Francisco Civantos, center, performs robotic removal of throat cancer at University of Miami Hospital. OR technician Michel De La Cruz, left, assists.

Surgeons from the Department of Otolaryngology at UHealth – University of Miami Health System have performed the first removal of throat cancer in South Florida using a surgical robot. The procedure represents a milestone in UHealth’s development of minimally invasive endoscopic procedures for treatment of head and neck cancers.

The operation was performed March 22 at University of Miami Hospital by Francisco Civantos, associate professor of otolaryngology and member of the Head and Neck Cancer Site Disease Group at Sylvester Comprehensive Cancer Center, and Giovana Thomas, associate professor of otolaryngology and member of the Head and Neck Cancer Site Disease Group at Sylvester. They were accompanied by Raymond J. Leveillee, professor of urology, who is an experienced urologic robotic surgeon.

Traditional surgery for various head and neck cancers requires large incisions extending from the lip, across the chin, and to the neck before entering the mouth or throat. Surgeons often need to cut through the lower jaw and move aside vital nerves to gain access to the back of the mouth and throat.

By contrast, surgeons using the da Vinci® Surgical System insert slender instruments into the mouth to reach the base of the tongue, tonsils, and throat. “As a surgeon,” says Civantos, “using a surgical robot allows for greater precision and dexterity to remove cancerous tumors from tight spaces in the mouth and throat.”

The University of Miami Hospital’s da Vinci system consists of robotic arms that replicate a surgeon’s motions. Throughout a robot-assisted surgery, patients are positioned as they would be during laparoscopic surgery. Surgical team members surround them; the surgeon is located at a console a few feet away. Supporting surgical team members mount the correct instruments and supervise the laparoscopic arms and tools being used.

Designed with seven degrees of motion that replicate the agility of the human wrist, each instrument has a specific surgical task such as clamping or suturing. Even though the surgeon is not physically in contact with the patient, the control console permits him or her to see the surgical field in superior detail as a result of the three-dimensional image transmitted from the laparoscopic cameras.

Civantos and Thomas say the benefits for patients with head and neck cancers are “dramatic” because the surgeries can be done endoscopically. “Because there are no external incisions,” Thomas points out, “it offers faster recovery time and a reduced risk of infection or other complications for the patient.”