Remote Access Surgery

What is cancer?

The uncontrolled growth of abnormal cells in the body is known as cancer. It grows when the normal control mechanism within the body stops working. The old cells do not die, but rather start to grow out of control leading to new abnormal cells. These abnormal extra cells generally form a mass of tissue which is called a tumor. Cancer may occur anywhere in the body.

What is remote access surgery?

The term remote access surgery is used to include techniques that provide us access to difficult reach areas of the body. This type of surgery is usually performed with an endoscope, which is a thin, flexible tube with a tiny camera on the end.

Most often, the reference is to endoscopic, laparoscopic or robotic techniques.

All surgical procedures where a visible incision on the neck is avoided come under remote access surgery, including the transoral robotic surgery, endoscopic/robotic thyroidectomy, and endoscopic resection of tumor in the salivary gland and neck.

Endoscopic techniques generally refer to any type of procedure that allows the surgeon to view the inside of a body cavity or organ through an existing opening or a small incision that is well hidden.

Head & neck robotic surgery: A type of remote access surgery using the da-Vinci surgical system, where the surgeon accesses the patient through remotely manoeuvring the robot for the resection of the tumor in the oropharynx, hypopharynx, larynx, and thyroid gland.

TORS (transoralrobotic surgery): This form of surgery is indicated in difficult to reach areas of the head and neck which are not in linear path of access. Oropharyngeal tumours commonly require mandible(jaw bone) to split to access the tumour resection. Splitting the mandible and plating it back after surgery is associated with marked morbidity with respect to swallowing and bone healing. Transoral robotic surgery helps to resect the tumour without mandible split. This is a form of surgery where a transoral approach can prevent a scar in the neck as well as ensure rapid recovery while removing a tumor that is usually otherwise performed through a neck incision by the conventional surgery.

This is one of the newest treatment option for the head and neck cancer. This technique is very promising for patients with cancers of the mouth, pharynx (throat), and larynx (voice box).

Transoral laser microsurgery (TLM): This technique uses a cutting laser and binocular microscope to remove the tumors. Surgeons use the cutting energy of the laser to separate and remove the cancerous cells from the healthy tissue.

The TLM technique has proved to help retain organ function and quality of life in the head and neck cancer patients after surgery. TLM is well suited for cancerous tissue removal in the voice box and the lower throat areas.

Fairly new, robotic surgery uses a sophisticated robotic system to perform remote access surgery. The surgeon, seated at a console across the room, wields instruments by watching the video monitor of the surgical area.

In Bangalore, we at CAN-C are experts in providing best remote access surgery treatment for head and neck cancer types.

Role of remote access surgery in head and neck oncology

Cancer is a disease which is very traumatic, debilitating, life threatening. Through continuous innovations, researches and studies, developments in the medical field newer and better methods of treatment methodologies are put in place to defeat cancer. Remote access surgery is one such step trying to aim at reducing the pain and scar of cancer through lesser painful surgery.

A common belief is that the remote access surgery is not a safe option in treatment of cancer, but this is not the case. The surgical procedure, the extent of removal of the tumour remains the same in both the open and the remote access surgery. The only glaring difference between the two is the external approach with respect to the incision. The small incisions in remote access surgery is associated with lesser pain due to minimal injury increasing chances of early recovery. Hence, REMOTE ACCESS SURGERY IS SAFE IN HEAD AND NECK CANCER SURGERIES, AS AND WHEN INDICATED.

We at CAN-C provide remote access surgery treatment (in Bangalore) for head and neck cancers.

Benefits of remote access surgery techniques

In remote access surgery, there is lesser pain, lesser bleeding, lesser scarring. The benefits depend on the type and stage of head and neck cancer being treated, the type of surgery, and equally important are the other factors such as the age and overall health of the patient as well as the surgeon and the surgeon's experience. Though rare instance, but sometimes, there are no benefits offered even with minimally invasive technique.

The risks of remote access surgery

The risks of remote access and conventional surgeries are the same. Additional procedures like tracheostomy or arterial ligation may be performed to minimise risk of bleeding during post operative period. Remote access thyroid surgeries are associated with long trajectory of flap elevation to access thyroid gland and hence patient may experience an additional day of neck drain and hospital than conventional open surgery.

Remote access surgery most suited for

Remote access surgery is limited to the head and neck regions. Remote access surgery is specifically referred to the surgeries of the head and neck. There is continuous progress happening with the remote access surgery in terms of its reach and newer and better treatment results.

There have been extremely promising developments in the head and neck surgery. Major resection of the head and neck cancers may give rise to the need of complicated reconstructions. Remote access surgery is able to successfully perform this also.

Over the last few years remote access surgery has been extensively applied to the treatment of cancerous/malignant head and neck diseases yielding favourable results.

Remote access oncologic surgery appears to be a safer and attractive alternative to the conventional head and neck oncology surgery, mainly because it holds promise to reduce the surgical trauma to the head and neck cancer patients. Remote access surgery is garnering much attention recently and is certainly here to stay. It is a much awaited boon to the head and neck cancer patients.

There is a gradual increase in the number of the remote access surgeries being performed indicating an increasing trend of the acceptance of the remote access surgery.

"CAN-C: Well-known centre for remote access surgery in Bangalore."

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