Johnny Cleveland thought he was having a heart attack when he went to a community hospital, but medical imaging revealed something suspicious with his pancreas.
The retired educator from Red Bay, Alabama, then went to Birmingham for more testing where he was diagnosed with an intraductal papillary mucinous neoplasm — a cyst in the duct of his pancreas that put him at very high risk for pancreatic cancer. The duct had swollen to four times its normal size. Cleveland knew he needed complicated surgery, so researching his options, he learned about the Vanderbilt surgical team led by Kamran Idrees, MD, MSCI, MMHC, Ingram Associate Professor of Cancer Research.
Idrees, chief of the division of Surgical Oncology and Endocrine Surgery, specializes in difficult-to-perform procedures. His patients include those with pancreatic and other abdominal cancers, as well as premalignant conditions, who have been told their tumors are inoperable. Cleveland went to his initial appointment with Idrees expecting to hear about wide incisions, an extended hospitalization and a long recovery time.
Even though he had a total pancreatectomy — which in his case entailed removing his whole pancreas along with his gallbladder, spleen, duodenum, parts of the stomach and bile duct — Cleveland had only small incisions with no wide cuts. Idrees, working alongside Sekhar Padmanabhan, MD, assistant professor of Surgery, performed the pancreatectomy utilizing robotic technology. They then created two separate connections, one between the bile duct and small intestine, and a second connection between the stomach and the small intestine robotically.
Robotic surgery requires a highly skilled surgeon, who, from a console, uses a powerful camera to see inside the body and controls miniature surgical instruments that can be rotated in ways beyond the dexterity of the human hand.
“I had seven holes produced instead of being cut from side to side and split up and down,” Cleveland said. “My hospital stay was very minimal. It was five days instead of 10-14.”
Idrees has utilized robotic technology for pancreas surgeries since 2019 and has performed more than 100 procedures with colleagues. However, Cleveland was his first patient to undergo a total pancreatectomy utilizing robotic surgery.
Pancreatic surgeries are performed to address premalignant conditions and cancer.
“Robotic surgery offers the advantages of quicker recovery time, shorter length of stay, quick healing and less pain medication requirements,” Idrees said. “Then, if a cancer patient requires chemotherapy, the patient can get to it sooner because patients heal and recover faster.”
Robotic surgery reduces hospital stays from a week to as little as two to three days, he said.
The National Pancreas Foundation has recognized Vanderbilt University Medical Center (VUMC) as a Center of Excellence for both pancreatic cancer and pancreatitis. The designation comes after a rigorous audit to determine that an institution offers multidisciplinary treatment of pancreatic cancer and pancreatitis with a focus on the “whole patient” to provide the best possible outcomes and an improved quality of life.
VUMC is the only National Pancreas Foundation Center of Excellence in Tennessee, having first earned the pancreatic cancer designation in 2021 and the pancreatitis designation in 2022. VUMC received renewal as a Center of Excellence for Pancreatic Cancer with added recognition for being an academic institution with expertise in research and clinical trials.
Cleveland, who had his surgery on Feb. 23 age 64, said he was surprised that he was able to get an initial appointment with Idrees only five days after the request. He said he feels blessed to have had a good outcome and to have his wife, Martha, a retired nurse, at this side. He’s grateful that he no longer worries about the cyst becoming cancerous.
“Mr. Cleveland’s whole pancreas was involved,” Idrees said. “With him being healthy and no other health issues whatsoever, we expect him to live for several years to decades more.”
Cleveland has returned to doing the things he enjoys.
“I had a 70% chance that my condition would become pancreatic cancer at some point,” he said. “I basically had an open window to go in there and get it taken out while it was completely curative. I want to thank my wife, Martha, my son, Chase, grandson Jonathon, my niece Michelle and her husband Stephen for being there during my surgery.
“I also thank my friends, neighbors and the Red Bay community for all of the prayers raised up for me during my surgery and recovery. I’m glad I came to the right place and had the right doctors. Vanderbilt was absolutely the right place, and God is great!
“I’m nine weeks post-surgery now and feel great! I’m grateful God put me in the situation where this was detected early, gave me the strength and support to get through it and gave my doctors the knowledge to do the things that they did,” Cleveland said.
The Vanderbilt Pancreas Center offers a protocol that prioritizes time to treatment, second-opinion sessions, a multidisciplinary clinic, and a nurse navigator to personally assist patients. For more information about visit www.vanderbilthealth.com/program/pancreas-center or call 615-473-1930.
