Oral Cancer Foundation. US: In a groundbreaking new study, UCLA researchers have for the first
time advanced a surgical technique performed with the help of a robot to
successfully access a previously-unreachable area of the head and neck.
This pioneering method can now be used safely and efficiently in
patients to remove tumors that many times were previously thought to be
inoperable, or necessitated the use of highly-invasive surgical
techniques in combination with chemotherapy or radiation therapy.
Developed by Dr. Abie Mendelsohn, UCLA Jonsson Comprehensive Cancer
Center member and director of head and neck robotic surgery at UCLA,
this new approach provides the surgical community with a leading-edge
technology roadmap to treat patients who had little or no hope of living
cancer-free lives.
“This is a revolutionary new approach that uses highly advanced
technology to reach the deepest areas of the head and neck,” said
Mendelsohn, lead author of the study. “Patients can now be treated in a
manner equivalent to that of a straightforward dental procedure and go
back to leading normal, healthy lives in a matter of days with few or
even no side effects.”
A New Approach to Saving Lives
The parapharyngeal space is pyramid-shaped area that lies near the base
of the human skull and connects several deep compartments of the head
and neck. It is lined with many large blood vessels, nerves and complex
facial muscles, making access to the space via traditional surgical
options often impossible or highly invasive.
Current surgical techniques can necessitate external incisions be
made to the patient’s neck, or the splitting of their jaw bone or areas
close to the voice box. Chemotherapy and radiation therapy are also
often required, further complicating recovery and potentially putting
patients at risk for serious (or even lethal) side effects.
Approved by the U.S. Food & Drug Administration in 2009, Trans
Oral Robotic Surgery (or TORS) utilizes the Da Vinci robotic surgical
system, the state-of-the-art technology that was developed at UCLA by
the specialized surgical program for the head and neck. TORS uses a
minimally invasive procedure in which a surgical robot, under the full
control of a specially trained physician, operates with a
three-dimensional, high-definition video camera and robotic arms.
These miniature “arms” can navigate through the small, tight and
delicate areas of the mouth without the need for external incisions. A
retraction system allows the surgeon to see the entire surgical area at
once. While working from an operating console just steps away from the
patient’s bed, every movement of the surgeon’s wrists and fingers are
transformed into movement of the surgical instruments.
Currently, Mendelsohn’s new procedure largely benefits patients with
tumors located in the throat near the tonsils and tongue, but it
continues to be adapted and expanded in scope and impact.
“We are tremendously excited about the possibilities for the surgical
community with this new advancement of TORS,” said Mendelsohn. “Now
patients have options they never had before, and we can even develop
potential applications for the procedure beyond the surface of the head
and neck.”
The study was published online ahead of print in the journal Head & Neck
David Alpern: One Patient’s Story
In 2012, David Alpern received devastating news. He was diagnosed with
throat cancer, and the treatment options given to him by his doctors
sound worse than the disease.
“They described a procedure where your face is split in half and it’s
basically reconstructive surgery. I was completely freaked out,” said
Alpern, a husband and father of two.
After careful examination and imaging by Dr. Abie Mendelsohn at UCLA,
the doctor determined David was a perfect candidate for TORS. The
husband and father of two was soon up and about in a matter of days
following the procedure. Like the over 100 similar TORS surgeries
performed with Dr. Mendelsohn at the controls, David’s tumor was removed
and he’s now completely cancer free.
“I try not to get too cocky or excited that I beat cancer, but I
think I did,” said David. “There are no side effects at this point. My
hopes are just to watch my kids grow up and enjoy my family and my
life.”
Source: UCLA’s Jonsson Comprehensive Cancer Center