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Robotic surgery ends apnea patient's sleeplessness
[August 05, 2010]

Robotic surgery ends apnea patient's sleeplessness


Aug 05, 2010 (The Oklahoman - McClatchy-Tribune Information Services via COMTEX) -- The doctor looked a little like a video gamer with his fingers inside controllers used to move robotic arms. He peered through an eyepiece and took aim at the bad guys: two tonsils shown in 3-D and magnified 10 times by a miniature camera.



The patient won this match.

Johna Jupe got the gift of sleep and clear breathing when the doctor successfully removed the tonsils in what is believed to be the region's first robotic surgery on the lingual tonsils.


The success was significant because Jupe suffered for decades with potentially life-threatening sleep apnea.

She had tried other treatments that failed and surgery that made her tonsils grow back even larger. She said even a continuous positive airway pressure, or CPAP machine, designed to blow air with enough pressure to keep her airway open, didn't solve her apnea.

Instead, it left her breathing much like a dog with its head stuck out the window of a car going 70 mph.

"You wonder how they breathe. That's what it felt like," she said.

Jupe, a Norman cake decorator, became so desperate to breathe and swallow more easily that she visited specialist Dr. Nilesh Vasan with the intention of getting a tracheotomy.

She thought the only way she could get her breath was by having an incision in the front of her neck, then getting a tube inserted to allow her to breathe without using her nose or mouth.

But the OU Medical Center surgeon had other ideas.

Vasan said the lingual tonsils are at the back of the tongue, then down at the base of the throat. Surgeons have to navigate that tiny anatomical turn with relatively large fingers, using rigid instruments through traditional surgery. Robotic surgery has been used about a decade but the Food and Drug Administration just recently approved treating obstructive sleep apnea with the latest medical robots such as the da Vinci-Si recently purchased by the OU Medical Center.

Vasan said he felt confident the new technology would help him safely remove the swollen tonsils and likely put an end to Jupe's sleep apnea.

"You miniaturize yourself and put yourself in a very small place," Vasan said. "The mobility of the robotic arms is more than your hand and gives you more angles from which to work." Jupe, 49, recalled that her journey began when she got tonsillitis in fourth grade and underwent the traditional antibiotic treatment. But the problem returned again and again, worsening over time. By her mid-30s, Jupe felt sleepy all the time and struggled to breathe or swallow because of the blockage in her throat. She jerked awake most nights, sometimes as many as six times, and her husband said she stopped breathing in her sleep and her throat made a gurgling, choking sound.

"It was like having a really bad roommate. You really wanted to get rid of it," she said.

She was often breathless, even after a long string of treatments.

Vasan explained that people with sleep apnea are at risk for heart failure, stroke, hypertension and other forms of heart disease.

Jupe decided it was time to give the robotic surgery a try.

She said she breathed better immediately after the June 25 surgery. She stopped the sleep medication she'd used for three years and her blood pressure medication was cut in half. "I can think more clearly. I can wake up in the mornings and I'm not exhausted," she said. "To basically breathe again and not feel like I'm suffocating, it makes a big difference. It was ... life-altering." To see more of The Oklahoman, or to subscribe to the newspaper, go to http://www.newsok.com. Copyright (c) 2010, The Oklahoman, Oklahoma City Distributed by McClatchy-Tribune Information Services. For more information about the content services offered by McClatchy-Tribune Information Services (MCT), visit www.mctinfoservices.com, e-mail [email protected], or call 866-280-5210 (outside the United States, call +1 312-222-4544).

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