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Stanford surgeon uses robot to increase precision, reduce complications of head and neck procedures

Thu, Jul 4, 2013

Oral Cancer News

Author: Margarita Gallardo

In today’s San Francisco Chronicle, writer Kristen Brown highlights how surgical robots are simplifying head and neck procedures. Known as transoral robotic surgery, or TORS, Stanford is one of the few places in the country using the da Vinci surgical robot to remove tumors or scar tissue from patients such as 70-year-old John Ayers, who is featured in the story (subscription required).

Edward Damrose, MD, chief of the division of laryngeal surgery at Stanford Hospital & Clinics, describes the procedure to Brown:

The da Vinci’s most frequent use in transoral procedures is in head and neck cancers. By operating through the mouth, surgeons can remove tumors in places that previously might have required much more complex procedures, such as breaking the jaw to get a good enough look.

The robot has four arms – three that can hold typical surgical tools, and a fourth that holds an endoscopic camera, giving a surgeon a full view of the patient’s insides.

“You get an almost panoramic view,” said Damrose. “It’s as if you were miniaturized and in someone’s throat looking around.”

The da Vinci was first used on a human for a head and neck procedure in 2005 at the University of Pennsylvania. An update to the robot made the experiment possible, when slimmer tools were developed for the robot that might more easily fit inside the mouth. (Even with the smaller tools, working inside someone’s throat can be a tight squeeze, depending on the patient.)

“If we’re able to operate through the mouth, we can avoid a lot of downsides to different approaches,” Damrose said, pointing to surgeries that involve breaking the jaw.

“Patients recover faster. They look better. They can swallow better,” he said. “It’s helping us a lot to accomplish procedures endoscopically where a few years ago these things would likely not have been possible.”

Ayers’ story is also captured in the Stanford Hospital video below.

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