Malignant tumor on tongue removed using robotics at LSU Health Shreveport

Audrey Don Henderson, a 72 year old retiree traveled from Fort Worth for the surgery by LSU Health Shreveport Surgeon Dr. Marc Dean, assistant professor in the Department of Otolaryngology/Head and Neck Surgery. 

Dean said the patient previously had tongue-base cancer several years ago and radiation treatments put the cancer in remission. Then, early this year, he discovered an enlarged node on his neck.

Doctors soon discovered that the cancer had recurred and recommended surgery. The patient began seeking alternatives to the traditional jaw-splitting open surgery and eventually was referred to Dean by a North Dallas Ear, Nose and Throat specialist.  

In the past, tongue cancer required a big incision or removal of the tongue, Dean explained. Endoscopic procedures were possible in some cases, but it was difficult to get good visibility.

Damage from previous radiation also ruled out endoscopic surgery in this case, he said.

    "With the robot, there is amazing visibility and dexterity," Dean said. "This is the kind of procedure the robot is designed for." Because of the dexterity, the jaw doesn't have to be broken, the patient won't need painful reconstructive surgery, so the recovery will be much quicker.

    "This surgery is designed for him. He is the perfect candidate," Dean said of Henderson, who will require an additional procedure on his neck.

    The patient is expected to spend about a week in the hospital and won't be able to talk right away, but he is expected to recover completely with his tongue intact.

     As cameras get smaller robotic assisted surgery will play an even bigger role in oral, head and neck surgeries, Dean predicted.

 Dean said smoking and HPV are the most common causes of tongue cancers. Oral, head and neck cancers are the six most common cancers.

Robotic assisted surgery began in the area about six years ago with procedures for patients with prostate cancer.

    Since that time, its use has expanded and more area physicians are becoming certified for other types of surgery, including urologic, pediatric, gynecologic and sleep apnea procedures.

Dean is one of two surgeons on the LSU Health Shreveport faculty trained in Transoral Robotic Surgery called TORS. The other is Dr. G. E. Ghali, Chairman of the Department of Oral Maxillofacial Surgery.