May 24, 2012

The UK's first robotic Mouth Cancer operation

PIONEERING surgery which allows doctors to remove cancer in the mouth using a minimally invasive technique is now available at the Wellington Hospital.

Traditionally, the only way to remove Squamous Cell Carcinoma – cancer of the oropharynx which encompasses the tonsils and base of the tongue – has been to split the jaw, take out the cancer and repair the neck with tissue from the forearm.

This 10-hour procedure requires two surgical teams and often has complications. Patients are in hospital for at least three weeks and need months of rehabilitation to help them swallow and speak again.

Because the treatment is so invasive, many doctors try to avoid it using chemotherapy and radiotherapy instead. However, surgery is often the best chance of a cure.

The new one-hour technique called Transoral Robotic Surgery allows the cancer to be removed without splitting the jaw or taking tissue from other parts of the body. Instead, the tonsils are accessed through the mouth using a specially designed robotic machine.

Developed in the US in 2009 and now approved by the American Food and Drug Administration and licensed for use in the UK, it uses the Da Vinci robot to access this difficult to reach area.

It gives the surgeon greater precision, dexterity and accuracy while carrying out the procedure and the patient has no stitches. Infection rates are reduced which speeds up recovery rates, patients are in hospital for just a week and are able to swallow normally soon afterwards and require no long-term feeding tubes.

Neil Tolley, a Consultant Head and Neck Surgeon at the Wellington Hospital, who is now carrying out the new technique, says: “The mouth is a small place. The da Vinci robot allows access to anatomical sites and permits surgery to be performed which would otherwise be technically very difficult or impossible to perform conventionally.

“On the patients treated so far, the swallowing outcomes have been excellent with no need for a gastrostomy tube to feed them, yet the same cure rates have been achieved.”

Three weeks after the procedure, patients have to go in for a second procedure on their lymph glands in the neck which involves a further 24 hour hospital stay.

After the operations, tissue taken from the tonsils and tongue is analysed to see whether radiotherapy or chemotherapy is needed.

One of the first patients to benefit from the new procedure is Stephan Spiriak, 55, a semi-retired electrician, from Edgware, north London.

He was diagnosed with cancer of the tonsils last February after suffering a sore throat for weeks.

Mr Spiriak is delighted to have had the opportunity to have the new procedure. “I was in intensive care for three days but there was no pain just discomfort of the tubes in my nose and mouth.

“After five days I was on liquids again and was allowed home within a week.

“Within 10 days I was virtually eating normally. I would sell this operation to anybody.”

Cases of Squamous Cell Carcinoma have increased three fold in recent years.

The disease was thought to be caused by lifestyle factors such as smoking and alcohol consumption but it is now known to linked to the Human Papilloma Virus.

For Further Information, please contact Neil Huband on 07808 298989 0r 020 7436 6372

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