Robotically Assisted Head and Neck Cancer Surgery Lessens Facial Trauma, Reduces Healing Time
Cancers of the head and neck are delicate to remove because of their placement in the body. But with robotically assisted surgery, UAB doctors are able to remove some forms of head and neck cancers while sparing healthy tissue and limiting the number of side effects that accompany traditional surgery.
Surgical oncologists William Carroll, M.D. and Scott Magnuson, M.D., have spent the last several years treating head and neck cancers at UAB, but are now experts at removing head and neck cancers through minimally invasive, robotically assisted surgery through the da Vinci Surgical System.
For a long time, many head and neck cancers were removed through traditional surgery, which often required breaking the jaw bone and lip to get to the cancer, increasing pain and healing time. “To treat these tumors surgically, you had to open a lot of normal tissue,” Carroll says. Patients also endured the cosmetic impact of this surgery. Additionally, tumors could be removed endoscopically with lasers and a rigid scope, but the line of sight to the tumor and surrounding tissue was limited, making complete tumor removal difficult. Robotically assisted surgery allows surgeons to work through the natural opening of the mouth to remove the tumor completely.
With robotic surgery, surgical oncologists use the da Vinci computer platform to control the robotic arms of the machine. Every move of the machine is a move made by the surgeon, aided by miniaturized wristed instruments maneuvering in ways the human hand cannot. With the 3D, high-definition camera, they can view a magnified image of the tumor and surrounding tissue. The robotic arm translates every move of the hand, pairing a state-of-the-art robotic surgical machine with the best surgical oncology know-how.
“The robot is an extension of the minimally invasive approach,” Carroll says. “Our first priority is getting rid of the cancer. Our second is to have fewer side effects. For instance, tongue-base tumors had been treated with radiation and chemotherapy instead of surgery, because the surgery was very difficult for the patient. But the robot lets us take out tongue-based tumors and decreases the swallowing and airway problems that occurred with traditional surgery.”
Patients who have had tumors removed robotically may still need radiation therapy or chemotherapy after the surgery. The doses are lower however and the doctors believe the patients will have fewer symptoms of the treatment. They can eat, drink and speak, and their activity level is normal, unlike traditional head and neck cancer removal surgeries. “We feel like their function is better than the average patient who’s been through traditional chemotherapy or radiation,” Carroll says. “They generally feel better and more normal. They are happy with the results.”
Ideal candidates for robotically assisted surgery for head and neck cancers have an early stage primary tumor, have had no previous treatment and show easy access to the tumor through the mouth or throat. Not everyone’s anatomy will allow for robotic surgery, and some cancers, such as oropharynx cancers, are easier to remove robotically than others.
Carroll and Magnuson are optimistic about the future of robotically assisted surgery for head and neck cancer patients. “Right now we are limited with the number of cancers we can remove through robotically assisted surgery,” he says. “Robotic surgery represents a paradigm shift in the way we treat patients with head and neck cancers, and we’re glad to be a part of the process.”
Carroll says he hopes that the future of robotically assisted head and neck cancer surgery will include the ability to remove neck masses, thyroid glands and skull-based cancers. “As the technology changes, any area of head and neck surgery will be a targeted application for robotic surgery,” he says.
Surgical oncologists William Carroll, M.D. and Scott Magnuson, M.D., have spent the last several years treating head and neck cancers at UAB, but are now experts at removing head and neck cancers through minimally invasive, robotically assisted surgery through the da Vinci Surgical System.
For a long time, many head and neck cancers were removed through traditional surgery, which often required breaking the jaw bone and lip to get to the cancer, increasing pain and healing time. “To treat these tumors surgically, you had to open a lot of normal tissue,” Carroll says. Patients also endured the cosmetic impact of this surgery. Additionally, tumors could be removed endoscopically with lasers and a rigid scope, but the line of sight to the tumor and surrounding tissue was limited, making complete tumor removal difficult. Robotically assisted surgery allows surgeons to work through the natural opening of the mouth to remove the tumor completely.
With robotic surgery, surgical oncologists use the da Vinci computer platform to control the robotic arms of the machine. Every move of the machine is a move made by the surgeon, aided by miniaturized wristed instruments maneuvering in ways the human hand cannot. With the 3D, high-definition camera, they can view a magnified image of the tumor and surrounding tissue. The robotic arm translates every move of the hand, pairing a state-of-the-art robotic surgical machine with the best surgical oncology know-how.
“The robot is an extension of the minimally invasive approach,” Carroll says. “Our first priority is getting rid of the cancer. Our second is to have fewer side effects. For instance, tongue-base tumors had been treated with radiation and chemotherapy instead of surgery, because the surgery was very difficult for the patient. But the robot lets us take out tongue-based tumors and decreases the swallowing and airway problems that occurred with traditional surgery.”
Patients who have had tumors removed robotically may still need radiation therapy or chemotherapy after the surgery. The doses are lower however and the doctors believe the patients will have fewer symptoms of the treatment. They can eat, drink and speak, and their activity level is normal, unlike traditional head and neck cancer removal surgeries. “We feel like their function is better than the average patient who’s been through traditional chemotherapy or radiation,” Carroll says. “They generally feel better and more normal. They are happy with the results.”
Ideal candidates for robotically assisted surgery for head and neck cancers have an early stage primary tumor, have had no previous treatment and show easy access to the tumor through the mouth or throat. Not everyone’s anatomy will allow for robotic surgery, and some cancers, such as oropharynx cancers, are easier to remove robotically than others.
Carroll and Magnuson are optimistic about the future of robotically assisted surgery for head and neck cancer patients. “Right now we are limited with the number of cancers we can remove through robotically assisted surgery,” he says. “Robotic surgery represents a paradigm shift in the way we treat patients with head and neck cancers, and we’re glad to be a part of the process.”
Carroll says he hopes that the future of robotically assisted head and neck cancer surgery will include the ability to remove neck masses, thyroid glands and skull-based cancers. “As the technology changes, any area of head and neck surgery will be a targeted application for robotic surgery,” he says.
