Ho-Sheng Lin, M.D., F.A.C.S.
Ho-Sheng Lin, M.D., F.A.C.S., associate professor of the Wayne State University School of Medicine’s Department of Otolaryngology and leader of the Head and Neck Oncology Multidisciplinary Team at the Barbara Ann Karmanos Cancer Center, is the first surgeon in Michigan to use the da Vinci Surgical System to perform minimally-invasive surgeries on head and neck cancer patients who visit the center for treatment.
For patient Robert Spears, 70, of Detroit, there was no hesitation when it came to choosing the minimally-invasive method. “Using the robotic surgery was great because it kept my features intact,” he said. “Robotic surgery was my No. 1 choice.”
Spears is one of the patients Dr. Lin has operated on since he began performing surgeries using the da Vinci Surgical System for head and neck cancers a year ago. Da Vinci has been used to treat prostate, urologic and gynecologic cancers in the past. It was approved by the U.S. Food and Drug Administration in January for surgery on the tonsils, base of tongue, supraglottis and pharyngeal wall.
“The da Vinci Surgical System has made major changes in how we operate on head and neck cancer patients,” said Dr. Lin, who also serves as chief of the Section of Otolaryngology in the Department of Surgery at the John D. Dingell VA Medical Center. “In the past, we would be reluctant to operate on many of the patients with cancer involving the back part of the throat and voice box because of the high degree of morbidity associated with this type of surgery. We would typically recommend radiation or chemoradiation as the first line of treatment. Da Vinci is really making a big difference.”
Spears noted that his health has mostly been good even though he had smoked since he was 14. He gave up smoking cigarettes when he was 49 and switched to a pipe. It was only when he experienced a persistent sore throat starting in March of last year that he suspected something was wrong. As a retired Army sergeant first class, he visited the John D. Dingell VA Medical Center emergency room and was diagnosed in October with cancer of the tonsils, the lymph nodes and the parathyroid. Doctors also discovered a large tumor on the base of his tongue.
Patients diagnosed with head and neck cancer, like Spears, typically have to prepare for major, invasive surgery that may require a surgeon to make long incisions through the jaw and throat to gain access to the oral cavity. In Spears’ case, Dr. Lin would have had to split his chin and break his jaw to perform the radical tonsillectomy, the tumor resection on his tongue, the removal of four teeth and surgery on the roof of his mouth -- the sort of surgery that often results in facial disfigurement and difficulty eating, speaking and swallowing.
“With the old way of performing surgery, it’s pretty hard to operate on the patient,” Dr. Lin said.
With da Vinci, the same procedure takes only one or two hours. The system is a surgeon-guided robotic system that allows the physician to perform the surgery through the mouth without the need for external incisions. The tiny robotic surgical instruments placed inside the mouth follow the exact movement of the surgeon’s fingers and hand to execute precise and delicate procedures to remove cancerous tissue.
Da Vinci also comes with a three-dimensional, high-definition viewing screen, which provides the surgeon a clearer view of the operative field in the back part of the throat and voice box.
With the traditional surgical method, patients would remain in the hospital recovering for one to two weeks. Dr. Lin said patients can leave the hospital a few days after minimally-invasive robotic surgery. Other possible benefits of the da Vinci system include less blood loss, no visible scarring, no tracheotomy, fewer surgical complications and better cancer control.
Spears said that he is cancer-free today. Following the surgery, he went through chemoradiation, which he completed in mid-February. Because of the surgery, his radiation oncologist, Harold Kim, M.D., associate professor or Radiation Oncology, was able to reduce the radiation dose to the primary site, which may potentially reduce long-term complications associated with high-dose radiation.
Spears has regained his ability to swallow after losing that for two months. He is hoping to regain his sense of taste, which doctors have told him will return in three to six months. His voice has been affected, but he is able to eat most foods.
“I feel great,” Spears said. “Dr. Lin was very nice and very thorough in explaining the procedure to me. I received wonderful service at Karmanos and everyone has been great.”