Michael S. Mulligan, MD

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Dr. Michael Mulligan: Thoracic Surgery with Heart

Life’s direction sometimes changes suddenly, pointing us towards a new, as-yet-unknown destination. That’s what happened to Dr. Michael Mulligan. A competitive athlete for years, Mulligan’s college athletic career ended after a series of injuries. At first, he wasn’t sure where to channel the drive that had helped him excel at sports. Then his family doctor pointed him toward medicine, and Mulligan hasn’t looked back.

Passion for his patients

As an undergraduate at Tufts University, Mulligan explored his interest in health and wellness, staying physically active and studying nutrition, philosophy and exercise physiology. He even wrote a thesis on the evolving role of holistic medicine in a world of rapidly advancing technology. On a visit home during summer break, his family physician encouraged him to pursue a conventional medicine degree.

“If you really want to make a difference, get an M.D. and bring that holistic sensibility to it,” Mulligan recalls the doctor saying. He took the advice and started medical school at the University of Connecticut on the path to becoming a general practitioner. Quickly, professors and mentors steered him toward surgery and then toward thoracic surgery in particular.

If his level of passion for his work is any indication, the choice seems to have been perfect. “You have to be passionate about what you do. You can be good at it, but if you aren’t passionate about it,” says Mulligan, you can’t bring the same level of care to your patients.

Mulligan, a leader in cardiothoracic surgery, has performed hundreds of lung transplants and thousands of other thoracic surgeries at University of Washington Medical Center (UWMC), a parent organization of Seattle Cancer Care Alliance. He's also the Director of Minimally Invasive Thoracic Surgery and regularly performs and teaches video-assisted thoracic surgery (VATS).

An evolved approach

VATS allows doctors to perform chest surgery through a series of small incisions. A camera inserted through one incision guides their work. The procedure is much less invasive than traditional open-chest surgery, which requires cutting through or spreading open the rib cage and cutting extensively through muscle. People who undergo VATS spend less time in the hospital, need less pain medication and recover much faster.

VATS anatomic lung resections are available at only about 30 centers in the country, including UWMC.

In a routine lung resection, surgeons usually follow a standard sequence of steps to hone in on the target area and cut it out, explains Mulligan. Some are more rigid about following these steps. With his extensive lung transplant experience, Mulligan felt comfortable beginning to deviate from the sequence years ago in the interest of preserving his patients’ tissue.

“I started using smaller and smaller incisions because of a heightened awareness of where things are in three dimensions,” he says.

For instance, after making a traditional skin incision, Mulligan would shift muscles out of the way, rather than cutting clean through them. Knowing he’d need to place drainage tubes in the chest at the end of the surgery, he performed surgery through the small drainage incisions from the outset when he could.

“Why wouldn’t we do on our patients what we would want on ourselves?” Mulligan asks. “We don’t just want to help patients survive, we want them to live and enjoy as much physical capacity as possible. For some, who enjoy athletics or just being active, one has to try to preserve muscular and skeletal integrity.”

 

Success from the start

In June 2005, Mulligan traveled to Cedars-Sinai Hospital in Beverly Hills to observe Dr. Robert McKenna. McKenna is one of the first doctors in the United States to use VATS to do anatomic resections. He typically spends a year or so training doctors in the technique, says Mulligan. But because Mulligan had progressed so far toward minimally invasive techniques on his own, their work together took only four days.

“Mike Mulligan is extremely smart and humble at the same time– it’s amazing!” says Lois Wedlock, a representative for U.S. Surgical, a company that makes laparoscopic and endoscopic surgical instruments used in VATS.

“I think he’ll be able to really help with the advancement of this procedure on a national level,” says Wedlock. “I think he’s probably going to be one of the top 10 or top 20 surgeons in the country, and that’s huge.”

It’s exciting, she says, to work with a doctor so willing to learn and embrace a new procedure with the potential to improve patients’ experience so much.

Outside the operating room

Besides performing surgery and directing the UWMC Lung Transplant Program, Mulligan is an associate professor in cardiothoracic surgery at UW. He has earned numerous teaching and research awards, belongs to a variety of professional associations for thoracic surgeons, and is among the youngest members ever elected to the American Surgical Association.

After earning his medical degree, Mulligan completed a general surgery residency at Columbia-Presbyterian Medical Center in New York City. He also completed two years of postdoctoral research training in lung immunobiology at the University of Michigan, as well as fellowships in heart and lung transplantation, cardiothoracic surgery and general thoracic surgery. Currently his research at UW focuses on acute and chronic rejection and tissue injury associated with lung transplantation.

When he’s not operating, teaching, researching, or training for waterskiing competition, Mulligan cares for his two sons, with his wife Lisa Mulligan, M.D., who has a private practice in Renton and Issaquah in ear, nose, and throat surgery.

Read the stories of these SCCA patients who have had VATS performed by Mulligan:

* Warren Bailey, who has leiomyosarcoma.
* Diana Rogers, who has lung cancer.

 

Learn about VATS in this KING 5 TV Special.