Another area of interest is developing new tests that could predict if a particular benign cyst might turn malignant, and which patient with chronic pancreatitis will develop more severe complications.
Visser also is one of a small handful of surgeons in the United States skilled in pancreatic laparoscopy, a minimally invasive surgical approach that avoids large, slow-to-heal incisions. He chose the specialty in part because of the challenge. "When I was a trainee," he said, "the pancreas was the jewel in the crown of surgery cases." Now, after more than 200 pancreatic laparoscopies, Visser is still on high alert. "Every case is its own challenge and every case has to be as perfect as a human can make it," he said.
Visser told Moynihan that her cyst was in the tail of the pancreas, on the left side, near the spleen. Deeper analysis of cells in the cyst revealed that they were certainly pre-cancerous. She could have chosen to wait, in that state called watchful observation, but did not want to live with the anxiety that comes from wondering when and if something has changed. She wasn't eager for any uncertainty, or being tested once or twice a year for years. Even if diagnosed at its earliest stages, pancreatic cancer is among the most lethal forms of cancer. Moynihan did not want to worry about what might be going on between tests. And she had complete confidence in Visser. "I was very comfortable with him, very impressed," she said.
Quick return to health
Visser’s laparoscopic approach meant Moynihan was home in a couple of days, going up and down her stairs on her first day home. The lesion was gone, and she had had less internal alteration to a neighboring organ than had been expected: Traditionally, because the blood vessels of the spleen are immediately adjacent to the pancreas, physicians have removed the spleen in such surgeries. But when allowed by the specific location of the cyst and the patient’s anatomy, Visser leaves the spleen to reduce trauma to the body. He was able to do that with Moynihan.
"I never felt bad and had any pain after the surgery," she said, and she has taken back the regular rhythm of her life. She’s a docent at the National Trust for Historic Preservation’s Filoli Gardens in Woodside, leading tours through its expansive acreage. She meets friends for outings and bridge games. She also delights in being an active grandmother of two little boys.
"She's had no troubles at all with the function of her pancreas," Park said. "She hasn't missed a beat."
As do many when they hear that a friend is having pancreatic problems, some of Moynihan's friends had been fearful for her. She's been happy to prove their fears unfounded. "I've done really well," she said, "and I'm enjoying my life!"