Robotic surgery to increase detection rate

Dr Hardman and Prof Paleri are going to investigate the impact of a combination of two techniques, one surgical, one pathological, on diagnosis and of treatment of patients with these undetectable primary sites.

Robotic tongue base mucosectomy (TBM) is a procedure, developed in the last 3 years, to remove the entire tongue base tonsillar tissue, thus enabling assessment of the entire area where primary cancer can reside. It’s both minimally invasive and precise.

Step serial sectioning (SSS) is a pathological assessment technique that will then be used to assess the TBM and tonsil biopsies. It involves taking very thin slices of biopsied tissue to find tiny cancer within. Traditionally, only random biopsies of this area are carried out, and it is purely chance that a malignancy is identified.

Our researchers hope that the primary cancer will be detected in a larger number of patients thus enabling targeted treatment to the cancer and the potential for complete removal of primary cancer in some.

Additionally, even where no primary cancer is found, the robust pathological assessment of the mucosa on the opposite side to the neck node (tonsil and tongue base) will assure clinicians and patients of the lack of a cancerous focus, allowing treatment to be limited to one side alone.