Robotics in the surgery theater is not new. But the advancements keep coming. What used to be a sci-fi fantasy used by just a few is now a growing reality, and robotics are making surgery safer and less invasive.
The most recent advancement at Baptist Health is robotic technology that allows a surgeon to treat head and neck cancers without needing to cut the patient’s face and neck to gain access to the cancer.
Through robotics, the cancer can be reached through the patient’s mouth.
Previously, an incision from the bottom lip, down the chin and down the neck might have been required.
Dr. Faisal Ahmad, an otolaryngologist at Baptist MD Anderson Cancer Center in Jacksonville, specializes in nose and throat cancers and has credentials in head and neck surgery and cosmetic surgery. He said cosmetic surgery can only do so much.
“If I’m a patient, I’m saying this has got to be fantastic. If you tell me that you have to split my face open. That’s got to be a tough healing process” he said.
“We do kind of tailor our incisions and put them in locations where they’re harder to see. We’ll follow shadows and creases and things like that. But an incision is still an incision, and no matter how well you try to hide it, you know it’s still going to form a scar.”
This new technique comes at an opportune time.
A recent report states:
“Baptist MD Anderson Cancer Center has seen a rise in oropharyngeal cancers in our region, which includes cancers affecting the palate, throat, base of tongue and tonsils.
“According to experts, the majority of newly diagnosed throat cancers are caused by human papillomavirus (HPV), a sexually transmitted infection that 80% of the population will be exposed to during their lifetime.
“Approximately 70% of oropharyngeal cancers in the U.S. are HPV-related, and more people are being diagnosed with the disease at a younger age.”
Advantages of using robots include:
• Quicker recovery time.
• Less blood loss.
• A greater chance that radiation and chemotherapy will not be needed.
• If further treatment is needed, it can begin sooner
While experienced surgeons first had to travel to learn the techniques, today it is part of a residency. Those earning a fellowship will receive even more education and training, said Steven Hodgett, a general surgeon with North Florida Surgeons who provides bariatric surgery at Baptist Health.
As is the case with innovations, some balked at the idea of robots as a surgical tool. Some thought using laparoscopies, the use of fiber optics, was the way to go.
“When you started using it, the benefits became really clear that were better visuals. You have three-dimensional visualizations. You have one eye seeing one lens, and one eye seeing another, just like your actual eyes do,” Hodgett said.
“You have 3D visualization, and so you can see things so much clearer. The depth perception that wasn’t available in laparoscopy became so much clearer.”
With robotics, the operating room has more flexibility. Surgeons can even have their back to the patient while operating.
They control operating tools with their thumbs and forefingers and cameras with their feet. The robots even have a “clutch” that allows a surgeon to adjust the view without moving operating instruments.
“It’s exactly like driving a stick shift, you know, someone can probably pick it up over the course of a few weeks, but it takes years and years and years to master it,” Ahmad said.
“If you just learn how to drive a stick shift, you probably don’t want to go driving up a mountain. You may be rolling back a little bit your first couple weeks out.”
Both surgeons stressed that human surgeons are manipulating the robots at all times.
“It’s important for people to understand the robot isn’t doing the operation,” Hodgett said.
“It’s not like you’re on a spaceship and you have a robot on top of you fixing a broken leg.
“This is something that the doctor is totally in control of. I explain that I can do it safer and better for the patient.”