3D surgery's new look at cancer
“It’s never easy telling someone they have cancer,” says Abdul Ahmed who breaks the news to dozens of patients a month in his role as a head and neck cancer surgeon.
Northwick Park Hospital is the regional centre for head and neck surgery specialising in cancers affecting the mouth, jaw, neck, salivary glands and skin.
It treats more than 150 patients a year across north-west London with the majority undergoing reconstructive surgery with the appliance of science allowing surgeons to create a 3D model of the affected area.
Surgeons use a software package which allows them to virtually pre-plan the procedures including the incisions, modelling and realignment of replacement bone and tissue. The technology offers greater accuracy and speed in procedures that often involve two teams of surgeons working on the same patient for up to 12 hours.
A recent example was a middle aged man from Harrow initially referred to the team with an ulcerated gum that wasn’t healing. Subsequent tests revealed a tumour with the cancer spreading through the jaw.
Mr Ahmed said: “The majority of surgery people undergo isn’t seen by anyone else because it takes place inside the body whereas we are operating on the most visual and expressive part of human anatomy: the face.
“The good news is we can surgically treat many of these cancers. It is important to catch the cancer early before it reaches the neck glands from where it can spread from to the rest of the body. Some of the cancers require additional chemotherapy and radiotherapy treatment to reduce the risk of recurrence.
Two teams of surgeons worked on the patient simultaneously during the procedure.
They first removed the neck glands and affected jawbone as well as prepping for the new implant, while the second team harvested the bone from the lower leg along with an attached veins and artery.
The 30cm long piece of bone was then sculpted into the new jawbone using a 3D designed templates and fitted into the mouth with the aid of titanium plates and screws.
The final stage of the 12 hour procedure was to reconnect the blood supply to the reconstructed jaw plumbing in the vein and an artery which provide a continuous flow of blood to and from the jaw.
Mr Ahmed added: “It’s a delicate process involving the use of microsurgery that utilises needles and sutures barely visible to the human eye. It’s a tricky process because when we reconnect the vein or artery there is a chance of a blood clots developing and that means taking the patient back into theatre.
“We temporarily attach a small device onto an artery in the neck to monitor blood flow during the first 48-72 hours.
The patient was awake and talking within 24 hours of the procedure and they usually get them home in a couple of weeks."
Mr Ahmed, who is also a fully trained robotic surgeon, originally trained in 3D surgery in Germany, says the next tech jump will be the use of augmented reality with surgeons wearing special glasses that allow them to carry out virtual operations in real time as well as trainees being able to see through the clinician’s eyes as the procedure takes place.
Northwick Park is the regional centre for the treatment of head and neck cancers looking after patients in North West London, East Berkshire, Hertfordshire, Middlesex and Paddington. It is a member of the member of the North West London Cancer Network.