Lung surgeries, when performed by opening the chest to spread the ribs or divide the sternum, can be effective but highly invasive procedures that lead to weeks of significant pain and recovery.  

Guided by the principle that "the needs of the patient come first," Mayo Clinic thoracic surgeons have begun using a single-port robotic system for surgeries that was recently cleared by the Food and Drug Administration (FDA). This minimally invasive approach enables surgeons to operate with enhanced precision and builds upon Mayo Clinic's leadership in advancing lung cancer care.

"What we have noticed is that Mayo Clinic is one of the few institutions that is starting to roll this out," says Mathew Thomas, M.B.B.S., M.D., a thoracic surgeon at Mayo Clinic in Florida who performed Mayo Clinic's first single-port robotic lung resection.

The evolution of thoracic surgery

As medical technology evolves, minimally invasive methods have emerged as alternatives to traditional lung surgery, including the multiport robotic system. 

Multiport robotic systems require surgeons to make several small incisions between the ribs to place a camera and instruments, allowing them to operate with greater visualization and precision.

However, operating between the ribs can still present challenges for both patients and surgeons, like considerable postoperative pain and anatomical variance. Factors such as tight rib spaces or reduced rib density can lead to intraoperative complications, including rib fractures.  

The single-port approach allows surgeons to operate through a single incision using similar robotic technology. In many cases, the procedure can be performed from beneath the rib cage, avoiding the need to work between the ribs.

Single-port robotic surgery has been used in other specialties for several years, such as for lymphedema and prostate cancer care. The FDA cleared its use for thoracic surgery in 2025.

At Mayo Clinic in Florida, where more than 90% of thoracic surgeries are performed using minimally invasive techniques, early experience with single-port lung resection has been positive.

"Many patients are able to go home the next day or a day or two later," says Dr. Thomas. Recovery times are shorter, with patients often returning to baseline in about seven to 10 days, compared with several weeks for other approaches.  

Bringing single-port robotics into practice

Introducing new surgical techniques supported by advanced tools — such as 3D imaging, virtual reality and navigation systems — demands careful preparation and coordination across the care team.

"We're so used to multiport and open surgery approaches, but single-port robotic surgery is a completely different way of operating," says Dr. Thomas. "The way we visualize the operation changes, and the instruments are also quite different from a multiport setup."

Dr. Thomas and his team met weekly for a month to complete simulation-based training, practicing with the single-port robotic system in a controlled environment before starting to perform these procedures on patients.

Their training also included hands-on experience in cadaver and animal labs, observing experienced surgeons and working with a proctor during initial cases to support safety. Dedicated operating room staff trained together throughout the process, building the coordination needed to perform the procedure effectively.

Next-generation thoracic care

For Dr. Thomas, single-port robotic surgery reflects a broader shift toward less invasive, precision-based care, offering faster recoveries and fewer intraoperative complications for patients with lung cancer.

The approach is also part of a larger effort across Mayo Clinic to integrate advanced technologies into thoracic surgery. 

As experience with single-port surgery grows, the team continues to expand its use and refine the technique.

"It's exciting to be at the forefront of innovation with my colleagues and to know Mayo Clinic supports its growth," shares Dr. Thomas. "We're rapidly expanding the number of patients who can benefit from this approach. I take great pride in what we've accomplished."

The post Mayo Clinic in Florida advances lung cancer care with single-port robotic surgery appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: I was just diagnosed with early-stage melanoma, and I am being referred to an oncologist. What happens next? Will I need a lymph node biopsy, or are there cases where it can be safely avoided? What other surgical or nonsurgical treatment options might be recommended?  

ANSWER: Melanoma is a type of skin cancer that begins in melanocytes, which are the pigment-producing cells. The pigment is called melanin. While it is less common than other types of skin cancer, it is more likely to metastasize, or spread, to other parts of the body. But when detected early, it is often highly treatable. 

Early detection

After a biopsy confirms the diagnosis, your care team will evaluate details of the tumor, including its thickness, and other features seen under a microscope, along with a physical exam to determine the clinical stage and guide treatment recommendations. 

In most cases, a procedure called wide local excision, which removes the melanoma along with a 1- to 2-centimeter margin of surrounding healthy tissue, is performed to ensure all cancer cells are removed. Some patients also may be recommended to have sentinel lymph node surgery. This procedure looks for cancer in the first lymph node, or nodes, that drain the area where the melanoma developed.  

For years, sentinel lymph node biopsy has been an important part of staging melanoma. It can help determine how advanced the cancer is and whether additional treatment might be beneficial. However, it's also a surgical procedure, and like any procedure, it carries some risks and isn't necessary for everyone.  

In fact, recent studies show that most people who undergo this operation, nearly 80%, do not have cancer in their lymph nodes. Because of this, researchers have been working to better identify which patients are most likely to benefit from the procedure and which patients may be able to safely avoid it. 

Advanced options for melanoma staging

One newer approach involves genomic testing of the melanoma tumor. This test analyzes the activity of the specific genes in the tumor, along with clinical factors such as age and tumor thickness, to estimate the likelihood that the cancer has spread to nearby lymph nodes. 

For some people with early-stage melanoma, a low-risk result on this type of test may indicate that the chance of lymph node involvement is very small. In these cases, patients and their care teams may decide, through shared decision-making, to safely avoid lymph node biopsy. 

At the same time, it's important to note that lymph node biopsy remains an appropriate and important option for patients with higher-risk features. The decision is individualized, based on both traditional staging and new tools that help refine risk. 

For many people with early-stage melanoma, surgery is the only treatment needed and is often curative. In these cases, follow-up care and regular skin checks are an important part of long-term management. 

However, additional therapies may be recommended in certain situations. If melanoma is found in the lymph nodes or has higher-risk features, your care team may discuss adjuvant therapy, which is systemic treatment given after surgery to reduce the risk of recurrence. This may be immunotherapy or targeted therapy, depending on your individual situation. 

Melanoma care is increasingly moving toward a more personalized approach. Traditional factors, such as tumor thickness and lymph node status, remain essential, and newer tools, such as genomic testing, are helping to refine decision-making. 

This means that instead of a one-size-fits-all approach, treatment can be better tailored to each person's tumor biology. In some cases, that may mean avoiding unnecessary procedures, while still ensuring that higher-risk cancers are treated appropriately. 

Tina Hieken, M.D., Breast and Melanoma Surgical Oncology, Mayo Clinic, Rochester, Minnesota 

The post Mayo Clinic Q&A: Advances in staging and surgical treatment of melanoma  appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: I was recently diagnosed with esophageal cancer, and I was told I may need surgery. How do doctors determine whether surgery is the right option? Are there newer, less invasive approaches available?

ANSWER: Treatment for esophageal cancer has evolved significantly in recent years, and surgery remains one of the most important tools for treating this disease. For many patients, it is one part of a larger, carefully planned treatment approach. Determining whether surgery is appropriate and when it should occur depends on the stage of the cancer and other individual factors.

Cancer stage

One of the most important considerations is the stage of the cancer, which describes how deeply the tumor has grown into the esophagus and whether it has spread elsewhere in the body. If cancer has spread to distant organs, known as metastatic disease, surgery typically isn't recommended. Instead, treatment may focus on systemic therapies, such as chemotherapy, immunotherapy or a combination of both.

For people whose cancer is still localized or regionally advanced, surgery is often considered as part of the broader treatment plan. However, it's uncommon for surgery to be the first step. Esophageal cancer frequently doesn't cause symptoms until it has progressed, so many people are diagnosed at a stage when additional therapy is needed before surgery. This is called neoadjuvant therapy, and it may include chemotherapy, radiation therapy, immunotherapy or a combination of these treatments. The goal is to shrink the tumor, improve the chances of complete surgical removal and address any microscopic cancer cells that may have spread.

In contrast, very early-stage esophageal cancers, often found during endoscopy for another condition such as chronic acid reflux or Barrett's esophagus, may be treated endoscopically. In select cases, physicians can remove these superficial tumors using endoscopic techniques, which are performed through the mouth without external incisions. These approaches can be highly effective when the cancer is confined to the innermost layers of the esophagus.

Surgery

When surgery is recommended, the procedure most commonly performed is an esophagectomy, which involves removing part or most of the esophagus and reconstructing it using the stomach.

In recent years, there have been important advances in how this surgery is performed. Traditionally, esophagectomy required large incisions in the chest and abdomen. Today, many patients may be candidates for minimally invasive approaches, including laparoscopic and robotic-assisted surgery. These techniques use smaller incisions and specialized instruments, allowing surgeons to perform the same operation with less trauma to the body. These approaches are designed not only to treat the cancer effectively but also to support recovery and reduce the physical effects of surgery.

Minimally invasive surgery can offer several potential benefits, including reduced pain, shorter hospital stays and faster recovery times. Not everyone is a candidate for these approaches, but they're increasingly used when appropriate and when performed by experienced surgical teams.

Even with these advances, esophageal surgery is a major, complex procedure, and it's important to understand how it may affect daily life afterward. Because the stomach is reshaped into a narrow tube to replace the esophagus, patients often need to adjust how and what they eat. Smaller, more frequent meals are usually necessary, and some people may experience symptoms such as reflux, dumping syndrome or a sensation that food moves more slowly. These changes can be significant, but many patients adapt over time with guidance from their care team.

Researchers are continuing to study whether some patients who respond well to chemotherapy and radiation may be able to delay or avoid surgery. However, current imaging tools for esophageal cancer can't always detect small amounts of remaining cancer. For that reason, surgery is still commonly recommended when a patient is a good candidate, even if scans show a strong response to treatment.

Multidisciplinary team approach

Because esophageal cancer care often involves multiple therapies, treatment planning typically includes input from several specialists. Reviewing all available information, including tumor stage, response to therapy and overall health, helps guide a plan that balances effectiveness with the potential effects on daily life. 

Given the complexity of esophageal cancer and the surgery used to treat it, patients may benefit from care at centers that have extensive experience with this disease and a coordinated, multidisciplinary team. This approach can help ensure that treatment decisions are carefully considered and that patients are supported throughout each phase of care.

Carlos Puig Gilbert, M.D., Thoracic Surgery, Mayo Clinic, Rochester, Minnesota

The post Mayo Clinic Q&A: When is surgery recommended for esophageal cancer? appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. — A Mayo Clinic study found that both metabolic and bariatric surgery and GLP-1 medications improve cardiovascular health in people with obesity, but surgery was associated with significantly greater reductions in long-term cardiovascular risk. The findings were published in Annals of Surgery.

The study is a direct comparison of two leading obesity treatments, evaluating how each approach affects overall risk of cardiovascular disease.

"Both treatments are effective, but surgery appears to provide a greater reduction in long-term cardiovascular risk, especially when it leads to larger and more sustained weight loss," says Wissam Ghusn, M.D., a Mayo Clinic research collaborator and first author of the study.

Researchers analyzed outcomes for 812 adults with obesity, including 579 who underwent metabolic and bariatric surgery and 233 who received GLP-1 medications.

Key findings:

• Lifetime cardiovascular risk decreased more with surgery (declining 8.6% versus 1.7%).
• Weight loss was significantly greater with surgery, averaging nearly 28% of total body weight compared with about 11% among those treated with medications.

Obesity is a major contributor of heart disease, stroke and diabetes, making effective treatment critical for long-term health. While GLP-1 medications have gained attention for their role in weight management, the findings highlight differences in how treatment options may affect long-term outcomes.

Importantly, researchers say the findings are not about choosing one treatment over another, but about better aligning treatment decisions with long-term health goals.

"This study reinforces that obesity treatment should be viewed as a strategy to reduce cardiovascular risk, not just body weight," says Omar Ghanem, M.D., a metabolic surgeon and chair of the Division of Metabolic and Abdominal Wall Reconstructive Surgery at Mayo Clinic in Rochester. "It supports a more individualized, patient-centered approach where treatment decisions are based on long-term health impact."

The study also found that greater weight loss was closely linked to larger reductions in lifetime cardiovascular risk, particularly among patients who lost more than 20% of their body weight after surgery.

The findings may encourage earlier and more balanced discussions about treatment options, including considering surgery as a front-line option for some patients, rather than a last resort, while continuing to support the growing role of effective medications.

"Rather than thinking of these treatments as competing options, we should view them as complementary tools," says Dr. Ghanem. "Both surgery and medications play important roles in reducing long-term cardiovascular risk, and the right approach depends on the individual patient."

Researchers note that longer-term studies are needed to evaluate clinical outcomes such as heart attacks, strokes and survival, as well as the durability of medication-based therapies and the potential benefits of combining surgical and medical approaches.

For a complete list of authors, disclosures and funding, review the study.

###

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Terri Malloy, Mayo Clinic Communications, newsbureau@mayo.edu

The post Mayo Clinic study finds bariatric surgery associated with greater long-term heart risk reduction than weight-loss medications  appeared first on Mayo Clinic News Network.

For years, a lifelong athlete was sidelined by chronic wrist pain that took more than just her ability to compete — it took a part of her identity. Now, thanks to an innovative surgical approach at Mayo Clinic, a Minnesota woman is back on the court, returning to the game that means so much to her. 

Watch: Innovative wrist surgery helps athlete return to the pickleball court after decades of pain

Journalists: Broadcast-quality video (3:06) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

"Being an athlete has always been a part of my life," says Tami Lucius.

A former college basketball player, the 54-year-old from White Bear Lake, Minnesota, also loved playing tennis. But devastating wrist pain kept her off the court for two decades.

"I didn't know what it was, but it was always on the outside of my wrist," she says. "I really had a sense of loss with my life and with that sense of community from not being able to be in sports. And then a girlfriend of mine from high school, out of the blue, said, 'Hey, come and play pickle with me.' I knew pickleball was something that I was going to love."

But unfortunately, almost immediately, Tami's wrist pain returned.

"It got so bad that I couldn't even do the acts of daily living. So even making a bed, washing my hair, it didn't matter what I was doing, the pain was always there and the instability was always there," she says.

Rather than giving up another sport and a community she loved, Tami came to Mayo Clinic to see Dr. Sanj Kakar, a hand and wrist specialist.

"She was struggling. I think the biggest frustration for her was the pain was affecting not only sport but also activities of daily living," Dr. Kakar says.

"He was such a kind person, and he knew that, for me, this journey was more than just the pickle, it was part of my life and my identity. And he took the time to really share with me what he felt we needed to do," Tami says.

"Just by listening to her, examining her, looking at the imaging, we then were able to pinpoint the major causes of her problem," says Dr. Kakar. "The TFCC, or the triangular fibrocartilage complex, sits right in this area. She had a problem not only with that TFCC, or that sort of shock absorber for that part of the wrist, but also the tendon. So for Tami — especially with sport — hitting tophand, topspin, forehand, backhands — anything with twisting and grip would cause pain in here."

Wrist surgery

With Tami's wrist problem diagnosed, Dr. Kakar recommended a novel surgical technique he and his colleagues developed at Mayo Clinic in Rochester, Minnesota.

"It's what we call the over-the-top TFCC technique, which allows us to more accurately place stitches, or sutures, in the tear exactly where the tear is, in a more minimally invasive manner," he says. "It's a very precise method to fixing an area."

Tears in the TFCC often don’t appear on traditional MRI scans and may only be identified once a camera is placed inside the joint. Dr. Kakar uses a smaller, more flexible camera system, allowing for clearer visualization and more precise diagnosis and treatment.

The technique has several benefits compared to some conventional wrist repair approaches, including faster completion, less radiation exposure and lower fracture risk.

Back on the court

After successful surgery at Mayo Clinic, Tami is now back on the pickleball court, three times a week — pain-free.

"My wrist is the most stable joint on my entire body today," Tami says. "It does bring tears to my eyes because I didn't realize how much I missed sports in general. I get such a sense of identity who I am, my passion for competition, my passion for people. Mayo didn't just give me my wrist back and the ability to play pickle again, Mayo gave me my life back."

Related post:

• Mayo Clinic Minute: How to prevent injuries when playing pickleball

The post Innovative wrist surgery helps athlete return to the pickleball court after decades of pain (VIDEO) appeared first on Mayo Clinic News Network.

Mayo Clinic orthopedic surgeon describes advances in care for common back, neck problems

ROCHESTER, Minn. — People worldwide seek medical care for back and neck pain, which can interfere with sleep, mobility and daily life. For individuals who need surgery for spinal conditions, advances in robotics, artificial intelligence (AI) and motion-preserving implants are expanding treatment options and allowing for more personalized treatment, according to Ahmad Nassr, M.D., orthopedic surgeon at Mayo Clinic.

Dr. Nassr treats a wide range of spinal conditions that can affect mobility and cause pain, including:

• Herniated disk, a problem with one of the rubbery cushions, called disks, which sit between the bones that stack to make the spine.
• Spinal stenosis, a narrowing of the space around the spinal cord that can put pressure on the spinal cord and nerves that travel through the spine.
• Scoliosis, a side-to-side curve of the spine that can cause pain and breathing problems. 
• Spinal tumors, lesions that start in or around the spine.
• Degenerative spine conditions that most commonly affect older adults, such as degenerative disk disease and adult degenerative scoliosis. These conditions can cause severe symptoms, including stiffness, numbness or tingling from nerve damage.

Research has shown that low back pain is the leading cause of disability around the world, and the elderly are one of the most vulnerable populations.

"My practice is to assess each of my patients holistically, regardless of their age, to determine whether they can benefit from spinal surgery based on the treatment goal, whether it's to reduce pain, restore their ability to work or improve their quality of life," Dr. Nassr explains.

Motion-preserving alternatives to fusion

Many spinal conditions — such as degenerative disk disease, scoliosis and spinal stenosis — used to be treated with fusion surgery, in which two or more spinal bones are connected and heal as one bone. The procedure reduces pain but also limits spinal flexibility.

Motion-preserving devices, such as artificial disk replacement, offer alternatives that maintain more natural spinal movement.

Dr. Nassr served as principal investigator at Mayo Clinic in randomized controlled trials that led to Food and Drug Administration (FDA) approval of the TOPS replacement device, which stabilizes the spine while preserving movement. The device can be used to treat pinched nerves and spondylolisthesis, which is a slippage between two vertebrae.

Mayo Clinic was the first medical center in the U.S. to implant the FDA-approved Minimally Invasive Deformity Correction (MID-C) device to treat scoliosis. 

Dr. Nassr and other researchers are studying next-generation implants designed to replace both the disk and facet joints to maintain natural flexibility.

Robotics and minimally invasive surgery

Surgeries that once required large incisions can now be performed through small openings, reducing postoperative pain, helping patients recover faster and shortening hospital stays.

Conditions such as herniated disks, misalignment of the spine, spinal stenosis or instability can now be treated with a minimally invasive approach.

Robotic-assisted platforms, combined with CT scans and MRI, allow surgeons to plan complex spinal procedures and determine the most precise pathways for implants before surgery begins.

"Advances in robotic-assisted surgery, AI, 3D models and motion-preserving implants are allowing us to treat complex spinal conditions with greater precision and less disruption to back muscles," Dr. Nassr says. "These technologies are changing how spine procedures are performed and can support faster recovery for patients."

Advances in anesthesia, including specialized nerve blocks, also have significantly improved postoperative comfort and shortened hospital stays.

Personalized surgery with 3D models

In complex cases, surgeons can create 3D-printed models of a patient's spine — including nerves and blood vessels — and design custom implants tailored to the person's anatomy. These models allow surgeons to rehearse procedures before the operation and refine surgical planning.

Complex cases — such as advanced adult scoliosis, revision surgery or spinal tumors — often involve a multidisciplinary team of specialists, including orthopedic surgeons, neurosurgeons, anesthesiologists and rehabilitation specialists.

AI in spine care

AI is integrated into multiple aspects of spine care at Mayo Clinic. AI-supported tools assist in analyzing clinical data to guide treatment decisions and enhance surgical planning. In research, Dr. Nassr uses AI to better assess bone health and osteoporosis for patients who may need spine surgery.

"Advances in spine surgery enhance patient care as well as our ability to provide more personalized treatments," says Dr. Nassr.

###

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Caroline Auger, Mayo Clinic Communications, newsbureau@mayo.edu

The post AI, robotics and motion-preserving implants expand spine surgery options for patients appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: I was recently diagnosed with oral cancer after an unusual lesion was discovered during my last dental exam, and I was referred to an oral and maxillofacial surgeon. What does surgical treatment entail, and will the surgery change my appearance or my ability to speak, chew, or swallow? 

ANSWER: Being diagnosed with oral cancer can feel overwhelming, especially when considering treatment options. Because surgery is often central to treatment, it's natural to have questions about what it involves and how it may affect your appearance and daily activities, like speaking, eating and swallowing. 

For many oral cancers, particularly those in the tongue, gums, cheeks or jaw, surgery is often the most effective treatment. Surgeons can remove the cancer and, when needed, rebuild the area to preserve appearance and function. Today, care focuses on treating the cancer and maintaining quality of life after treatment. 

Surgical treatment  

After cancer is confirmed with a biopsy, your care team will complete a detailed evaluation. This typically includes imaging, such as CT or PET scans, to determine the tumor's size and location, and whether it has spread. This process, called staging, helps guide treatment. 

During surgery, the goal is to remove the tumor along with a small margin of surrounding healthy tissue to ensure no cancer cells are left behind. Some centers, like Mayo Clinic, can analyze tissue during the operation using a technique called frozen section pathology to confirm that all cancer has been removed before the procedure is finished. This real-time feedback can reduce the need for additional surgery later. 

Because oral cancers can spread through the lymphatic system, lymph nodes in the neck are often evaluated or removed. Examining these lymph nodes, along with the tumor, gives surgeons additional information about the cancer, sometimes called surgical staging. This can determine whether additional treatment is needed after surgery, most commonly radiation therapy, and sometimes radiation with chemotherapy. 

Preserving appearance and function 

A common concern is how surgery will affect your appearance and the ability to speak, chew or swallow. These are important considerations, given the visible and essential role of your mouth and face in everyday life. 

One way surgeons help preserve appearance and function is through advanced planning before surgery even begins. Using detailed imaging, the surgical team can create a personalized plan based on each person's unique anatomy. In some cases, this includes 3D modeling and printed surgical guides and custom titanium implants, which allow surgeons to remove the tumor and rebuild the area with high precision — all during the same operation. 

For larger tumors, reconstruction may involve using tissue from another part of the body, such as the leg, arm or shoulder blade, to rebuild areas of the face or jaw. Surgeons use a technique called microsurgery to connect very small blood vessels under a microscope, so the transplanted tissue remains healthy. Once connected, the tissue can help restore both structure and function. 

Reconstruction is designed to rebuild what was removed and support everyday activities like speaking, chewing and swallowing. In many cases, this includes planning for dental rehabilitation. If teeth are removed as part of treatment, dental implants are often placed at the time of surgery to support replacement teeth. 

By combining cancer removal with immediate reconstruction and dental planning, oral and maxillofacial surgeons aim to help patients return to daily life with as few long-term changes as possible. The goal is to restore both appearance and function so patients can feel comfortable eating, speaking and interacting with others. 

Many patients can return to eating, drinking and speaking relatively soon after surgery. However, some may need additional support from speech and swallowing specialists to regain function. 

Key considerations 

Oral cancer care often involves a team of specialists, including surgeons, speech and swallowing experts, and, when needed, radiation and medical oncologists. Coordinating this care closely and starting the right treatments at the right time can make a meaningful difference in outcomes and recovery. 

It's also important to remember that treatment is highly individualized. Not every patient will need extensive surgery, reconstruction or additional therapy. Your care team will guide you through what to expect based on your specific diagnosis. 

Ultimately, the goal is twofold: to treat the cancer while balancing quality of life. Today's surgical approaches are designed to do both — removing the disease while helping you maintain the ability to speak, eat and engage in daily life. 

Because treatment needs vary from person to person, it's important to work with a care team experienced in managing oral cancer. Asking questions and understanding your options can help inform your decisions and make you feel more confident about your care.  

Kyle Ettinger, M.D., D.D.S., Oral and Maxillofacial Surgery, Mayo Clinic, Rochester, Minnesota 

The post Mayo Clinic Q&A: Understanding surgical options for oral cancer  appeared first on Mayo Clinic News Network.

Some severe headaches aren't migraines. They may be caused by a nerve being pinched. When other treatments don't work, surgery may offer relief. Learn more from Dr. Antonio Forte, a Mayo Clinic microvascular plastic and reconstructive surgeon with deep experience in migraine surgery.

Watch: The Mayo Clinic Minute

Journalists: Broadcast-quality video (1:14) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

Often called trigger site-induced headaches, pain from compressed nerves can last all day and be resistant to treatments like medication.

"Headaches that originate from compression of the occipital nerve will usually have a pain that starts on the back of the neck and radiates to the side of the head," says Dr. Forte. "Patients who have headaches that originate from compression of the supraorbital and supratrochlear nerve, they will usually start with a pain site that is above their eye, and that pain will radiate to their forehead."

Evaluation and care

Nerves can be compressed by surrounding tissue or muscle. At Mayo Clinic, patients are evaluated by a multidisciplinary team that gathers the necessary data and imaging to develop a personalized care plan, which may include surgical nerve decompression.

Dr. Forte explains that occipital nerve decompression starts with a 5-centimeter incision made along the hairline.

"We are able to then identify your greater occipital nerve and then remove the adjacent muscle and fascia that may be compressing the nerve," he says. "When patients undergo surgery for decompression of the supraorbital or supratrochlear nerve, we then perform an incision that is similar to the incision that we do when we are performing a cosmetic eyelid surgery."

Surrounding tissue is removed to relieve pressure on the nerve. Dr. Forte says many patients feel relief within weeks of nerve decompression surgery.

The post Mayo Clinic Minute: Treating severe headaches caused by nerve compression appeared first on Mayo Clinic News Network.

Dancing is more than just a hobby or passion for 22-year-old Reagan McDaniel. It's her life's calling. When she entered the Bachelor of Fine Arts program at Jacksonville University in Florida as a dance major, Reagan felt like she was on her way to the life she had dreamed about. 

But after finishing a challenging dance routine during the fall recital of her freshman year, Reagan felt a sharp ache in her left hip. She stretched, and it felt better the next day. However, when the pain kept returning sharper and lasting longer, Reagan got the nagging sensation that something was wrong.

"I continued to dance on it for months," says Reagan. "I know a lot of dancers have chronic pain. I thought this hip pain might just be something I would have to learn to live with."

After five months of progressive pain, Reagan finally mentioned it to her mother, who works in the medical field. Her mom, who previously underwent surgery for a hip labral tear, recognized the signs and made an appointment for Reagan with a sports medicine and orthopedic specialist at Mayo Clinic in Florida, where she works.

Crushing news 

Reagan met with Dr. Luke Spencer Gardner, an orthopedic surgeon specializing in hip surgery. As Reagan's mom suspected, an MRI revealed a torn hip labrum, the cartilage lining the hip joint socket. 

Dr. Spencer Gardner explained that Reagan had femoroacetabular impingement (FAI). FAI occurs when the ball-and-socket of the hip joint don't fit together properly, and the hip bones rub together. In Reagan's case, a bony protrusion on the ball caused the misalignment. It's not uncommon for extra bone to develop during natural growth and development, but when it pinches the labrum, it can lead to tearing. Repetitive or twisting motions, like those used in dancing, are also a contributing factor and can make tearing more likely.

"I remember getting the news that I had been dreading," says Reagan. "I was so upset. But my mom assured me that Dr. Spencer Gardner would take good care of me, and sure enough, he did."

Hip preservation surgery times 2 

Reagan tried physical therapy to reduce the pain, but between her dance schedule and the severity of her tear, she was not making good progress. Dr. Spencer Gardner suggested hip preservation surgery to fix Reagan's structural hip injuries and eliminate her pain so she could get back to dancing. Hip preservation also has added long-term benefits by helping prevent early onset osteoarthritis and delaying the need for hip replacement.

In November of her sophomore year, Reagan underwent a hip arthroscopy and labral repair. Dr. Spencer Gardner fixed the tear and shaved down the bone spur, operating through small incisions using a tiny camera called an arthroscope and specialized instruments. 

The minimally invasive surgery was an outpatient procedure, and Reagan went home the same day with no complications. The expected recovery time for the procedure is typically six months. 

But less than two months later, Reagan once again experienced the nagging feeling that something was wrong. This time, the pain was in her right hip.

"I had just started my spring semester and was still using a crutch to recover from the first surgery, when I felt the same kind of pain," says Reagan. "I told myself that my hip was just sore from overcompensating during my recovery, but soon I was back in front of Dr. Spencer Gardner and getting another MRI." 

Imaging showed a similar labral tear and smaller FAI in her right hip. At the end of January, less than eight weeks after her first surgery, Dr. Spencer Gardner performed a second hip preservation surgery (arthroscopy and labral repair) on Reagan's other hip.

"I remember being in that hospital the second time and wondering whether I was ever going to dance the same way I had before," says Reagan. "Then I locked in and made the decision that I wanted to be back dancing by six months from my first surgery."

The road back to dancing 

Physical therapy was critical to Reagan's recovery. The physical therapists at Mayo Clinic guided and supported Reagan as she pushed to regain her strength and restore flexibility. Four months after the second surgery, Reagan started easing back into dance.

"I was worried I might get injured again, but I know my body well enough to know when to start," says Reagan. "I began with marking, a dance term for performing movements on a much smaller scale to mentally rehearse and then working yourself up to bigger and bigger movements."

Reagan spent time learning choreography and teaching at several local studios. She worked hard to make up for all the dance training she missed. Somewhere along the way, she found herself drawn to hip-hop.

"While I was not fully back by the six-month mark, I was doing hip-hop at that point," says Reagan. "Hip-hop doesn't require as much leg lifting and floorwork as other dance styles, so it was easy to start with it. But I realized how much I loved it."

Dancing toward a bright future 

Reagan is forever thankful to her entire team at Mayo Clinic. The nurses helped calm Reagan when she was nervous about anesthesia. The physical therapists pushed her and supported her quick recovery. Dr. Spencer Gardner gave Reagan back the gift of dancing.

After college graduation, Reagan has plans to move to Los Angeles, where she will be pursuing a career in professional dancing.

"I'm finally back to where I was before my surgeries," says Reagan. "I may not be as flexible as I used to be, but I have the same strength and movement quality I had before. And my passion for dancing is stronger than ever."

Related post:

• Mayo Clinic in Florida expands shoulder arthroplasty with robotics, scaling capability across sites

The post Dancer’s comeback made possible by hip preservation surgery appeared first on Mayo Clinic News Network.

Mayo Clinic in Florida recently performed its first robot-assisted shoulder arthroplasty, marking the arrival of enhanced, precision orthopedic care for patients in the Southeast and bolstering Mayo Clinic's commitment to advancing models of care across the organization.

Shoulder arthroplasties — also known as shoulder replacements — are reserved for patients with shoulder osteoarthritis whose symptoms are not manageable with nonsurgical treatments such as physical therapy, injections and medications. Shoulder replacements have traditionally been performed using manual instrumentation and surgeon-estimated alignment. While this approach has been effective, it is inherently limited by visual estimation and anatomic variability in patients. 

"What's happened over the past 10 to 15 years in orthopedics is we've started using computer navigation and now robotic assistance," says Dr. Erick Marigi, a Mayo Clinic orthopedic surgeon. "In the hip and the knee, they've been doing robot-assisted replacements for years, but for the shoulder (because it’s a smaller complex joint), it's just been harder to develop, until now."

In manual shoulder replacements, surgeons make an incision and use guides to position implants. Though 3D computer planning has been available and is helpful, execution in the operating room has remained manual.

"We're no longer limited by our eyes and using a guide, which has a few millimeters of variance," says Dr. Marigi. "Now it's one degree of variance and under a millimeter of precision."

Another key advantage of robot-assisted shoulder replacements is improved consistency and reproducibility, particularly in complex cases. The technology simplifies procedures for patients with significant bone wear or other challenges that make conventional techniques difficult, allowing surgeons to achieve more predictable results. 

Long-term efficacy data for robot-assisted shoulder replacements are emerging, but evidence from robot-assisted hip and knee replacements is promising. Cases once considered highly complex can now be approached more like standard procedures.

Innovation and integration

Dr. Marigi says the adoption and integration of robot-assisted surgery is a testament to Mayo Clinic's spirit of bridging innovation into action.

"It is the spirit of Mayo Clinic in general: constantly pushing the envelope and providing solutions that help patients," he says.

Dr. Marigi's mentors, Drs. Joaquin Sanchez-Sotelo and John Sperling, both orthopedic surgeons at Mayo Clinic in Rochester, laid the foundation for robot-assisted orthopedic surgeries across Mayo Clinic. 

"Collaborative efforts have never been better across Mayo Clinic as a healthcare enterprise," says Dr. Sanchez-Sotelo. "The implementation of robot-assisted shoulder arthroplasty across all campuses allows us to offer the same quality care to all our patients, regardless of geography. It also facilitates lines of collaboration for innovation and research across our institution."

Dr. Sperling, who in April 2024 completed the world's first robot-assisted shoulder surgery, says, "Robotic shoulder arthroplasty has the potential to significantly improve our ability to enhance the quality of care for our patients worldwide."

Later that year, Dr. Sanchez-Sotelo also performed a robotic total shoulder replacement. 

"Our new generations will embrace robot-assisted surgery and enjoy iterative processes through which digital enabling technology will only continue to improve," says Dr. Sanchez-Sotelo.

Among that new generation is Dr. Jeff Hassebrock, an orthopedic surgeon at Mayo Clinic in Arizona, who performed the first robot-assisted shoulder replacement in the Southwest, extending the site's leadership in robotic orthopedic surgery. He believes that the intersection of artificial intelligence, preoperative planning and robotic procedural execution will lead to a renaissance in how standard shoulder replacements are performed.

"Mayo Clinic's investments in advanced technologies reflect our commitment to providing innovative, patient-centered care," says Dr. Hassebrock. "Robotics improves the precision and execution of surgical plans that meet the evolving needs of orthopedic care. The era of pre- and postoperative measurement is at hand."

Dr. Marigi believes Mayo Clinic surgeons will continue shepherding this next phase of innovation in orthopedic care. Now, for patients in the Southeast, the technology offers access to innovation closer to home.

"Patients will all have access to this internationally renowned technology locally. That was a big deal for our team," says Dr. Marigi. "I think this is going to be one of our pillars in the future, and the people leading that charge will be Mayo Clinic surgeons."

The post Mayo Clinic in Florida expands shoulder arthroplasty with robotics, scaling capability across sites appeared first on Mayo Clinic News Network.