Kochi: Robotic technology can play a significant role in reducing the morbidity of head and neck surgery. However robots cannot be used for cancer below the voice box because the robotic arms cannot reach below it. Doctors at VPS Lakeshore hospital, Kochi have come up with a new surgical method to solve this problem.
Endo robotic surgery is the name of the procedure in which the lower part of the head and neck cancer reaching the food pipe is removed using a combination of endoscopic surgery and robotic surgery.
A 75-year-old woman from Palakkad had cancer in the beginning of the food pipe (post-cricoid region). Initially, she took radiation treatment for this, but the cancer did not respond. Subsequently, a comprehensive examination revealed no signs of the disease elsewhere in the body.
Typically, surgical removal of the voice box and food pipe is the course of action in this condition, followed by the reconstruction of the food passage using tissue from other parts of the body. This surgery is known to be highly morbid and causes significant challenges for the patient, including the loss of the natural ability to speak and eat.
The present procedure provides a new solution to this problem. The part of the cancer that the robot couldn't reach within the food pipe was incised using a gastro endoscope, while the upper part was approached from the oral cavity using robotic surgery. The whole cancer affected area was thus removed en bloc and intra operative pathology reports were used to confirm the completeness of cancer removal.
Post-surgery, the defect of surgery was reconstructed using tissue from the inner part of the cheek with the help of the robot. This is also a novel approach to reconstruction of such defects.
The patient is currently recovering, having regained the ability to talk and drink water. Doctors are optimistic that with some more days of rehabilitation, the patient will be able to eat more comfortably.
Doctors suggest that endo-robotic surgery can emerge as a promising solution for patients with similar conditions.