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Robot Gives Surgeons Another Weapon Against Throat Cancer

Mon, 07/19/2010 - 7:53am
Jan Jarvis, Star-Telegram

It started with hoarseness that refused to go away.

Then swallowing became difficult. Within a month, Madonna Griffin could no longer eat. By the time she finally learned what was causing the hoarseness, she could barely breathe.

It took Dr. Yadro Ducic just one look down her throat to identify the cause. A 2-inch tumor was growing in the 38-year-old Azle grandmother's larynx, blocking her airway.

"I could look down her throat and see this big cancer," said Ducic, co-medical director of the Skull Base Center at Baylor All Saints Medical Center in Fort Worth. "But the voice box was obstructing the view."

To remove the tumor, Ducic turned to the da Vinci Surgical System, which gave him a much better view of the throat from different angles.

"The nice thing about the robot is you can see around the corner so you can operate around the corner," he said. "It allows you to take out things you can't otherwise."

The May 21 operation is believed to be the first such throat surgery in North Texas using the da Vinci Surgical System and was performed less than six months after the federal Food and Drug Administration approved the procedure, according to Baylor All Saints officials. A week later, UT Southwestern Medical Center surgeons performed the same robotic surgery on a patient in Dallas.

The transoral robotic surgery is an alternative to the conventional approach using lasers to remove throat tumors. For the nearly 13,000 people in the United States who will be diagnosed with throat cancer this year, the robotic surgery offers the possibility of returning to normal speech and swallowing without any disfigurement, according to Nora Distefano, a spokeswoman for Intuitive Surgical, the maker of the device.

Robotic surgeries have become increasingly popular in recent years, largely because they result in minimal scarring, decreased blood loss and a shorter recovery period. The da Vinci system has been used for thousands of procedures from gall bladder surgery to hysterectomies and prostate removal.

The surgery is performed through the mouth, so there's no scar. What makes the surgery unique is the robot's precision and dexterity, which allow the surgeon to see the tumor and remove it without damaging surrounding tissue.

For Griffin, the robotic surgery has meant the difference between speaking again and losing her voice entirely. Although the diagnosis came as a huge shock despite years of cigarette smoking, she said that she's on her way to a full recovery and looks forward to eating again. Ducic was able to spare half of Griffin's voice box, but he had to remove lymph nodes, part of her tongue and her tonsils. Griffin was left with a scar from the tracheotomy that she needed to help her breathe.

Open surgery sometimes requires an ear-to-ear incision and splitting of the jaw that can result in speech loss and the inability to swallow. And when a laser is used, it has to be a straight shot, which makes it difficult to get to certain locations, Ducic said.

Griffin, who is younger than most patients with throat cancer, still faces chemotherapy and radiation. After losing 30 pounds, she has regained 10 and is learning to swallow and speak again. She is still dependent on a feeding tube

Although she's still hoarse, she's optimistic that as her throat heals, her speech with improve.

"My throat is still asleep, but it's waking up," Griffin said. "It takes a while, but I'm willing to wait."

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