Head And Neck Surgery Abroad: Commando Procedure

Head and neck surgery (Commando Procedure) cost:
{the cost covers all destination medical & logistics costs}
International Destinations: India, Jordan, Mexico, South Korea, Turkey

Composite resection of the Head and Neck is also referred to as the “commando” procedure, which involves the resection of the primary tumor, a part of the mandible, and surrounding cervical lymph nodes.

This procedure is commonly used for cancers affecting the tongue, floor of the mouth, larynx, pharynx, maxilla, mandible, and palate. This term is coined ‘commando procedure’ as it’s a surgical attack on the diseased tissue.

The head and neck surgery involves the resection of the mandible with the floor of the mouth and the dissection of the entire lymphatic system of the neck along with the sternocleidomastoid muscle and internal jugular vein.

The procedure requires a substantial amount of surgical reconstruction of the facial structures and is used mainly for cancers affecting the head and neck. ‘Commando Operation’ is a difficult surgery and mandates the need for an experienced medical team to manage the pre-operative and post-operative care.

Turkey, Mexico, Jordan, India, and South Korea are some of the countries where these procedures are available at relatively lower cost.

When Do You Need a Commando Procedure?

The commando procedure is done for cancers affecting the oropharyngeal region.

• Cancers of the head and neck follow a predictable pattern of moving from the head to the neck to the chest. Hence a composite resection improves the chances of preventing the spread of the malignancy.
• Normally, cancers of the head and neck move only along one side of the body. Hence in addition to the removal of the tumor, the lymphatic channels of the neck are also dissected to halt the spread of the disease. This is referred to as neck dissection.
• While conducting a composite resection for cancers of the oropharyngeal region, it is of essence to remove the entire tumor while preserving the functions, which is of secondary importance. Hence, a composite resection is invariably more aggressive in nature to ensure that no disease part is left behind after the surgery.

Preparing for Head and Neck Surgery: Commando Procedure

It is essential for any patient undergoing a composite resection of the head and neck to follow the below-mentioned requirements,

• Notify your medical team about all your routine medications and provide all details of your medical history.
• Avoid aspirin, ibuprofen, or any other medications that cause thinning of the blood, at least one week prior to the scheduled surgery. These medications tend to interfere with the blood clotting process and result in excessive bleeding after the procedure, thereby delay in healing.
• You are expected to not eat or drink after midnight, the evening prior to the scheduled surgery. You may, however, brush your teeth in the morning without consuming any fluids.

Understanding the Commando Procedure:

• The surgical management of oral cavity tumors involves creating an opening through the lower lip and jawbone (mandible). The malignant tissue is then completely removed.
• This may be accompanied by cordectomy i.e. removal of a single vocal cord for lesions in the vocal cord. The partial removal of the tongue is also advocated in some tumors that have transcended the primary location.
• Following the surgery, reconstruction is done by a plastic surgeon using a flap of skin graft from the forearm, leg, abdomen, or thigh.
• Occasionally, the jawbone is also resected if the tumor affects the jawbone (mandible).
• The surgeon will oppose the two sides of the jaw bone again and stitch them together.

Post-operative Care After Commando Procedure

• In variably after major and extensive surgery of the oral cavity, patients face difficulty in swallowing. This is due to the swelling in the internal part of the oral cavity caused by the surgery.
• A temporary feeding tube is inserted either through the nostril or mouth, directly to the stomach. It is a simple outpatient procedure and is conducted prior to the surgical resection
• In order to ensure that healing takes place actively, it is crucial that the patient maintains a good nutritional intake of food and liquids through the tubes. Even after the tubes are removed, the patient is requested to notify the medical team if he finds it difficult to eat or drink
• Immediately after the surgery, speech will be considerably impaired, which will subsequently improve over a period of time, with or without the assistance of a speech therapist.
• Occasionally post-operative radiotherapy is required.

Common Post-operative Complications Include:

• Bleeding may occur in about one percent of the cases. This is attributed to the extensive vascularity of the organs involved
• Infection may occur, though the patient is given a post-operative cover of antibiotics
• Pain is inevitable, considering the magnitude of the procedure. Painkillers, mainly morphine derivatives, are given to alleviate pain.
• Fistula is also a common problem, which is resolved by simple medications and rinsing. Surgical intervention is rarely required.
• The patient may experience numbness and weakness, which is attributed to the pressure of the swollen tissue on the nerves. This will subsequently resolve, but occasionally it is a permanent defect.
• The patient may occasionally suffer from hypersensitivity of the skin around the site of surgery due to a neuroma. This takes years to develop, and the neuroma can be surgically removed.

Commando Procedure in India

India has garnered a repute for having some of the most trained and experienced oncologists and onco-surgeons across the globe. With the advantage of providing low-cost and excellent-quality healthcare services, India is one of the rapidly emerging focal points for medical travel tourists.

Commando Procedure in Mexico

Mexico is one of the closest medical travel destinations for Americans, which has leading JCI-approved hospitals that provide extremely good quality medical care at a fraction of the rates in the United States.

Commando Procedure in Turkey

Turkey has acquired a substantial repute in the Middle East for its high-quality and low-cost medical and surgical care services. Turkey, with the intent to emerge as the hub for medical care travel, is now improving its standards further to attract medical tourists from the United States.

Commando Procedure in Jordan

Jordan has emerged as a preferred destination for medical tourism, thanks to its advantage of cost, quality and proximity (compared to South East Asia and the Far East). The number of medical tourists is rising exponentially to the country, which speaks volumes for its medical care services.

Commando Procedure in South Korea

With rapid technological advances, South Korea is a hub for management of oncology cases both surgical and medical. The country has trained medical teams, international quality infrastructure and is abreast of the latest technological improvements in medical science.

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