UH Performs Head and Neck Surgeries Using Novel Da Vinci Single Port Robotics Capabilities

Innovations in Ear, Nose & Throat | FALL 2024

Surgeons within the University Hospitals Ear, Nose & Throat Institute recently performed the health system’s first cases using the Da Vinci SP, s high-performance single-port robotic surgical system from Intuitive Surgical Inc.

Madelyn Stevens, MD

Madelyn Stevens, MD joined Shawn Li, MD to complete the first surgery at the institute. “We have a great group of folks here who perform a high volume of robotic surgery,” Dr. Stevens says. “Dr. Li is our director of robotics for ENT, and he put a lot of effort into acquiring the latest in advanced technology that provides noninvasive access to hard-to-reach tumors.”

Originally from Northeast Ohio, Dr. Stevens returned home and joined the UH Ear, Nose & Throat Institute this summer. She specializes in robotic surgery, microvascular reconstruction and cancers of the head and neck. Prior to completing a fellowship in Head-Neck Oncology/Microvascular Reconstructive Surgery at the Medical University of South Carolina, Dr. Stevens completed her residency in Otolaryngology-Head and Neck Surgery at Vanderbilt University Medical Center. She earned her medical degree at Duke University School of Medicine. 

Dr. Stevens gained specialized training on the Da Vinci robot during her fellowship, as academic medical centers are increasingly adopting robotic technology to address complex head and neck tumors. “With any surgery, there is a learning curve,” she says. “I am excited to be able to integrate my experiences with a group already very well-versed in robotic surgery.”

World-class Precision

The Da Vinci SP provides 360 degrees of anatomical access and is uniquely designed for single-incision or natural orifice surgeries such as the transoral procedures performed by otolaryngology-head and neck surgeons. A single arm delivers three or four multi-jointed instruments and a fully articulating 3DHD endoscope, increasing opportunities to offer high-complexity robotic procedures to a broader range of patients.

“The camera gives a more enhanced image than you can see with the naked eye,” Dr. Stevens says. “When you are trying to differentiate abnormal tumor cells from normal tongue-based cells, that level of definition and clarity on the robotic camera is helpful.” The capability to flex the camera into a variety of positions also enables surgeons to visualize the throat at multiple angles. 

Reduced Surgical Morbidity

“Robotic surgery in ENT is not new, but there is a subclass of HPV-related cancers that tend to present in the tonsils or base of the tongue at the back of the throat that are very treatable tumors,” Dr. Stevens says. “These patients are living longer, and we need to be thoughtful about the morbidity of treatment.”

Historically, surgeons split the mandible or deemed these tumors not surgically accessible, limiting treatment options to chemotherapy and radiation. “The beauty of the single-port Da Vinci robot is that it decreases morbidity to the patients because we do not have to make a large incision in the neck or jaw to access the oropharynx,” Dr. Stevens says. “We can limit cuts to removing cancers or benign tumors. The robotic arms allow for extremely fine movements, perhaps even a finer response than standard surgical movements.”

Systemwide Collaboration

Although the Da Vinci SP is located within the UH ENT Institute, team members are partnering with other departments to ensure the robotic capabilities are strategically utilized. Specialists from urology, OBGYN and general surgery are identifying procedures that would lend themselves to the new technology.

“It is exciting to see the support of the hospital system to find champions in other subspecialties to explore how we can expand access to patients and see what else this robot can do,” Dr. Stevens says. “It has been a testament to the collaborative effort among our surgical staff, nurses and sterile processing team to implement the new equipment so we could get up and running quickly.”

For more information, contact Dr. Stevens at Madelyn.Stevens@UHhospitals.org.

Contributing Expert:
Madelyn Stevens, MD
Department of Otolaryngology – Head and Neck Surgery
University Hospitals Ear, Nose & Throat Institute
Assistant Professor of Ototlarnygology Head- Neck Surgery
Case Western Reserve University School of Medicine