Specialists at Apollo Cancer Institutes, perform a trans-oral robotic surgery to remove a remotely located tumour!

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Dr TPS Bhandari, Senior Consultant, Robotic & Minimal Access Oncosurgeon, Apollo Cancer Institutes; with the patient Mrs Suman Aggarwal (Left) who underwent a rare minimally invasive scarless Trans Oral Robotic Surgery (TORS), for a neurogenic tumour located at a remote part of the throat, performed for the first time in this part of the country, at Apollo Cancer Institutes, Jubilee Hills, today. Conventional surgery would have involved opening up of the jaw bone. Also seen are patient’s son and husband.

Hyderabad, 23rd April 2022: Surgical Oncology Specialists led by Dr TPS Bhandari, Senior Consultant, Robotic and Minimal Access Oncosurgeon, Apollo Cancer Institutes, Jubilee Hills; performed a minimally invasive Trans Oral Robotic Surgery (TORS), to relieve a 50-year-old female patient of neurogenic tumour, at Apollo Cancer Hospital, today. The patient reported at the hospital with a complaint of persistent cough for the last six months. Clinical examination revealed a natural hollow in the throat in the tonsils area and seemed like a lump in the throat.

A Contrast Enhanced CT (CECT), of the neck revealed an oval shaped thinly scattered lesion of the size 6x5x3 cms., in the centre of the left parapharyngeal space of skull base. Further tests revealed it to be a benign neurogenic tumour, which originates from cells that make up the nervous system. The cause for neurogenic tumors is unknown, mostly presumed to be hereditary related. The typical symptoms of these tumors are pain, numbness, weakness and swelling in the location of the tumor. The incidence of neurogenic tumors in skull base is extremely rare and their recurrence can depend on the nature of the tumor, with negligible recurrence if its benign, while malignant one can recur.

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Dr TPS Bhandari, Senior Consultant, Robotic & Minimal Access Oncosurgeon, Apollo Cancer Institutes; with the patient Mrs Suman Aggarwal (Left) who underwent a rare minimally invasive scarless Trans Oral Robotic Surgery (TORS), for a neurogenic tumour located at a remote part of the throat, performed for the first time in this part of the country, at Apollo Cancer Institutes, Jubilee Hills, today. Conventional surgery would have involved opening up of the jaw bone.

The minimally invasive Trans Oral Robotic Surgery was performed on the patient for the first time in this part of the country, to completely excise the mass, while preserving the vital vessels and nerves. The procedure took thirty-five minutes. She recovered optimally in the postoperative period, was tolerating oral feeds and was discharged in a stable condition on the second day of surgery.

TORS
Dr TPS Bhandari, Senior Consultant, Robotic & Minimal Access Oncosurgeon, Apollo Cancer Institutes; performed a rare minimally invasive scarless Trans Oral Robotic Surgery (TORS), for a neurogenic tumour located at a remote part of the throat, the first in this part of the country, at Apollo Cancer Institutes, Jubilee Hills, today. Image at the top is the conventional surgical approach involving cutting of the jaw bone and the bottom image is of a scarless Trans Oral Robotic Surgery.

Robotic surgery has the advantage of being completely scar less without the need for opening the jaw bone, operative time is minimal and blood loss is negligible. The supple limbs of robot enable access to the remotest location without harming the surrounding tissue. This patient was consuming oral liquids by evening and discharged the next day with no need for prolonged hospitalisation or painful recovery process of bone healing, says Dr TPS Bhandari.

The tumour was remotely located in the upper part of the neck and had restricted access. Conventional surgery would have involved cutting the jaw bone to gain access to the tumour and later plating it to fix the jaw bone. Open surgery would have prolonged the operation duration by three hours, jaw healing would have been time consuming and increased the post operative morbidity of the patient. The post-surgery restricted mouth opening and difficulty in swallowing would have led to extended recovery period of up to three weeks.

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