University of Rochester Expands Robotic Surgeries to Oral, Pharyngeal Cancers
URMC physicians were first in upstate New York to incorporate the precision and dexterity of a surgical robot to remove cancerous tumors in the mouth and throat.
This procedure expands the Medical Center’s robot-assisted surgery capabilities to include procedures for head and neck, urologic and gynecologic conditions.
“Traditional approaches to these tumors have the potential to be invasive and disfiguring, oftentimes leading to an extensive recovery and rehabilitation period,” said Miller, a fellowship-trained head and neck cancer surgeon. “The robot allows us to limit or even eliminate some of the side effects associated with more invasive surgeries while still effectively treating the cancer."
Traditional surgery for some head and neck cancers requires large incisions – extending from the lip, across the chin and to the neck before entering the mouth or throat. Often, surgeons need to cut through the lower jaw and move aside vital cranial nerves to gain access to the back of the mouth and throat.
Strong Memorial Hospital’s daVinci Surgical Systems consist of robotic arms that replicate a surgeon’s motions in real time. The surgeon works from a console, across the room from the patient. Using the high-precision system, surgeons insert the slender instruments into the mouth to reach the base of the tongue, tonsils, oropharynx and throat.
Benefits for people with head and neck cancers are dramatic because surgeries can be done without incisions and offer faster recovery time and a reduced risk of infection or other complications. The jaw is left intact and the cranial nerves are avoided.
“Unfortunately, therapies for head and neck cancers haven’t offered any significant increase in survival over the past several decades. Yet, our ability to improve our treatments – through surgical advances such as robotics, targeted radiation therapy and better chemotherapies – has had a dramatic impact on the quality of our patients’ lives,” said Miller.
George Maines of North Greece didn’t expect a cancer diagnosis when he pointed out a lump on his neck to his doctor. He’d noticed it when he was shaving, but ignored it, figuring that it would go away on its own.
Testing showed a two-inch tumor in a lymph node and doctors suspected it had spread from someplace else. Further investigation showed a tumor on the base of his tongue, the primary source of the cancer.
The Wilmot Cancer Center’s multidisciplinary head and neck cancer team, which includes otolaryngologists, oncologists, radiation oncologists, speech pathologists, nurses and other support staff, reviewed Maines’ scans and test results and determined that surgery followed by radiation therapy would be the best way to treat the disease. In February 2010, Miller removed the tumor from Maines’ tongue using the robotic system and then made a small incision on his neck to remove the cancerous lymph nodes.
The volume of robotic surgeries has risen dramatically in the past decade, as demand for the minimally invasive approach increases and surgeons grow more comfortable with the technology.
URMC has three surgical robots, two at Strong Memorial Hospital and one at Highland Hospital. In 2003, Strong introduced the daVinci Surgical System to the region; since then, surgeons have performed more than 2,500 procedures for urologic and gynecologic conditions.
URMC’s Center for Robotic Surgery and Innovation was created to expand the use of robotic technology at Strong and research into its use. The center will also provide hands-on education for doctors who want to specialize in robot-assisted surgeries and use techniques honed by URMC surgeons.
“As the medical community embraces robotic-assisted surgery, our researchers, nurses, and surgeons will continue to lead this field,” said Jean V. Joseph, M.D., urology surgeon and director of the Center. “This will offer our patients significant benefits because the quality and experience of our surgeons will surpass all others. We are at the forefront of this field.”
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