Minimally invasive supraomohyoid neck dissection for oral squamous carcinomas

Introduction: Various surgical techniques are being developed to improve aesthetic and functional outcomes in all surgical conditions including cases of malignancy. Neck dissection via a big cervical scar is questioned nowadays when majority of primary oral cancer lesions are addressed by intra-oral resection. Recently two papers have been published for robotic assisted neck dissection with the same philosophy. We present a small series of five cases operated by total endoscopic method.

Objectives: To study feasibility of total (pure) endoscopic technique for selective neck dissection (using CO2 insufflation) in cases of early oral cancers.

Methods: Consented patients (total of five) were operated by a single surgeon using total (pure) endoscopic technique using conventional laparoscopic instruments. The parameters for assessment of results were: duration of surgery, amount of blood loss and complications for intra-operative outcome, hospital stay and cumulative length of incision for functional outcome and number of lymph nodes dissected in pathology specimen for oncological outcome.

Results: Average duration of surgery was 99.2 minutes, average blood loss was 40 ml and there was no reported intra/post-operative complication. Average hospital stay was 2.4 days and average cumulative length of incision was 4.1 cm. The average number of lymph nodes dissected in pathology specimen was 19.4.

Conclusion: Minimally invasive supra-omohyoid neck dissection for oral squamous cancers by total endoscopic surgical technique is feasible with better aesthetic outcomes without compromising oncologic principles. It can become a cheaper option to robotic surgery.

Biography :

Ravindrasinh Raj is a Renowned Surgical Oncologist in India. He has been trained from esteemed Tata Memorial Centre (No1 cancer institute of India). He has provided services as Medical Director at Bharat Cancer Hospital, Surat, India and at present working as Chief Surgical Oncologist and Medical Director at Ratandeep Cancer Centre, Surat, India. He has been involved in numerous protocol researches. He has developed a novel surgical technique for minimal access neck dissection in cases of oral squamous carcinomas, which has been published in “Surgical Endoscopy”, the official journal of SAGES, USA. The same has been awarded as “Best Research Video” by Society of Laparoendoscopic Surgeons (SLS), USA in 2014.

E-mail: rajravi22@gmail.com

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