Commando Surgery to the Rescue

Posted by Cancer Specialist on Sep, 14, 2018 ,  Category: Blog

The COMMANDO Operation or COMMANDO Procedure (COMbined MAndibulectomy and Neck Dissection Operation ) is a complicated operation for 1st degree malignancy of the tongue and most oral cavity cancers. It comprises glossectomy (total removal of the tongue) and hemimandibulectomy together with block dissection of the cervical nodes.

Infiltrative processes that extend into the intervalvular fibrosa, such as infection or calcification, often mandate a complex reconstructive procedure known as the Commando operation. First described less than 20 years ago, this operation is not widely implemented, with experience limited to a few select centers, Onkaulogy Kombine being one of them.

For a mandibulectomy (or mandibular resection), the surgeon removes all or part of the jaw bone (mandible):

  • If the jaw bone looks normal on imaging tests and there’s no evidence the cancer has spread there, the bone may not need to be cut all the way through. In this operation, also known as a partial-thickness mandibular resection or marginal mandibulectomy , the surgeon removes only part or a piece of jaw bone.
  • If the x-ray shows the tumor has grown into the jaw bone, a large part of the jaw will need to be removed in an operation called a segmental mandibulectomy . The removed piece of the mandible can then be replaced with a piece of bone from another part of the body, such as the fibula (the smaller of the lower leg bones), hip bone, or the shoulder blade. A metal plate or a piece of bone from a deceased donor may also be used to repair the bone.
  • If cancer has grown into the hard palate (front part of the roof of the mouth), all or part of the involved bone (maxilla) will need to be removed. This operation is called a maxillectomy or partial maxillectomy . The hole in the roof of the mouth this operation creates can be filled with a special denture called a prosthesis. This is created by a prosthodontist, a dentist with special training.