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Head and neck cancer doctor performing surgery

In many cases, minimally invasive surgery is the first-line treatment for head and neck cancer. Using advanced surgical techniques, a skilled surgeon can remove as much cancer as possible while preserving the physical function, sensory function and appearance of the nearby structures.

Minimally invasive surgery offers several advantages over traditional open surgery, including reduced trauma to surrounding healthy tissues, less scarring, a shorter hospital stay, a faster recovery and potentially fewer surgical complications.

Common types of minimally invasive head and neck cancer surgery include:

Endoscopic laser surgery

The specific techniques used in endoscopic laser surgery can vary depending on several factors, including the location and extent of the head and neck cancer and the patient’s overall health and preferences. In general, the procedure is performed using a thin, flexible tube (endoscope) with a miniature camera and high-intensity laser attached to the tip.

The surgeon guides the endoscope through a natural opening, such as the mouth or nasal cavity, then uses the camera to create high-definition images of the tumor and surrounding tissues. The images are displayed on an external monitor in real time, allowing the surgeon to visualize the tumor site while operating.

After identifying the tumor, the surgeon uses the laser to precisely remove or destroy (ablate) the cancerous tissues. The laser delivers a concentrated beam of light that heats and vaporizes cancer cells and seals blood vessels to help control bleeding. During the procedure, the surgeon may also take tissue samples for microscopic analysis by a pathologist to determine the cancer’s stage and plan further treatment.

Transoral robotic surgery (TORS)

TORS is an advanced surgical procedure in which a surgeon utilizes a robotic system to access and remove tumors through the mouth. The robotic system incorporates a miniature camera, which the surgeon uses to create three-dimensional, high-definition images of the surgical site. The images are continually displayed on an external monitor while the surgeon operates, allowing for heightened surgical precision.

Using a special console to maneuver and control the robotic arms, the surgeon can navigate through complex anatomical structures with enhanced dexterity and precisely remove cancerous tissues while minimizing any disruption to the surrounding healthy structures.

Minimally invasive video-assisted thyroidectomy (MIVAT)

MIVAT is a surgical technique that can be used to remove the thyroid gland in certain cases. To determine whether MIVAT is an option, a surgeon will consider several unique factors, including the size of the thyroid gland and the patient’s overall health and preferences.

When performing a MIVAT procedure, the surgeon makes a small incision in a natural crease in the neck, then inserts an endoscope for visualization of the thyroid and surrounding tissues. Guided by real-time images displayed on an external monitor, the surgeon then inserts specialized surgical instruments through the incision to manipulate and remove the thyroid.

As compared to a conventional thyroidectomy, a key advantage of MIVAT is that it significantly reduces the risk of damage to the recurrent laryngeal nerve, thereby helping to prevent partial or complete voice loss.

Neck dissection

A neck dissection may be performed to help prevent cancer spread, assess the extent of cancer spread or remove cancerous lymph nodes. After making a small incision in a natural crease in the neck, the surgeon removes some or all of the lymph nodes in the neck and possibly some surrounding tissues.

The surgical technique used for a neck dissection can vary. Depending on the location and extent of the cancer, the surgeon may perform a:

  • Selective neck dissection to remove some lymph nodes in the neck
  • Modified radical neck dissection to remove all lymph nodes in the neck while preserving the non-lymphatic structures
  • Radical neck dissection to remove all lymph nodes in the neck along with some other structures, such as the sternocleidomastoid muscle, internal jugular vein and spinal accessory nerve

Pharyngectomy

A pharyngectomy may be performed if a tumor involves the throat (pharynx), a hollow tube that connects the mouth and nose to the esophagus. The goal is to remove as much cancerous tissue as possible while preserving swallowing and speech function.

Depending on the location and extent of the tumor, the surgeon may perform a:

  • Partial pharyngectomy to remove the portion of the pharynx that contains the tumor, then repair or reconstruct the remaining healthy pharyngeal tissue
  • Total pharyngectomy to remove the entire pharynx, then reconnect the mouth and esophagus
  • Laryngopharyngectomy to remove the entire pharynx and voice box (larynx), then reconnect the mouth and esophagus

Tracheal resection

Tracheal resection is a complex procedure that involves the removal and reconstruction of a portion of the windpipe (trachea). After making an incision in a natural crease in the neck, the surgeon carefully separates the underlying tissues to gain access to the trachea, then removes the damaged segment. Next, the surgeon connects the remaining healthy portions of the trachea to restore a functional airway.

Benefit from world-class care at Moffitt Cancer Center

The surgeons in Moffitt’s Head and Neck Cancer Program perform the latest techniques for addressing head and neck cancer. Likewise, the surgeons in our Reconstructive Oncology Program perform the latest techniques in reconstructive plastic surgery. Each patient receives a comprehensive treatment plan developed by our collaborative multispecialty team, and we offer all aspects of diagnosis, treatment and support in a single, convenient location.

Moffitt also offers a robust portfolio of clinical trials with active protocols for many types of head and neck cancer. Through these important research studies, many of our patients are among the first to benefit from promising new treatments, including innovative surgical techniques. Our dedicated research team continues to evaluate new therapies that show potential, and every day we are learning more and improving outcomes.

If you are a candidate for head and neck cancer surgery, the experts at Moffitt can explain your treatment options and help you make informed choices. You can request an appointment by calling 1-888-663-3488 or submitting a new patient registration form online. We do not require referrals.