ENT Goes Robotic
The da Vinci Surgical System is a highly technical robotic system that has been utilized over the past decade for a variety of surgeries. The robotic system advances minimally invasive laparoscopic procedures, providing surgeons with greater range of motion, more dexterity and greater clarity in the 3-dimensional view of surgical areas. The patient benefits from its precise incisions, less invasion to the surgical site, shorter operating time, and more accurate excision capabilities.
The first robotic surgery at UK Chandler Hospital, a left internal mammary artery (LIMA) mobilization, was performed in January, 2004. Since then, the da Vinci system has been utilized by UK surgical teams for urologic, abdominal and gynecological complications.
The FDA just recently approved use of the da Vinci Surgical System for head and neck cancer surgery. On May 6, 2010, Dr. Thomas J. Galperformed the first TransOral Robotic Surgical procedure (TORS) at UK utilizing the da Vinci Surgical System. The patient’s diagnosis was Stage III squamous cell carcinoma of the tongue base.
“Typically, this procedure lasts ten hours with extensive reconstruction,” said Dr. Gal. “Forty percent of patients will never eat again. With TORS, the operation took one hour. There was no tracheotomy and no feeding tube necessary. We expect the patient to be eating within the next few days.”
Traditional surgery for these cancers, which can involve ear-to-ear incisions and splitting the jaw, leaves many patients with large scars, and can result in speech and swallowing deficiencies. Utilizing the TORS procedure, surgeons are now able to access the cancer through the mouth with exact precision. This translates into less time in the OR, less anesthesia, less blood loss, lower risk of infection and less pain. With TORS, patients also enjoy shorter recovery time, which means less time in the hospital and a faster return to normal daily activities. Some patients have even recovered without the need for follow-up chemotherapy or radiation treatments.
Earlier this year, Dr. Gal received TORS training at the University of Pennsylvania from the physicians who created the procedure, Drs. Gregory Weinstein and Bert O’Malley. The University of Kentucky will be one of a select group of facilities nationwide to have received formalized training and certification in these procedures. The goal is to create a center of excellence, serving as a regional referral center as well as a potential training hub for surgeons to learn these techniques.
Nationally, head and neck cancers account for three to five percent of cancers or about 45,000 patients per year. In Kentucky, the rate is higher, primarily due to the high prevalence of tobacco use in the state. In the past, UK sees approximately 200 of these cases per year. These numbers are likely to increase as the awareness of the benefits of TORS increases. Dr. Gal, along with Division of Otolaryngology colleague Dr. Joseph Valentino, will be heading the TORS program at UK.
