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Robotic surgery at St Vincent’s Hospital saves Melbourne man’s voice and ability to eat

The 27-year-old was told he might never speak or eat again after a lump was found in his throat.
Jennifer Bechwati, National Health EditorBy Jennifer Bechwati, National Health Editor

Robotic surgery at St Vincent’s Hospital saves Melbourne man’s voice and ability to eat

The 27-year-old was told he might never speak or eat again after a lump was found in his throat.
Jennifer Bechwati, National Health EditorBy Jennifer Bechwati, National Health Editor

A 27-year-old Melbourne man has had his voice and his life saved by cutting-edge robotic surgery, performed in a world-first procedure at St Vincent’s Hospital.

Jordan Robotis works in before-and-after-school care and said it all started around Christmas time.

“I sort of was noticing my voice was kind of changing,” he said.

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“And then further down, my cousins noticed that there was a lump in my throat. So then I got that checked out from the doctors.”

Initially, he said: “They were a little bit unsure about it,” and after ultrasounds, CT scans and a biopsy, he ended up at St Vincent’s Hospital.

“They were able to give me a better understanding of what it actually was,” Robotis said.

Jordan Robotis. Credit: 7NEWS

“They also put a camera in my nose and into my throat and I was able to actually see the tumour, which was pretty confronting.”

The tumour was in a highly complex part of the throat, located between the voice box, tongue and side wall of the throat where critical nerves and arteries are tightly packed.

“I was a little bit, I guess, in shock,” Robotis said. “Sort of unsure on what it is because obviously you hear about it, you see it everywhere. But when it’s you, it’s a little bit confronting.”

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“You sort of go into survival mode... What do we do now?”

After being told at another hospital he might never speak or eat again, Robotis was referred to St Vincent’s Professor Ben Dixon, Director of the ENT Head and Neck Service.

The tumour was in a highly complex part of the throat. Credit: 7NEWS

“They actually did tell me that I’d lose my voice completely. I would never speak again. I’d never eat again. I would have a feeding tube, all that fun stuff,” Robotis said.

“They said they would do their best to avoid all of those, I guess, critical parts and from what I heard, they were one of the best at what they do.”

Professor Dixon told 7NEWS the surgery required “complete removal with a margin around it,” but the challenge was to preserve critical functions such as breathing, swallowing, speech and voice.

“With a more standard or larger approach… it may have left him with more swallowing dysfunction, voice dysfunction, even potentially requiring a permanent breathing tube,” he said.

The team used the da Vinci robot to operate from the inside of the throat outward.

The team used the da Vinci robot to operate from the inside of the throat outward. Credit: 7NEWS

“We were able to go in through the mouth, define the limits of exactly where the tumour was, make precise cuts around the lining of the throat and the voice box so that we could maintain function in as much of it as possible,” Professor Dixon explained.

“Then we were able to go externally through the neck and remove it knowing that we’d made the internal cuts in all the right areas.”

“You need to get it all out in the one go… If you leave bits behind or have positive margins, that could be a disaster.”

Jordan had no idea the surgery would be done by a robot.

“I was a little bit unsure at the beginning because obviously you don’t really expect to be hearing something like that,” he said.

“But I had full trust and faith in the medical team, so I didn’t really stress too much. I knew I was in good hands.”

After the tumour was removed, plastic surgeon Dr Edwin Morrison used the Simani microsurgical robot to help reconstruct the area using tissue from Jordan’s thigh.

“It’s one of a kind. There is no alternative to it,” Dr Morrison said.

The tissue transfer involved repairing blood vessels just 1mm to 1.5mm in diameter. Credit: 7NEWS

“It provides us with unparalleled abilities to operate at the microscopic level. Some would say superhuman. It’s probably not that unreasonable to put it that way.”

He explained the tissue transfer involved repairing blood vessels just 1mm to 1.5mm in diameter.

“We’re restoring a circulation or bringing it back to life, if you will,” he said.

“The confidence in repairing vessels… less than one to one and a half millimetres, is not there (without robotics).”

Dr Morrison said their goal was simple.

“At the end of the day, we reconstruct defects, we restore form and function - but what it’s really all about is restoring patients… and in Jordan’s case, their quality of life after their treatment,” he said.

The operation took place on May 5th. Recovery was not easy.

“Coming out of surgery, I was in all sorts. It was a lot. It was probably the hardest few weeks of my life,” Robotis said.

“But after getting out of the first few weeks and coming home, it was a lot easier to kind of start healing.”

He’s now focused on getting his strength back.

Returning to the operating theatre where he underwent his surgery 7NEWS was there as Jordan thanked his doctors for saving his voice and his life.

“I guess… thank you. Just for everything they’ve done. Just how efficiently and quickly it all kind of happened,” he said.

“That’s all I can really appreciate is that I’m here.”

Professor Dixon said the case highlights how robotic-assisted surgery is transforming outcomes for patients.

“Jordan being a young man with a tumour in a difficult spot… it’s a great example of how using technology in the right case can really allow someone to live with a very high quality of life,” he said.

“And really importantly, offer this to as many people in the public as possible.”

And if you’re still unsure about robots in the operating room?

“The surgeon still controls the robot,” Professor Dixon explained.

“It is not an automated robot. It’s fully controlled by a surgeon.”

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