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Montefiore in the News

November 10, 2010

Surgeons at Montefiore-Einstein Center for Cancer Care Use daVinci Robot to Rebuild Man's Tongue after Severe Damage from Radiation

NEW YORK CITY, NY (November 10, 2010) -- As the official firehouse cook for the Lindenhurst Fire Department, 66-year-old Tom Scaccia has been preparing meals for himself and his fellow volunteers for the past 20 years.

His enthusiasm for that role was diminished when radiation therapy for tongue cancer left him in chronic pain and unable to swallow.  The retired Long Island Railroad worker, who is still an active volunteer fireman and SPCA peace officer, was limited to eating pureed foods. While the radiation had effectively eliminated his cancer, it had also severely damaged tissue at the base of his tongue.  

A novel transoral robotic surgery performed at the Montefiore-Einstein Center for Cancer Care in the Bronx has returned Mr. Scaccia's life to normal. Referred to Montefiore by his doctors in Long Island, Mr. Scaccia today is free of pain and back to his regular activities. "I call it a miracle," he said.

At Montefiore, Richard V. Smith, MD, Vice Chairman, Department of Otorhinolaryngology-Head and Neck Surgery, and Evan Garfein, MD, Plastic and Reconstructive Surgery, used the da Vinci Robotic Surgical System to perform the complex reconstruction, and they agree that the results they achieved for Mr. Scaccia are better than expected.

"His recovery is fantastic," Dr. Smith said. "He healed much faster and regained function much earlier than we thought he would."

After performing preliminary surgery to remove tissue damaged by radiation, Dr. Smith and Dr. Garfein performed a robotic reconstruction of the base of Mr. Scaccias tongue. Because the robot is designed to maneuver in tight spaces, the surgeons used it to close a hole where the damaged tissue had been. This was done by using tissue from his forearm to fill the hole.  In order for the tissue to live in its new location, blood vessels that supplied the forearm tissue were attached to vessels in his neck using a microscope.  The robotic procedure was performed through the mouth, allowing Mr. Scaccia to avoid a significant open surgery that would have required splitting the jaw for access.

Within a few weeks of the robotic surgery, Mr. Scaccia was almost completely healed and was no longer in pain. While the type of procedure performed on him, known as a robotic free flap reconstruction, has been done at a handful of medical centers, this robotic procedure to reconstruct the base of the tongue is believed to be the first of its kind to be performed anywhere. "Very few medical centers in the U.S. are doing robotic reconstruction procedures like this," said Dr. Garfein.

Dr. Smith is experienced in using the daVinci robot to perform delicate surgeries on patients with head and neck cancer and was the first surgeon in the world to perform robotic total laryngectomies in patients with cancer of the larynx.