How Doctors and Robots Are Combating Hard-to-Reach Cancers | UPMC

Being told that you need surgery for cancer is a daunting prospect. Worrying about how you’re going to look after surgery is even more daunting—especially if you have a head or neck cancer. Umamaheswar Duvvuri, MD, PhD, knows that as well as any surgeon.

“Nobody with a throat or larynx tumor comes into my office and says, ‘I want you to make an incision in my neck that will leave a significant scar.’ No one has ever said that,” Dr. Duvvuri says. “But they do need surgery. Robot-assisted surgery makes it possible to eliminate many of the most worrisome parts of removing head and neck cancer.”

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It’s not just an aesthetically better option to employ a robot-assisted platform to access and remove tumors in the tight, hard-to-navigate areas of the throat, back of the tongue, pharynx and larynx. It also makes surgery more efficient and faster and allows for an easier recovery.

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Robots for the Assist

“When people hear ‘robot-assisted surgery,’ at first many of them think that a robot is going to do the surgery,” says Dr. Duvvuri. “It isn’t. The robot is just a tool. The one we use has two thin arms that we insert into the patient’s mouth to give us direct access to tumors in the head and neck region. The robotic arms navigate in a snake-like motion to access the tumor and provide retraction and suction.”
Until recently, there was no minimally invasive option for head and neck cancer intervention—no laparoscopic equivalent existed. Traditional surgery requires a large incision in the neck and moving the structures of the throat to access the tumor. With the robot, no incision is needed.

“The robot enters a natural orifice of the body—in this case, the mouth—and can perform procedures in small spaces without dissecting tissue,” says Dr. Duvvuri. “It’s faster, safer, and ultimately patients have better outcomes with shorter hospital stays and less recovery time. They get back to work faster, too.”

Robot Technology Delivers Big Benefits

Hundreds of patients across the country have experienced the benefits of robot-assisted treatment; the technology has proven to be both safe and effective. Dr. Duvvuri alone performs approximately 100 such procedures annually at UPMC.

Another welcome result of using robot technology: Operations that once took as long as six or seven hours now take just one or two.

“Shorter procedures require less anesthesia, which means faster recovery for patients,” says Dr. Duvvuri. “And when there’s no cutting, there’s less swelling—which means there’s no need for a tracheostomy or feeding tube afterward.

Patients can breathe on their own and eat by mouth after the robotic surgery. What used to involve weeks in the hospital now can just mean a two-day stay. Pain management is easier, as well.”

The Future Is Robotic and Collaborative

Robot-assisted surgery is here to stay. Dr. Duvvuri envisions a future of continued collaboration with engineers, scientists, and physicians resulting in an environment in which the technology is so efficient and the imaging tools so effective that tumors are easier to find and remove.

The robots are becoming more at home in the operating room for many different types of surgery. Dr. Duvvuri is the medical director of Pittsburgh CREATES (Collaborative Research, Education, and Technology Enhancement in Surgery), a center within the University of Pittsburgh’s Department of Otolaryngology that specializes in research, training, and innovation for advanced surgical technologies. The center works with companies to help solve challenges and make advances in minimally invasive surgical approaches across many disciplines.

“There will come a time when there will be autonomous robots doing parts of various surgical procedures,” says Duvvuri. “We aren’t there yet, but it’s likely coming soon to an operating room near you.”

About UPMC Hillman Cancer Center

When you are facing cancer, you need the best care possible. UPMC Hillman Cancer Center provides world-class cancer care, from diagnosis to treatment, to help you in your cancer battle. We are the only comprehensive cancer center in our region, as designated by the National Cancer Institute. We have more than 70 locations throughout Pennsylvania, Ohio, and New York, with more than 200 oncologists – making it easier for you to find world-class care close to home. Our internationally renowned research team is striving to find new advances in prevention, detection, and treatment. Most of all, we are here for you. Our patient-first approach aims to provide you and your loved ones the care and support you need. To find a provider near you, visit our website.