TRIPLER ARMY MEDICAL CENTER, Hawaii (Jan. 31, 2012) -- In May of 2011, the da Vinci Surgical System was embraced by two of Tripler Army Medical Center's otolaryngologists. The robot, which was first purchased in 2009, has been used to support a variety of surgical specialties.
Otolaryngology is a branch of medicine and surgery that specializes in the diagnosis and treatment of ear, nose, throat, and head and neck disorders.
Lt. Col. Joseph Sniezek, chief, Otolaryngology, Department of Surgery, Tripler Army Medical Center, known as TAMC, and Lt. Col. Christopher Klem, chief, Head and Neck Surgery, Otolaryngology, Department of Surgery, TAMC, are excited that the robot has found its way to head and neck surgery. Since last May, the specialists have performed about eight thyroidectomies and about a dozen Trans Oral Resection Surgeries, or TORS.
"These are surgeries we are familiar with, but (now) we have a new tool," Sniezek said. "It takes a little different thought process for how to approach it. It sort of is a fresh way to do a surgery that we do all the time and the patients do better, so it is exciting."
Tripler is the first Department of Defense medical treatment facility and the first hospital in the state of Hawaii to do these two types of head and neck surgeries using the robot.
One of the major advantages of using the robot to perform these surgeries is dramatically better cosmetic results.
It is a very difficult area of the body to access, Sniezek explained.
"We would have to do pretty radical procedures like big incisions to open the face or splitting the jaw in half," Sniezek explained. "The robot allows us to just use the arms of the robot and a camera placed through the mouth, a natural orifice, and then we can resect the tumor without having to split the mandible or do facial incisions."
Sniezek added that this applies to the thyroidectomies as well because instead of removing the thryroid through the neck, in certain cases they can enter through the arm pit.
For TORS, Klem said the recovery time is much quicker for the patient and typically less chemotherapy and radiation are required.
"When we talk about recovery, we talk about speech and swallowing," Klem said. "So far, since this is a relatively new procedure, studies are showing that speech and swallowing is much better than for open surgery for this type of resection."
"The quality of life and overall function has been much, much better with this type of minimally-invasive surgery followed by lower dose radiation therapy," he added.
Sniezek and Klem are excited about the possibilities that this technology gives surgical specialties.
Sniezek said after the technology was created in the early 1990s, the Defense Advanced Research Projects Agency became very interested in supporting it because of its potential to allow surgeons to operate remotely on Soldiers wounded on the battlefield.
"You don't have to be in the same room to control the robot," Sniezek said. "You can be on another continent. It would allow a surgical specialist here at Tripler to operate on a wounded warrior in Afghanistan."
In December 2011, Klem and Sniezek started doing head and neck surgeries at Queens Medical Center in Honolulu and one of the surgeries involved the robot.
"This is a great resource sharing agreement between Tripler and Queens, that I think is a great example of the partnership between military and civilian medical resources," Sniezek said.
Tripler and Queens use the same kind of robot to perform the surgeries.
"I think it is important to get the word out that military medicine has the same cutting edge treatment for these difficult cancers as anyone does," Klem said.
"We are committed to staying on the cutting edge of advancements in surgical treatments, particularly for cancer therapies," Sniezek added. "Tripler is offering the very latest in techniques and technologies that are available."
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