Chennai, Nov 12: Apollo Proton Cancer Centre, Chennai, a premier destination for the most advanced, multidisciplinary cancer care, has successfully treated a 53-year-old man who had previously undergone treatment for tongue cancer and radiation therapy has undergone complex surgery for a new cancer in the back of the tongue and tonsil at Apollo Proton Cancer Centre, Chennai, using an innovative hybrid robotic approach that helped surgeons access and remove the tumour without cutting through the lips, mouth and jawbone.
The patient had remained disease-free for 11 years following his earlier treatment before developing a new tumour in the right tonsillar region and back of tongue A biopsy confirmed moderately differentiated squamous cell carcinoma. However, previous surgery and radiation had caused significant scarring and fibrosis, severely restricting his mouth opening to less than one finger breadth. This made conventional minimally invasive access through the mouth extremely challenging.
To overcome this, a team led by Dr. Naveen Hedne, Head and Neck Oncologic Surgeon, Apollo Proton Cancer Centre, Chennai, used a trans-oral–trans-buccal robotic approach. In addition to accessing the tumour through the mouth, the surgeons created a small additional opening through the cheek to introduce another robotic arm. This provided an alternative route to the tumour and enabled its removal without cutting the lip, mouth and jawbone, a more extensive approach that may otherwise be required to gain adequate surgical access.
The tumour was removed in one piece with clear surgical margins and the surgical defect was reconstructed using a nasolabial flap. Final histopathology confirmed that the margins were free of cancer, with no evidence of spread into the lymphatic or blood vessels or along the nerves.
The patient recovered well following the procedure. He was started on oral liquids on the second postoperative day and discharged on the fifth day. At the three-month follow-up, he remained disease-free, with preserved swallowing and intelligible speech. The cheek incision had also healed well with minimal visible scarring.
“Previous surgery and radiation can sometimes cause severe fibrosis and restrict mouth opening to the extent that conventional approaches become difficult. In this patient, the additional access through the cheek provided us with the necessary working space to reach the tumour while avoiding an extensive open procedure involving the jawbone. This approach allowed us to address the cancer while also focusing on preserving important functions such as swallowing and speech,” said Dr. Naveen Hedne, Head and Neck Oncologic Surgeon, Apollo Proton Cancer Centre, Chennai.
Mr. Karan Puri, Chief Executive Officer, Apollo Proton Cancer Centre & Apollo Specialty Hospitals said,
“At Apollo Proton Cancer Centre, we continuously strive to push the boundaries of cancer care through advanced technology, clinical expertise and innovation. This case reflects our commitment to delivering complex cancer treatments while prioritizing patient outcomes and quality of life.”
