KVNO News

Friday Faculty Focus: Estelle Chang

By Brandon McDermott, KVNO News

August 23rd, 2017

Estelle Chang poses for a photo. (Courtesy UNMC)

It’s time again for Friday Faculty Focus. This week, KVNO reporter Brandon McDermott speaks with otolaryngologist Dr. Estelle Chang, from The University of Nebraska Medical Center.

Brandon McDermott: Dr. Estelle Chang, thanks for coming on the show.

Dr. Estelle Chang: Thank you for having me; it’s a pleasure to be here.

McDermott: What made you choose to do the fellowship in robotic head, neck and thyroid surgery?

Dr. Chang: So my main focus — my main aspect of interest in my career is thyroid — I came across robotic thyroid surgery when I was studying for my Master’s degree and I immediately became very attracted to the concept.

So, I started doing more research on it on my own and reviewing the literature and noticed that the procedure was invented by a South Korean surgeon Dr. Chung who’s the leading surgeon in robotic surgery and also the pioneer in the field and also runs Yonsei Severance Hospital and has performed the most number of cases in the world and when I got recruited to UNMC I talked to my chairman Dr. Dwight Jones and explained to him about this interest of mine and asked whether he would be supportive of me going to South Korea to receive this training.

Both Dr. Jones and this institution, the leadership are quite forefront in their way of thinking and thought that it would be an excellent addition in terms of skill set for the institution, so they had to support me to go for six months for this training.

McDermott: You talked a bit about this robotic thyroid surgery procedure. Who really who fits the bill who would be an ideal candidate for this type of surgery?

Dr. Chang: So, there are a few factors that make me recommend robotic surgery. First of all, it’s really any patient above the age of 12 who wishes to avoid the scar — a visible scar. Having said that, in South Korea they do offer this robotic surgery in children less than 12 years old, but I don’t think at this point currently when I’m trying to develop my practice — here in Omaha where it’s a new technique nobody has ever done the robotic very surgery until I perform the very first one in the Midwest — so it’s important for me that I am very cautious in the beginning in terms of patient selection, to really show the institution and to our community that it is a safe surgery.

So for those reasons I do make the cut off at 12 and also in terms of other aspects of things I was able to learn three different approaches — and not to bore the audience with details of it — but given different approaches I was able to learn it also allowed me to expand the patient criteria, because each approach has a different unique set of advantages. Also, (with) the tumor characteristics, currently I do not offer robotics to patients with metastases or invasion into the local surrounding structures, but what I generally tell patients is that given the fact that I do not only do robotics, or other remote access thyroid surgery but I also do specialize in open thyroid surgery which is the conventional way of removing the thyroid gland.

Anyone who is interested in that procedure is more than welcome to come to my clinic, where after I review the imaging and review the history and other tests that have been performed, I have an honest discussion with the patient and based on his or her physical characteristics, I may recommend one or two approaches among the three and I also go over — in detail — the risk profile for each approach which is a little bit different — to make sure that the patient really understands the full picture — and then take it from there on. I do tend to have in my general practice overall I do weigh considerably the patients desire and wishes — which are very important to me.

McDermott: Dr. Estelle Chang, thanks again for coming on the show.

Dr. Chang: Thank you so much for having me.

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