First in Nebraska: Surgical Robot Used to Remove Oral Tumor - The Nebraska Medical Center First to Offer Minimally Invasive Option
It's a space-age treatment for a life-threatening condition. For the first time, it's available in Nebraska. Surgeons at The Nebraska Medical Center are now using robotic surgery techniques to remove cancerous tumors from patients' throats.
Medical center surgeons performed the first such case in late August. The patient, Vickie Hebing of Council Bluffs, IA went looking for this specific treatment. "After I was diagnosed, my daughter did a lot of research on the Internet," Hebing recalled. "It sounded a lot better than chemotherapy and radiation, and certainly better than open surgery."
Hebing's primary care doctor discovered the tumor, a squamous cell carcinoma on her right tonsil during a routine check-up. From there, things moved quickly. "I was referred to the med center," Hebing said. "I knew I could have radiation and chemotherapy, but we found out about this robotic surgery. I wanted surgery and when I found out they could do it here, I knew this was the place."
Hebing met with Russell Smith, MD, a head and neck surgical oncologist at The Nebraska Medical Center and associate professor at The University of Nebraska Medical Center. They decided robotic surgery would give Hebing a great option for recovering quickly and beating the cancer.
Robotic surgery for tumors like Hebing's was approved by the FDA earlier this year.
"Using the robotic approach allowed us to incorporate surgery in a way we could not before," explained Dr. Smith. "Had we seen Vickie before this was available, we would have recommended chemotherapy and radiation as her best primary treatment. And we did give her that treatment option in this case."
An open surgical option exists as well, but it is a much more invasive treatment that could potentially bring with it more complications.
Dr. Russell Smith controls the surgical robot during Vickie Hebing's operation
"In some cases to surgically remove a tumor like Mrs. Hebing's, instead of working through the mouth, we would have had to potentially do a surgery that splits the lip and breaks the jaw bone so that we could get to the tumor to remove it," Dr. Smith said. "That can have a very negative impact on swallowing and speech function."
The robotic surgery has a much quicker recovery, two to three days in the hospital; compared to the open surgery where a patient can spend a week or more in the hospital.
During the operation, Dr. Smith sat at the controls of the DaVinci Surgical Robot system. About five feet to his right, Hebing lay on the operating room table. Two visual ports transmitted the picture from the operating table to the control console, giving Dr. Smith a three-dimensional view of the anatomy of Hebing's throat. The surgeon's hands controlled the two instruments that removed the tumor. A surgical assistant sat next to Hebing during the entire operation providing another set of hands.
"That allows us to have a four-handed surgery inside someone's mouth," said Dr. Smith. "You couldn't do that with traditional techniques."
Assistant surgeon Robert Lindau, MD helps Dr. Smith during Vickie Hebing's surgery
Assistant surgeon Robert Lindau, MD helps Dr. Smith during Vickie Hebing’s surgery
Hebing will still require radiation therapy. She expects to begin in the coming weeks.
"Our goal is, having done the surgery, we may be able to eliminate chemotherapy from her treatment and use a lower dose of radiation," Dr. Smith said. "So hopefully, the side effects of those treatments will be lessened."
"I think I was probably a difficult case," Hebing said. "But it went as well as I could have hoped. I think it's a really favorable outlook at this point."