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Surgeon offers new approach page 2
Now at Mary Washington Hospital: lung surgery through small incisions

 A CT scan of a Anita Froggatt's lung shows a mass in the upper lobe of her right lung (left).
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Date published: 9/30/2007

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While Ivory worked, the others--Connie Ramirez, Judy Bowmar, Rebecca Coons and Maureen Brennan--prepared Froggatt.

They positioned her on her left side on a bean bag and stuffed pillows around her to hold her in place. They wrapped her in a warming blanket and sterile drapes.

On her side, where Sherwood would make his incisions, they applied a plastic wrap, soaked in iodine, to fight infection.

Sherwood made the first incision at 8:30 a.m., just beneath her right armpit. One cut was an inch long. The others were smaller, so small that when he placed the tip of his finger in one, it fit snugly.

The journey within

The holes were portals to Froggatt's inner chest. Into them Sherwood slid cutters, clamps, prods and grabbers. At one point, Froggatt had five tools sticking from her chest.

A thin silver rod that glowed at the end was the most important. This was the camera.

"A little more to the right, please," Sherwood said to Ramirez, his assistant, who stood across the table, directing the camera.

Sometimes Sherwood leaned over Froggatt and peered into the largest of the holes. More often he watched a monitor in front of him.

The monitor displayed a landscape of pinks and reds, folded tissues with ribbons of blood and air.

Sherwood pushed deeper through this maze to a point 7 inches below the surface of the skin. He poked, prodded and peeled, dissecting into the fissures between the lobes.

"Turn the Bovie down to 20-20, please," he said.

"20-20," Brennan replied.

The Bovie was Sherwood's "scalpel," an electric wand that burned and sealed whatever it touched. When he used it, a veil of smoke temporarily obscured the camera.

When Sherwood reached the upper lobe, the color changed from healthy pink to something more ominous.

"There it is," he said.

Isolate the vessels

The spot that looked white on Froggatt's CT scan was actually a mix of brown and black. When Sherwood touched it with a probe, it was dense and firm.

The lobe would have to come out, but before Sherwood could remove it he had to isolate it from the rest of the lung and the adjacent heart.

First he found the pulmonary vein, purple and blue, and inserted it into the mouth of his stapler.

"A moment of trepidation," he said.


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The Fredericksburg area's medical community has grown in recent months with the addition of Dr. Timothy Sherwood, a thoracic surgeon, and a host of other specialists and sub-specialists. Among them are:

Drs. Maha Alattar, Sandra Crouse and Amandeep Sangha arrived this summer to serve as inpatient and outpatient neurologists at Mary Washington Hospital. Alattar is also a sleep specialist. She completed a fellowship in sleep disorders at The Cleveland Clinic.

Drs. Brian Mirza and Victor Stelmack arrived this summer to do bariatric, or weight-loss, surgery. Mirza also completed fellowship training at The Cleveland Clinic in minimally invasive surgical procedures.

Drs. Reshma Parab, Leslie Taguba and Francisco Cruz arrived in March to begin an inpatient and outpatient endocrinology practice at the hospital.

Dr. Kay Blanchard arrives this week from Houston to work as the area's first female general surgeon and the first female surgeon to specialize in breast cancer.

Also new are Dr. Rod Flynn, a surgical oncologist; Dr. Avnit Ahuta, a rheumatologist; and Dr. Lawrence Roberts, a trauma surgeon and medical director of the hospital's new trauma service.

--Jim Hall