UPMC Surgeons Remove Head and Neck Tumors With New Robot

By: Anita Srikameswaran, Tim Betler and John Dillard

Head and neck surgeons at UPMC are the first in the country to use the Flex® Robotic System, a snake-like device, to remove masses from otherwise hard-to-reach places in the oral cavity and throat. The surgeons have used the system for several cases since September, and all patients have done well after their procedures.

Conventional surgery to access certain sites, such as the base of the tongue, usually requires large incisions in the neck, explained Umamaheswar Duvvuri, M.D., Ph.D., director of robotic head and neck surgery at UPMC. Lasers can be inserted through the mouth to burn away tissue, but it can be challenging for the surgeon to get a clear line of sight to the lesion using these straight instruments.

“This is the first non-linear robotic system,” Dr. Duvvuri said. “Its flexibility allows us to literally turn corners to view the lesion and position our instruments in ways that were not possible before. We expect this will allow patients to have a quick recovery with fewer or no incisions at all.”

The Flex robot, which is made by Medrobotics, was initially invented at Carnegie Mellon University, and Dr. Duvvuri and University of Pittsburgh experts helped develop it for surgical uses. The articulated scope can twist and turn to get into the right spot, where it can be “parked” to hold a rigid shape at the operating site. The surgeon can then insert flexible instruments along the scope to excise a mass.

“This is really the next wave of progress in surgery,” Dr. Duvvuri said. “Imagine being able to reach a lung tumor through a small incision in the neck, or removing a large mass in the colon without going through the abdomen. This technology has a very bright future.”

He and a patient talk about the new device in this video.