Made in City of Hope: Pushing the limits of liver cancer surgery (w/VIDEO)

November 6, 2014 | by City of Hope

Cancer that spreads to the liver poses a significant threat to patients, and a great challenge to surgeons. The organ’s anatomical complexity and its maze of blood vessels make removal of tumors difficult, even for specialized liver cancer surgeons. Following chemotherapy, the livers of cancer patients are not optimally healthy. This compromises the power of the residual liver to compensate functionally, postsurgery, and to regenerate over time. Hence, saving as much of the liver as possible is key.


Dr. Gagandeep Singh Gagandeep Singh, clinical professor and chief of the Division of Surgical Oncology, devised a technique that incorporates tools normally used in laparoscopy and neurosurgery to remove  liver cancer tumors.


An innovator

Gagandeep Singh, M.D., has long pursued surgical techniques that would allow for successful removal of tumors. Over time, he devised a technique that incorporated tools normally used in laparoscopy and neurosurgery.

Using this technique in 2012, he operated on Susan Stringfellow, a patient in her 60s, whose colon cancer had metastasized to her liver. Removal of the tumors required resecting almost 75 percent of her liver. In the year following the surgery, the patient’s liver regenerated itself. Encouraged, Singh continued to use the technique, teaching it to his surgical oncology fellows at City of Hope. Close to 200 surgeries later, he had amassed data confirming that the technique reduced the need for blood transfusions and resulted in no biliary leaks.

A breakthrough idea

Inspired by his results, in 2013 he set out to design a high energy vessel- and tissue-sealing tool that combined the capabilities of the various tools he had used in surgery. Wanting to make the tool as accessible as possible, he envisioned something ergonomic, lightweight, easy to use and inexpensive.

A single tool, he reasoned, would shorten the time needed to perform such surgeries. And because of the technique’s success with the liver, he was certain that a tool based upon it could also be used on other challenging organs, including the stomach, colon, pancreas and uterus.

It could only happen here

As a specialized cancer treatment center, City of Hope had no shortage of patients who could benefit from such an advance in surgical technique. Singh was able to confirm over a relatively short period of time the advantages of his technique, and to make a case for a tool based on it.

In a different clinical setting, Singh might have lost valuable time navigating the patent process. But with the support and expertise of City of Hope’s Office of Technology Licensing, he was able to file two patents on his design.

Manufacturers and institutions rarely fund new devices. But in 2014, City of Hope awarded Singh a $575,000 grant to build a prototype of the tool.

Moving forward

The patents and the prototype for the tool are underway. Meanwhile, surgeons around the world can use Singh’s surgical technique to obtain better outcomes for people like Susan Stringfellow.


Read more articles from City of Hope's annual report.


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