Commando Operation - Of The Mouth

: Admin : 2022-05-25

The "commando" technique, which comprises removal of the main tumor, a portion of the mandible, and adjacent cervical lymph nodes, is also known as composite resection of the head and neck. The tongue, floor of the mouth, larynx, throat, maxilla, mandible, and palate are all often treated with this surgery. The phrase 'commando operation' was created to describe a surgical assault on sick tissue. Resection of the mandible with the floor of the mouth, as well as the whole lymphatic system of the neck, as well as the sternocleidomastoid muscle and internal jugular vein, are all part of head and neck surgery.

The method involves extensive surgical rebuilding of face features and is mostly used to treat tumors of the head and neck. The 'Commando Operation' is a challenging procedure that requires the management of pre-operative and post-operative care by an experienced medical team.

When is a Commando procedure required?

• For malignancies of the oropharyngeal area, the commando method is used.
• Head and neck cancers move in a predictable path from the head through the neck to the chest. As a result, a composite resection increases the odds of the cancer not spreading.
• Head and neck cancers usually only spread to one side of the body. As a result, in addition to removing the tumor, the lymphatic pathways in the neck are also dissected to prevent the illness from spreading. Neck dissection is the term for this procedure.
• When doing a composite resection for tumors of the oropharyngeal area, it is critical to remove the whole tumor while keeping the functions intact. As a result, a composite resection is almost always more aggressive in order to guarantee that no diseased tissue remains following surgery.
• Commando Procedure for Head and Neck Surgery Preparation
• It is critical for every patient having a composite resection of the head and neck to adhere to the following guidelines: Inform your medical staff about all of your regular medicines and give a complete medical history.
• At least one week before the planned operation, avoid taking aspirin, ibuprofen, or any other blood-thinning drugs. These drugs tend to interfere with the clotting process, resulting in significant bleeding and a delay in healing following the treatment.
• You are not allowed to eat or drink after midnight on the night before your procedure. You may clean your teeth without drinking anything in the morning.

Understanding Commando Techniques:

• Oral cavity tumors are treated surgically by making a hole in the lower lip and jawbone (mandible). The cancerous tissue is then removed entirely.
• This may be combined with cordectomy, which is the removal of a single vocal cord to treat vocal cord lesions. Some cancers that have spread beyond their originating site may benefit from partial tongue excision.
• Following surgery, a plastic surgeon reconstructs the area using a flap of skin transplant from the forearm, leg, belly, or thigh.
• If the tumor affects the jawbone, the jawbone may be removed as well (mandible).
• The surgeon will sew the two sides of the jaw bone together once again.

Following a Commando Procedure, Post-operative Care:

• Patients often have trouble swallowing following large and extensive oral surgery. This is related to the surgery-induced edema in the inside region of the mouth cavity.
• A temporary feeding tube is placed into the stomach via the nostrils or mouth. It's a quick outpatient operation that's done before the surgical resection.
• It is critical that the patient maintains an adequate nutritional intake of meals and drinks via the tubes in order for active healing to occur. 
• Speech will be significantly hindered immediately after surgery, but it will gradually recover over time, with or without the help of a speech therapist.
• Occasionally post operative radiotherapy is required.

Common postoperative complications include

• In roughly one percent of instances, bleeding may occur. The substantial vascularity of the organs implicated is to blame for this.
• Though the patient is given antibiotics as a post-operative cover, infection is possible.
• Given the scope of the surgery, pain is unavoidable. Pain relievers, primarily morphine derivatives, are administered.
• Fistula is another frequent issue that may be treated with basic medicines and washing. Surgery is only used in exceptional cases.
• Because of the pressure of the enlarged tissue on the nerves, the patient may suffer numbness and weakness. This is usually temporary, but it may sometimes be a lifelong deformity.
• Due to a neuroma, the patient may have hypersensitivity of the skin surrounding the operation site on occasion. The neuroma may be surgically removed after years of development.