• 10/18/2006
  • Orlando, FL
  • staff
  • wftv.com

Background:
The American Cancer Society estimates about 30,990 new cases of oral cavity and oropharyngeal cancer will be diagnosed in the United States in 2006. More than 7,000 people will die of these cancers this year. Oral cancer is cancer that starts in the mouth, while oropharyngeal cancer is cancer that develops in the part of the throat just behind the mouth, called the oropharynx. The treatment options for people with oral and oropharyngeal cancers are surgery, radiation therapy, and chemotherapy either alone or in combination, depending on the stage of the tumor. Depending on where the cancer developed, surgeons may need to cut through the outside of the throat to get to the tumor. Gregory Weinstein, M.D., and Bert O’Malley, M.D., are co-directors of The Center for Head and Neck Cancer at the University of Pennsylvania. “Traditional approaches are incisions in the neck and into the throat to get exposure to the cancer,” says Dr. Weinstein. “Sometimes it can be involved in splitting the jaw and opening up the tissues widely to get exposure to the lesions.”

A New Approach:
Now, Drs. Weinstein and O’Malley are partnering on a new way to approach these kinds of cancers: through the mouth using robotic surgery equipment. “We haven’t done a full objective analysis, but our experience suggests that patients do better in speech and swallowing after the surgery,” says Dr. O’Malley. “We remove the entire tumor, but we don’t have to do things such as live incisions on the neck, or breaking or splitting the jaw bone and moving the tongue aside and making larger cuts in areas that create problems after the surgery.”

Researchers from the University of Pennsylvania School of Medicine have completed two studies that demonstrate the daVinci Surgical Robotic System is an effective way to operate on oropharyngeal cancers. This included cancers of the tongue, tonsils, voice box, and back of the throat. In the first study, researchers used the daVinci Robot and operated on a mannequin. In the second study, the surgeons performed a variety of surgical procedures on a human cadaver. They concluded that robotic surgery may shorten operating time and allow for minimally invasive treatment of more cancer patients. The self-contained daVinci robotic system has three main components: a mechanical robot with three multi-jointed arms; a computer command center several feet from the patient, where the doctor sits, and a 3-D computer monitor similar to a “viewfinder” that affords a magnified view of the surgical site inside the patient. “The real advance is that we can use instruments that go into the mouth, and the robotic arms, which are long arms with very small instruments at the very end, mimic standard instruments, but very small,” says Dr. Weinstein.

Current Study:
This procedure is now being tested in actual patients. The doctors are encouraged by the results they’ve seen so far. “A definite advantage is that we don’t have to do the trachiostomy, which is a tube in the wind pipe,” says Dr. Weinstein. “Another important advantage is that, in certain areas, we’re able to do the surgery with decreased side effects in terms of long-term problems, swallowing and speech, and getting better outcomes with surgery.” Additionally, he says the robotic surgery takes about one-third the time of the standard procedure.