Hollings Cancer Center surgeons introduce da Vinci single port robotic system in South Carolina for head and neck cancer care

The operating room team with Dr. Alexandra Kejner, center.

Doctors with MUSC Hollings Cancer Center are the first in South Carolina to perform head and neck cancer surgery with the da Vinci SP, a single port robotic system.

The new system gives patients more options for care, particularly patients with HPV-related cancers that are often caught at early stages and can be treated with surgery.

“It really has revolutionized our ability to treat this area,” said Alexandra Kejner, M.D. She was the first head and neck surgeon in South Carolina to use the new robot, though it wasn’t her first outing with the system. She was also the first to use it in Kentucky and agreed to join MUSC Health last year only with the promise that a da Vinci SP was on the way.

“It’s like dial-up compared to broadband,” she said, comparing the robot previously in use to the new one.

W. Greer Albergotti, M.D., who has also now used the system, called it a “huge advancement.”

“It gives us a much closer, magnified view of the tumor and the surrounding normal anatomy that we want to make sure to avoid,” he said. “Overall, it’s a leap forward for the quality of surgery that we're able to provide to patients in South Carolina.”

In robotic surgery, “ports,” or incisions, are made to insert the robotic instruments and camera into the surgical area – in the head and neck this means the mouth, without any external incisions. The surgeon then controls the instruments from a console rather than standing over the patient. Previously, surgeons used a robot that had three arms – one for a camera and two for instruments. That’s a lot to fit in someone’s mouth, Kejner pointed out, and it wasn’t feasible for every patient or every tumor. In addition, the camera was attached to a rigid endoscope. It could move forward or backward, but it couldn’t snake around the contours of the throat.

The da Vinci SP single port system uses only one arm, and the instruments and camera all emerge from that single arm. In addition, the camera is on a flexible endoscope that the surgeons can manipulate to look up, down and around.

Kejner anticipates that the system will be especially useful for patients with HPV-caused cancers. These patients tend to be younger and are likely to do well after treatment, she said, and they may want to avoid potential long-term side effects of other types of treatment, like radiation. Additionally, the system can be used as salvage surgery for patients for whom chemotherapy and radiation have failed and reduces the potential morbidity of larger, open procedures.

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