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Thyroid Surgery Internal Scar Tissue

In 2009, I started developing a lisp. I didn’t understand why. So, I went to my doctor and he thought maybe it was a problem with a heart attack. So, he had me do an MRI and it wasn’t. So then, I went to a specialist and they did a biopsy, and there it was, tongue cancer in the back of my tongue. So, they tell me this and I say what I say to a lot of people. I say, We’ll, fix it. And so, they sent me to six weeks of radiation and once a week I had chemo.

Then, I got through radiation, then I caught a cold. The cold made my throat swell up, and I couldn’t breathe. And I went down to Stanford Hospital and I said, Fix it. When I met John, he had extensive scar tissue that had compromised not only his swallowing ability, but also his speech and more importantly, his breathing ability. You can see here that the throat is, essentially, scarred down into a very small opening, and it was through this opening that John was trying to swallow and breathe. So, we had cured the cancer, but he was entirely dependent on a feeding tube for his nutrition.

And now he had required a tracheotomy. The options that we had for John were either fairly conservative, such as having him maintain his feeding tube, maintain a tracheotomy, or rather radical, meaning complete removal of his voice box, major reconstruction of his esophagus. Usually in that situation, we take a piece of bowel from the patient and bring it into the next to reconstitute a conduit so that they can swallow again. What really pushed us forward was the fact that John, developed thyroid cancer, so now he was going to need surgery and there would have been no way to successfully intubate.

TransOral Robotic Surgery TORS at Stanford John Ayers story

John so that he could have this operation. The timing of this coincided with the development of our transoral robotic surgery program. We now had another option to give John. He started talking to me about this robot. And it, and it made sense, logical sense to me, so, I said, I’m all for it. Stanford is one of the few institutions that utilizes the Da Vinci surgical robot to perform transoral robotic surgery. The robot has allowed us to reach further, get better access and see better than we have.

Been able to in the past. In addition, it has allowed us to extinguish the natural tremor in a surgeon’s hand. The surgeries we were contemplating before required fairly extensive incisions, splitting the mandible, approaching tumors through the neck and through the jaw. Now, we can approach these lesions entirely through the mouth with no incisions, Complications are lower. It’s been truly a winwin for both the patient and the surgeon. We then went on and removed his thyroid cancer, and we were able to cut, reshape and remove scar tissue so that we could make the airway now fully open.

The next step after that was removal of his tracheotomy tube. And that began a series of operations now to stretch, dilate and remove scar tissue that was blocking his esophagus. The ability to do this for people is the reason I went in to medicine. There are many patients like John out there that need help, and there’s precious few opportunities that we have to help them, but this is one of them. Let me tell you, it’s a wonderful feeling to be able to taste and have things go down.

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