Cancer Treatment Centers of America

How can flexible robotic surgery help head and neck cancer patients?


Many head and neck cancer patients undergo treatments that end up disrupting their quality of life. For example, surgery to remove tumors in the head or neck area typically requires large incisions that may affect the patient’s ability to eat, speak and swallow. If the incisions were smaller, the lasting impacts may be less severe, experts say. That’s why some head and neck oncologists are excited about a new surgical option that involves smaller incisions and more flexibility in accessing hard-to-reach tumors.

When Michael Hill, a 42-year-old resident of Rogersville, Missouri, was diagnosed with throat cancer, he learned he was a candidate for flexible robotic surgery, a minimally invasive procedure. “My doctor told me of the benefits of the surgery, including that I may heal faster than I would with traditional throat cancer surgery,” Hill says.

During a flexible robotic surgery, the surgeon inserts a camera and flexible robotic instruments through the patient’s mouth, using controls to direct the endoscope to the surgical site. When the surgeon moves his hand, wrist and fingers, the system translates those motions in real time, directing the instruments through the procedure. The technology is designed to allow surgeons to operate on areas of the oropharynx (the part of the throat directly behind the mouth), the hypopharynx (the part of the throat that serves as the entrance to the esophagus) and the larynx (the voice box) that aren’t typically or easily accessible with standard instruments. “Traditional surgeries generally require a large incision or the use of an inflexible endoscope that is limited to lines of sight,” says Dr. Brad Mons, a Head and Neck Surgeon at our hospital in Tulsa. “Flexible robotic surgery is much less invasive. It allows us to remove tumors we weren’t historically able to remove without operating on a larger area than was necessary.”

Dr. Mons says the minimally invasive surgery may have a number of benefits to some patients, including shorter recovery times, less damage to affected tissues and muscles, reduced post-surgical pain, a lower risk of infection and complications, less blood loss, less scarring and a faster return to normal activities.

After his flexible robotic surgery at our hospital in Tulsa, Hill experienced pain and difficulty swallowing for two weeks. But after a Cancer Treatment Centers of America® (CTCA) speech pathologist helped him overcome his swallowing difficulties, he was able to go back to work three weeks after his surgery. Dr. Mons says that recovery time is typical for flexible robotic patients, while recovery after a traditional surgery for head and neck cancer may take up to a month or two. “Patients who undergo traditional surgery often are unable to swallow very well for months,” he says. “They also typically need aggressive speech and physical therapy, and they may need a feeding tube for several months until they can swallow on their own again.”

Patients with cancer in their tonsils or in the base of their tongue, both of which are forms of oropharyngeal cancer, and those with largyneal cancers like those of the hypolarynx and supraglottis, may be candidates for flexible robotic surgery. Oropharyngeal and laryngeal cancer are types of throat cancer.

“My recovery really went well considering what it could have been,” Hill says.

Learn more about a tracheoesophageal puncture, or TEP, which is a voicing option for some head and neck cancer patients.

No case is typical. You should not expect to experience these results.