Robotic technology is giving Kiwis with oral cancers a better chance at beating the disease

Thursday , 17 November 2016 by Alistair Gray

Kiwis with oral cancers can now have their tumours removed robotically through a new surgical technique.

The first trans-oral robotic surgery (TORS) performed in New Zealand was at Southern Cross Hospital North Harbour by surgeons Dr Andrew Cho and Dr Francis Hall last month and gives some oropharyngeal cancer patients a treatment option that’s significantly less invasive than traditional options.

Traditional surgical options can require splitting the jaw or a large incision under the jawline to gain access to the tumour.

Dr Cho says the diagnoses of oropharyngeal cancers has grown significantly in recent years along with public awareness of the disease – thanks in part to publicity from celebrity cases such as Val Kilmer and Michael Douglas, as well as debate around government funding of the HPV vaccine for both boys and girls.

“As awareness of this cancer increases so has the number of men and women being diagnosed early,” says Dr Cho.

“Around 250 Kiwis are diagnosed with oropharyngeal cancer each year with patients tending to be otherwise healthy, active men in the middle of their lives with no history of smoking.

“Oropharyngeal cancers - which can be caused by undiagnosed HPV - are curable if caught early,” says Dr Hall. “With the right treatment people can recover and go on to live normal healthy lives which is what this new technique aims to achieve.”

Due to the invasive nature of the traditional methods doctors have historically favoured chemotherapy and radiotherapy which can leave patients with issues such as a damaged and brittle jaw, salivary and speech problems, dental decay, hearing loss and in some cases patients in recovery needing to be tube fed.

In head & neck procedures surgeons operate close to vital structures, so the precision of the robot technology is a welcome addition. The da Vinci reinforces a skilled surgeon’s dexterity and offers better visualisation of important anatomical structures, while increasing precision.

When using the robot the surgeon sits at a console, manipulating miniaturised instruments on robotic arms which replicate their exact movements on the patient in real-time.

John, 59, of Half Moon Bay, was the first recipient of the procedure in New Zealand.

“I’d had an ache in my throat that wouldn’t go away. When I was diagnosed it turns out half of my throat was blocked by the tumour – the only way I had been able to continue playing sport and breathing normally was because I was fit and healthy.

“The other surgery and chemotherapy options sounded pretty extreme and I was happy that I was an ideal candidate for TORS – it was a fairly localised tumour. Despite the tumour being close to my vocal chords my speech is unchanged, I was discharged from hospital within three days and am eating normal meals at home a few weeks later. It’s pretty remarkable.”

Southern Cross Hospital North Harbour is the only hospital in New Zealand with credentialed surgeons and staff trained to operate the da Vinci robot for TORS.