Bob C Breathing Easy: Bob C

A team of doctors—and a robot—eradicate a man’s fungal lung infection.

Nearly every day, Bob Cannella meets with close to a dozen of his lifelong friends over breakfast. When the weather is nice, they sip coffee in a local park. When it turns colder, they head to a local bakery. It’s a tradition that goes back many years.

“We’re all between 70 and 90 years old,” says Cannella, 76, of Belleville. “I’m almost the youngest!”

Cannella’s morning routine got interrupted twice over the past three years. First, he survived a serious bout with COVID-19 in 2021. Then, last February, he developed a potentially deadly lung infection.

He had no idea the infection was growing inside his left lung until a winter storm hit that month. “I was out shoveling,” he says. “I came in, and I was breathing heavy. The next day, I was coughing up blood.”

Cannella headed to the Emergency Department at Clara Maass Medical Center (CMMC), where doctors found that he had a fungal infection in the lower portion of his left lung.

“Aspergillus is a type of fungus found naturally in the environment,” says Joanna Sesti, MD, Director of Thoracic Surgery at Cooperman Barnabas Medical Center (CBMC) and a member of RWJBarnabas Health Medical Group. “It doesn’t routinely cause infection, but sometimes it creates a cavity within the lung, called an aspergilloma, that’s resistant to antibiotics. If the infection is untreated, it can erode into blood vessels within the lung and result in life-threatening bleeding.”

While Cannella’s aspergilloma was benign, it caused critical health problems, including massive internal bleeding, which required immediate care. “Due to the complexity of his condition and the potential need for cardio-pulmonary bypass during surgery, he was transferred to CBMC,” says Dr. Sesti.

Once at CBMC, thoracic surgeon Adam Lackey, MD, placed a small balloon into the lower lobe bronchus (an airway connecting the lung to the trachea) where the bleeding was occurring in order to temporarily halt the bleeding. From there, interventional radiologists Daniel J. Garnet, MD, and Todd Markowitz, MD, worked to identify the source of bleeding by performing a minimally invasive angiogram. Once it was located, they completed an embolization procedure, which stopped the bleeding. This not only saved the patient’s life but also allowed his surgery to be performed on a non-emergent basis through a minimally invasive approach.

A few weeks later, after Cannella completed a course of antifungal medications to control the infection, Dr. Sesti performed a robotic lobectomy to remove Cannella’s aspergilloma through four tiny incisions using the da Vinci Xi robotic surgery system. She also performed a pedicled pericardial fat flap, carefully removing a thin section of tissue from near Cannella’s heart and transplanting it over the cut edge of the lung to help prevent future complications.

Cannella returned home a couple days after his surgery. His breathing, he says, is getting back to normal, and he’s back to his morning breakfast routine. “I couldn’t have asked for better care,” he says. “Everyone took the time to talk to me and explain what was happening. They’re all so good at what they do.”

Learn more about interventional radiology or surgical services at Cooperman Barnabas Medical Center.