Removing the stone growing in your mouth

FRESNO, Calif.

Salivary stones form naturally, from the chemicals in saliva, but once they develop, it can take open surgery, and sometimes even removing the salivary gland itself, just to get the stone out. Now, there's a new, high-tech approach to removing these painful stones without a single scar.

For 32-year-old civil engineer Akhil Chauhan, planning and problem-solving for a variety of projects is all in a day's work. But he never knew he had a problem until it showed up on a dental visit.

"He took x-rays of my full mouth and then like he saw this like on the x-ray, he saw this calcified mass thing," Akhil told Ivanhoe.

It was a stone, as big as an olive, deep in Akhil's salivary gland. Standard procedure would remove the stone and the gland through an incision in his neck.

"I was worried about having a scar like after the surgery," Akhil said.

LSU head and neck surgeon doctor Rohan Walvekar offered him a much less invasive alternative. He's pioneered a procedure that merges miniaturized endoscopy with surgical robotics to remove even large, deeply-imbedded stones without open surgery.

"When I saw this, when I read about it, I said, 'let's go for it.' Akhil said.

"What we did is use salivary endoscopy to document and identify the location of the stone, and then we use the robot to do the dissection in the mouth," Rohan Walvekar, M.D., a head and neck surgeon at LSU Health Sciences Center, explained.

Doctor Walvekar says 3D imaging, endoscopic magnification and the precision of the robotic arm, improves visibility and accuracy.

"My assistants can do a better job because they're seeing what I'm doing, and I get a three dimensional view," Dr. Walvekar said.

Now, less than a year after Akhil's salivary stone surgery, there's no visible sign he had surgery at all. A busy problem-solver, who now has one less problem to worry about.

In recent years, endoscopy has become a more viable option for removal of small salivary stones, but for very large stones, and those located deep in the salivary glands, accessing the stones, even endoscopically can be extremely difficult. Thanks to its early success, doctor Walvekar's new robotic approach is attracting patients and surgeons from all over the United States.

If this story or any other Ivanhoe story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Marsha Hitchcock at mhitchcock@ivanhoe.com

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