Advancing futuristic technology in oncology surgery today

Nimble robotic digits smaller than a finger that can excise cancerous
tissue from the throat without cracking the patient’s jaw.
Patient-physician conversations via an iPad that can eliminate costly
travel expenses when a patient lives hundreds of miles away. Wearable
medical devices that can measure a patient’s activities, providing the
physician with valuable data on the patient’s recovery.

Sounds futuristic, but such technology is being used and studied
today at MD Anderson through a program
called MINTOS — Minimally Invasive New Technology in
Oncologic Surgery

The program, now in its 10th year, is helping our surgeons discover
new, innovative ways to treat cancer with less invasive procedures,
providing better quality of life and successful outcomes for our patients.

Influencing the future of robotics in oncology surgery

While MINTOS involves much more than robotic surgery, the daVinci
robots used at MD Anderson are usually the
first things that come to mind.

Equipped with miniature surgical tools and 3-D cameras with
magnification of the operative view, the four robots allow our skilled
surgeons to operate with extreme precision through tiny incisions. For
our patients, robotic surgery means shorter hospital stays, quicker
recovery times and better cosmetic outcomes.

Our surgeons have performed more than 7,000 robotic surgeries over
the last 10 years. And we rank second in efficiency among top cancer
centers in the country, with approximately 325 cases per robot each year.

“Even with the complexity of surgery required for our patients’
diagnoses, we do more cases per robot than most hospitals, and our
program is still growing,” says George Chang, M.D., director of clinical
operations for MINTOS.

Surena Matin, M.D., medical director of MINTOS,
says the program has created a uniquely collaborative environment for
our surgeons.

“Surgeons have never before had a common platform to rally around,’’
he says.

“We’re hoping to influence the next generation of robotic surgery,
and we’re well-poised to do that with a terrific team of
multidisciplinary collaborators and an institutional environment that
supports partnering with industry,’’ Matin says.

“Our leadership has created a culture and strategic vision resulting
in focus and momentum, and has been tremendously supportive.”

Unique cancer research opportunities

Clinical research is another innovative area of focus for MINTOS.

Because our head and neck surgeons see a tremendous number of
patients with cancers related to human papillomavirus (HPV), we have an
opportunity for surgery-related clinical research in that area, says
Neil Gross, M.D., director of clinical research
in Head and Neck Surgery.

Gross is studying transoral robotic surgery (TORS), which uses
state-of-the-art robotic techniques to remove cancers commonly found
on the tonsils or base of the tongue.

“These patients tend to have a high cure rate and to be young,
active and high-functioning,’’ Gross says. “If it’s possible to do
surgery and eliminate chemotherapy or radiation, it can make a big
difference in their long-term quality of life.”

His research also includes intensity modulated proton therapy (IMPT), which
zaps the cancer while sparing surrounding healthy tissue. In addition
to standardized swallowing outcome measures, digital wristband
monitoring helps better measure the overall impact of treatments on
function, providing important data on the patient’s expected rate of recovery.

“We can combine different treatments here that other places struggle
to do and find the best options for our patients,” Gross says.

Telemedicine with infinite potential

The use of telemedicine – communication between physicians and
patients via iPads and other mobile devices – is another area under study.

“The intention is to use telemedicine as a follow up to facilitate
discharge,’’ says Matthew Katz, M.D. “It may help reduce
readmissions and complications. People seem to love it.”

Telemedicine also is being explored for patients dealing with a
cancer recurrence. This way, care can be provided remotely without
compromising quality.

“We’re seeing more patients we’ve treated in the past who just need
surveillance – they just need a scan and to say hello,’’ Katz says.
“Potentially this is a way to help us see more of these patients more efficiently.”

Working with the AT&T Foundation, MD
hopes to develop an infrastructure to make all of
these tele-technologies feasible. In the future, telemedicine could be
used for perioperative visits, meetings with referring physicians,
initial screenings, mentoring and on-boarding new physicians.

“There’s infinite potential,’’ Katz says.

A longer version of this story originally appeared in Messenger,
MD Anderson’s quarterly publication
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