Doctors at VPS Lakeshore Hospital in Kochi, Kerala, successfully performed the first-ever endo-robotic surgery on a 75-year-old woman.
Endo-robotic surgery involves a procedure in which the lower part of the head and neck cancer reaching the food pipe is removed using a combination of endoscopic surgery and robotic surgery.
Robotic technology has proven invaluable in minimizing the morbidity associated with head and neck surgery. Its application has historically been limited to areas above the voice box due to the constraints of robotic arm reach. However, to solve this problem, the doctors at the hospital came up with a new surgical method.
The upper part of the cancer was approached through the oral cavity using robotic surgery, and the part of the cancer that the robot couldn't reach within the food pipe was incised using a gastro-endoscope.
Devakiamma, the patient, who is a Palakkad native, started experiencing throat pain in 2022. Devakiamma was diagnosed with cancer in the upper end of the food pipe (post-cricoid region). Initially, she resorted to radiation treatment, but the cancer did not respond. Then, a comprehensive examination revealed that there were no signs of the disease elsewhere in the body.
Generally, surgical removal of the voice box and food pipe is the course of action in this condition, followed by reconstruction of the food passage using tissue from other parts of the body. This surgery is known to have significant challenges for the patient, including a loss of their natural ability to speak and eat.
The whole cancer-affected area was removed en bloc, and to confirm the completeness of the cancer removal, intraoperative pathology reports were used.
After surgery, the defect was reconstructed with the help of a robot using tissue from the inner part of the cheek. This was also one of the novel approaches to reconstructing such defects.
The doctor informed that the patient is currently recovering, having regained the ability to talk and drink water. The doctors are optimistic that with some more days of rehabilitation. Devakiamma will be able to eat more comfortably. But the chances of a recurrence of cancer can't be completely ruled out.
The surgery took around seven hours, but the doctors are confident that in the future they will be able to perform the surgery in less than half time.
(Input from various sources)