Q: Will you take it out with the Robot?

Surgeon Console

A: Robotic surgery was introduced in 2009 and has recently become popular for removing certain types of head and neck malignancies, including cancers in the base of the tongue, cancers in the tonsil and oropharynx, and cancers in the thyroid. Robotic surgery is most useful in small cavities such as the throat, where magnified vision and miniaturization of instruments allows greater precision.  The surgeon sits at a console a few feet from the patient.  The surgeon places his hands in the console which transmits the surgeon’s hand movements to miniature instruments inside the patient’s throat. The surgeon will cut, clamp, tie and suture just as he or she would do in traditional surgery, except that the robotic “hands” are small enough to reach into places where the surgeon cannot.

Why does this matter? Prior to robotic surgery, surgeons often split the jaw in half to get to these tumors. Smaller tumors were often referred first for radiation and chemotherapy, because the risk and injury caused by surgery was simply too great.  Now, patients who are diagnosed with early stage oropharyngeal cancer can often have the entire tumor removed and avoid radiation and chemotherapy altogether.

A 2017 study in the American Medical Association journal JAMA Otolaryngology  found that patients who have the tumor completely removed with robotic surgery recover faster and have fewer swallowing problems than patients who require postoperative radiation.

To protect yourself against oral cancer:

• Never smoke.
• See a dentist twice a year for routine cleaning and oral cancer screening.
• See an otolaryngologist if you notice lumps or swelling in the neck or throat, or if you have persistent throat pain, bleeding, hoarseness, swallowing or speech problems.