Using lasers to remove tumors and other growths from the throat has always been a bit of a top-down affair. Surgeons peer down the patient's throat to gain direct sight of the target tissue, then vaporize it in segments with a fixed external laser attached to an operating microscope.
But now, with the help of a CO2 laser fiber and a surgical robot, doctors at Cleveland Clinic have introduced a more flexible approach to throat surgery, one that allows tumors to be viewed and removed more quickly and with greater precision.
Developed by a research team from the Massachusetts Institute of Technology, the laser energy is delivered from the end of a flexible, spaghetti-thin fiber that can be positioned above, beneath or next to the target tissue. Moving the fiber into precise position is a surgical robot, called Da Vinci, more commonly used in heart surgery. Providing surgeons with an unequalled 3-D close-up of the operating area are twin mini-cameras - an extra pair of super-powered eyes set at the end of fiberoptic cables.
"The paired cameras, combined with the flexible laser, provide an amazing depth of field," says Marshall Strome, M.D., an otolaryngologist and Chairman of the Cleveland Clinic's Head and Neck Institute. "They enable me to see the tumor better than ever before and, when used in combination with the flexible laser fiber, also allow more strategic incisions, initially speeding the overall operation."
During the procedure, Dr. Strome works from a nearby booth, watching the video feed and manipulating hand controls that get translated into the delicate movements of the twin robot arms that move laser, lights and cameras.
"This is the future of throat surgery," he says. "As the lasers and robots continue to evolve, I see them being used for a full range of procedures, whether it's a tumor of the vocal cords, tongue or wall of the throat."
While robotic and laser surgery currently requires the surgeon and patient be in the same room, Dr. Strome envisions a day when such surgeries will be performed remotely, from across town or from across the globe.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 9/1/2006
