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Robotic device appears useful for surgical removal of cancer involving the tonsils
December 18, 2007A new robotic surgery technique appears promising for the removal of cancer involving the tonsil region, according to a report in the December issue of Archives of Otolaryngology-Head & Neck Surgery, one of the JAMA/Archives journals.
Typically, surgeons trying to remove tonsils of patients with cancer through the mouth have limited access to the area, according to background information in the article. If the cancer has spread to any of the surrounding tissues, an open approach involving cutting through the skin is needed. These procedures take a long time, can cause long-term difficulty swallowing and usually require the placement of a tracheotomy tube.
Gregory S. Weinstein, M.D., and colleagues at the University of Pennsylvania, Philadelphia, evaluated the feasibility of a new surgical technique-transoral robotic surgery (TORS)-on 27 participants undergoing radical tonsillectomy for cancer between May 2005 and April 2007. The surgical system consists of a console, where the surgeon sits at a distance from the patient; a surgical cart; three instrument-holding arms and a central arm with an endoscope. This lighted optical instrument with two video cameras offers a three-dimensional view of the inside of the body. The surgical arms are controlled by the surgeon's movement of handles in the console. In TORS, the mouth is held open and incisions are made in the gums, soft palate, tongue and throat muscles to reach and remove the tonsils and any surrounding cancerous tissue.
"The surgeons successfully performed TORS in all cases," the authors write. "All robotic arms functioned optimally during the procedures, and no interference between robotic arms was noted." In 25 patients (93 percent), surgeons were able to remove all cancerous tissues. The average length of surgery was one hour and 43 minutes. Following the procedure, 26 out of the 27 patients were swallowing without the use of a stomach tube.
No deaths occurred, and although complications occurred in five of the 27 patients (19 percent), most were resolved without significant consequences. "The early complication rate is comparable to the rates reported for the alternative therapies of non-robotic transoral surgery, open surgical resection and concurrent chemoradiation treatments," the authors write. Complications-including death, pneumonia or fistula (an opening or passage in the skin or organs)-that are usually reported during these other types of procedures did not occur in the TORS patients.
"Radical tonsillectomy using TORS is a new technique that offers excellent access for resection of carcinomas of the tonsil with acceptable acute morbidity," or complications, they conclude. "Future reports will focus on long-term oncologic and functional outcomes."
JAMA and Archives Journals
"The surgeons successfully performed TORS in all cases," the authors write. "All robotic arms functioned optimally during the procedures, and no interference between robotic arms was noted." In 25 patients (93 percent), surgeons were able to remove all cancerous tissues. The average length of surgery was one hour and 43 minutes. Following the procedure, 26 out of the 27 patients were swallowing without the use of a stomach tube.
No deaths occurred, and although complications occurred in five of the 27 patients (19 percent), most were resolved without significant consequences. "The early complication rate is comparable to the rates reported for the alternative therapies of non-robotic transoral surgery, open surgical resection and concurrent chemoradiation treatments," the authors write. Complications-including death, pneumonia or fistula (an opening or passage in the skin or organs)-that are usually reported during these other types of procedures did not occur in the TORS patients.
"Radical tonsillectomy using TORS is a new technique that offers excellent access for resection of carcinomas of the tonsil with acceptable acute morbidity," or complications, they conclude. "Future reports will focus on long-term oncologic and functional outcomes."
JAMA and Archives Journals
Robotic Surgery Current Events and Robotic Surgery News RSSCarnegie Mellon scientists develop method for verifying safety of computer-controlled devices
Researchers at Carnegie Mellon University's School of Computer Science have developed a new method for systematically identifying bugs in aircraft collision avoidance systems, high-speed train controls and other complex, computer-controlled devices, collectively known as cyber-physical systems (CPS).
Robot improves suture proficiency more rapidly for surgeons inexperienced in laparoscopic techniques
New research published in the April issue of the Journal of the American College of Surgeons suggests that, among surgeons inexperienced in laparoscopic techniques, closing incisions using robotic-assisted laparoscopic surgery (RALS) requires less time to learn and results in improved outcomes compared with suturing done via traditional, "open" surgery or with freehand laparoscopy.
New Catheter-less Technique May Ease the Pain and Discomfort of Prostate Cancer Recovery
To ease the pain of recovery following prostate cancer surgery, physician-scientists have developed an innovative and patient-friendly approach that eliminates the use of a penile urinary catheter.
Robotic Surgery Lowers Risk of a Rare but Serious Complication of Gastric Bypass
The use of a robot to assist with the most commonly performed weight-loss surgery appears to significantly lower a patient's risk of developing a rare but serious complication, according to a study published in the most recent edition of the Journal of Robotic Surgery.
State's first single incision robotic kidney removal
For the first time in Michigan, a diseased kidney has been surgically removed at Henry Ford Hospital using highly sophisticated 3D robotics through a single incision.
NewYork-Presbyterian/Columbia leads research into robotic surgery for kidney cancer
Clinical research at NewYork-Presbyterian Hospital/Columbia University Medical Center is helping bring the advantages of robotic surgery, including reduced pain and quicker recovery, to kidney cancer patients.
New Surgery Improves Head & Neck Cancer Treatment
A new surgical procedure for head and neck cancer at the University of Alabama at Birmingham offers improved accuracy for surgeons and reduced post-operative pain for patients.
Study finds that minimally invasive robotic bypass surgery provides health and economic benefits
Minimally invasive heart bypass surgery using a DaVinci robot means a shorter hospital stay and faster recovery for patients, as well as fewer complications and a better chance that the new bypass vessels will stay open.
3T MRI plays significant role in detecting prostate cancer, study says
The use of MRI without endorectal coil can detect prostate cancer and provide undistorted images with diagnostic image quality and accurate tumor localization, according to a recent study conducted by researchers from The Ohio State University in Columbus, OH.
Just hours apart, 2 brothers undergo robotic prostate cancer surgery
"We are blessed to have each other to depend on. If you have to go through something bad like cancer, you're glad to have a friend to go through it with," said one of two brothers from Savannah, Georgia recovering from robotic prostate cancer surgery.
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