With a goal to make recovery from head and neck cancer surgeries quicker, Baptist MD Anderson Cancer Center in Jacksonville has added a single-port robotic surgical system to help remove head and neck cancers.
The system adds to its toolkit of robot-assisted surgeries for prostate, abdominal, colorectal, lung, thoracic, cardiovascular, gynecological and other malignancies, says Dr. Ron Landmann, chief of colon and rectal surgical oncology at Baptist MD Anderson.
Surgeons at the hospital perform about 800 robotic surgeries annually.
Head and neck cancers, which can affect a variety of areas such as the lips, mouth, nasal cavity, throat and larynx, are increasing across the nation. An estimated 60% to 70% of oropharyngeal cancers (affecting the back of the throat and the base of the tongue and tonsils) are associated with human papillomavirus (HPV), according to the CDC. This type of cancer affects younger patients as well.
Traditionally, surgeons used open approaches that involving slicing the lip and jaw to access the areas affected by cancer, says Dr. Faisal Ahmad, section chief of head and neck surgical oncology at Baptist MD Anderson. Radiation therapy also can be used, but that can have longer term side effects, like dry mouth.
Head and neck surgeons guide robotic surgery through the mouth. The robot has three arms with a flexible camera and surgical instruments, and the surgeon can direct the robot’s movements.
“What the robotic platform does is allow us to get access to areas in the back of the throat that we normally would have trouble getting access to and take out these cancers with a minimally invasive approach,” Ahmad says.
This leads to a surgery time cut in half — about three hours instead of six to seven hours — along with a shorter hospitalization. Patients also avoid the need for a feeding tube immediately after surgery.
Up to 40% of patients with head and neck cancer qualify for robotic surgery, Ahmad estimates. Those who are not good candidates may not qualify due to their age, the use of blood thinners, or having a larger tumor, or tumor location, he explains. In those cases, radiation is often used.
“The goal is tailoring the treatment approach to what is going to work best for the patient long-term,” he says.
Many surgeons at Baptist MD Anderson are immersed in robotic surgery, such as Dr. Subrato J. Deb, a thoracic surgeon. Deb says that he uses robotic surgery with the majority of his patients. Even when a patient may have limiting factors like cancer stage, there still is a chance they can make robotic surgery work.
“As the technology advances and as surgeons gain more experience, that small niche of patients that may not qualify is becoming smaller,” he explains.
Improved visualization and the use of AI to fine-tune surgery will assist robotic cancer surgery moving forward, Landmann believes.