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Surgeons for the first time operated a malignant tumor in the spine with a robot

Surgeons for the first time operated a malignant tumor in the spine with a robot

University of Pennsylvania

Surgeons from the University of Pennsylvania performed the first of their kind surgery to remove a malignant tumor from one of the cervical vertebrae of the patient. As reported in the press release of the university, the operation was carried out in three steps, and during one of them, doctors used robotic arms (transoral robotic surgery) to get close to the tumor. So far, operations using this technology have been carried out to remove tumors in soft tissues, but in this case, doctors used it for surgery on the spine (the bones of the vertebra were pre-sawn).

27-year-old New Yorker Noah Pernikoff (Noah Pernikoff) in 2016 fell into a car accident. As a result, he received not very serious injuries and pain in the neck. When the young man underwent X-ray diagnostics, he was diagnosed with a neoplasm in the cervical spine. Subsequent studies and biopsy revealed a chordoma in Pernicoff, an extremely rare slowly growing form of cancer that occurs in the cervical or coccyx-sacral parts of the spine. Pernikoff had a tumor in the second cervical vertebra.

Removal of the tumor could cause serious complications. If the spine is damaged during surgery, the patient will remain paralyzed; Because of damage to bones or soft tissues, Pernikoff could have lost his sense of smell or had minor motor problems. In the event that surgeons have not removed the entire tumor, it would begin to grow again and possibly faster than before. Therefore, radiotherapy could be an alternative to the operation.

The neurosurgeon, who was treated to a resident of New York, connected him with surgeons from the University of Pennsylvania. Doctors examined the patient and still decided to perform a complex three-stage operation using transoral robotic surgery. This technology allows you to remove tumors in the mouth and larynx through the mouth with minimal interference and damage. So far, robotic surgeons have been used to remove tumors in soft tissues, but surgeons from Pennsylvania for the first time performed such an operation on the spine. For the operation, MD Neil Malhotra, an assistant professor in the neurosurgery and orthopedic surgery departments of the University Hospital of Pennsylvania, assembled an interdisciplinary team of surgeons.

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The operation was done in three stages. First, doctors using an ultrasound device cut the spine around the tumor from the side of the neck and carefully, so as not to touch the tumor and not damage the spinal cord, remove the bone fragments. At the second stage of surgery, surgeons first “cleared” the path to the tumor with the help of a robotic surgeon, and then removed it through the larynx. The last step was to restore the bone to the vertebra with the help of bone tissue from the patient’s thigh and rods. The operation was conducted in August 2017, within two days. In total, it lasted 20 hours.

Surgeons for the first time operated a malignant tumor in the spine with a robot

Scheme of chordoma removal with transoral robotic surgery

Now nine months have passed since the operation, the patient returned to work and says that he is grateful for the car accident, which allowed to identify the cancer at an early stage. “I was lucky because they caught my [swelling] at an early stage. For many people, if it were not found and not cured, it would be lethal, “says Pernikoff. “The doctor said that if I had not found the tumor after the accident, it would continue to grow until I had a paralysis or I died. I was very fortunate in this sense. “

Previously, American engineers developed a soft robot for the colonoscopy, which is able to move squeezing and unclenching. According to the idea of ​​the authors, this design will help reduce the unpleasant sensations during the procedure, so people will be more willing to use this method of diagnosis, which allows to detect intestinal cancer at an early stage.

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