Tumour removed by robotic surgery

Surgery led by Indian-origin surgeon

In a first, a robot was used to successfully remove a rare tumour from a patient’s neck in a surgery led by an Indian-origin surgeon.

Chordoma is a rare type of cancer that occurs in the bones of the skull base and spine. A chordoma tumour usually grows slowly and is often asymptomatic for years.

In the case of 27-year-old Noah Pernikoff from the U.S., a 2016 car accident revealed his surprising diagnosis. Among his injuries from the accident, Mr. Pernikoff tore his rotator cuff and had several herniated discs. More important, however, was his post-accident nagging neck pain, which lead to an x-ray that revealed a concerning lesion in his neck, on his cervical spine.

Three-step surgery

Mr. Pernikoff became the first patient in the world to undergo a complex three-part, robotic-assisted surgery, which was completed at the Hospital of the University of Pennsylvania in the U.S. in August last year. First, the neurosurgeons went through the back of Mr. Pernikoff’s neck and cut the spine around the tumour to prepare for the second stage, removing the tumour through his mouth.

The lesion was clearly unrelated to the accident, and far more concerning than the minor injuries he had endured.

After making a recovery from the accident, a biopsy of the spot resulted in a diagnosis of chordoma.

“I’m lucky because they caught mine early. For a lot of people, if it’s not found and treated early, it’s lethal,” Mr. Pernikoff said.

“The doctor said if I hadn’t discovered it through the car accident it probably would have kept growing until it came to a point on my spinal cord where it caused paralysis or death,” he said.

Chordoma is extremely rare. It affects only one in one million people each year. Mr. Pernikoff’s specific type of chordoma, located on his C2 vertebrae, is even rarer, making treatment a challenge.

A team led by Dr. Neil Malhotra, an assistant professor decided to remove the tumour through a rare and complex spinal surgery approach by using a trans-oral robotic (TORS) approach for the second part of the surgery. TORS is the world’s first group of minimally invasive robotic surgery techniques to remove benign and malignant tumours of the mouth and throat.

Nine months after the surgery, Pernikoff is already back to work.