Robotic surgery feasible in removal of tumours

Washington, April 24 (Inditop) Robot-assisted surgery appears feasible for treatment of selected head and neck cancers, according to a new report.

“Since the introduction of the surgical robot in 1999, robot-assisted cardiac, gynecologic and urologic procedures have become widely accepted throughout the country,” according to the study authors.

In these specialties, robotic procedures have been associated with less blood loss, fewer complications, shorter surgery durations and fewer days in the hospital or in intensive care compared with traditional open procedures.

“Robotic surgery in the head and neck offers the possibility of limited surgical morbidity [illness], reduced hospital stay and improved lesion visualization over open approaches and traditional transoral [through the mouth] techniques.”

Bridget A. Boudreaux and colleagues at the University of Alabama, Birmingham (UAB) assessed the feasibility and safety of robot-assisted surgery in 36 patients with tumours involving the oral cavity, throat or larynx.

Between March 2007 and May 2008, 29 (81 percent) of the patients underwent successful robotic resection, or removal of the diseased tissue.

The operating room was arranged with the surgeon’s console, from which he or she operated the robotic arms that held the surgical equipment, approximately eight feet from the head of the bed.

Negative margins (when no cancer cells are found at the edge or border of the removed tissue) were obtained in all 29 patients who successfully completed surgery.

Of those, 21 had breathing tubes that had been in place during the surgery but were safely removed before leaving the operating room. The average operating time was 99 minutes, and the average hospital stay was 2.9 days, said an UAB release

“The surgical robot has several advantages over traditional endoscopic and open approaches, including three-dimensional visualization, tremor filtration [steadying of any shaking in the surgeon’s hands] and greater freedom of instrument movement,” the authors wrote.

Patients who had smaller tumours and no teeth appeared more likely to have successful robot-assisted procedures. However, the authors noted that no clinical guidelines for robotic procedures in head and neck cancer patients yet exist.

These findings were published in the Archives of Otolaryngology – Head and Neck Surgery.