas Hospital on the morning of July 8, she learned that another thyroid patient had beaten her to it. Deftly and methodically, Kim made a six-centimeter incision under her right armpit and inserted three of the robotic arms through her upper chest area to the right lobe of her thyroid gland. A fourth arm entered through a one-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 her 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 following day with little pain—and no visible neck scar. She learned later that small patches of cancer cells were found in the lobe that was removed. But Kim told her those findings were incidental. He says her 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, the 39-year-old is confident about her prognosis—and her future. Dargenzio recently became engaged to marry longtime boyfriend R.J. Smith.

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