Dr. Suraga Belakawadi Surgical Oncologist

RIA-MIND: robotic neck dissection without a neck scar

Robotic Infraclavicular Approach for Minimally Invasive Neck Dissection. Lymph nodes in the neck are removed through small cuts below the collarbone instead of a long cut across the neck.

For patients

Why the neck lymph nodes are removed

Many cancers of the mouth and throat can spread to the lymph nodes in the neck, sometimes before they can be felt. Removing these nodes is called a neck dissection. It treats any spread and tells your team whether more treatment is needed.

The usual operation, and the difference with RIA-MIND

A conventional neck dissection is done through a long cut across the side of the neck, which leaves a scar that stays visible every day.

With RIA-MIND:

  • The robotic instruments enter through a few small cuts below the collarbone.
  • The surgeon works up under the skin of the neck to remove the lymph nodes.
  • Clothing covers the small scars, and the neck is left without a visible scar.

What to expect

  • The operation is done under general anaesthesia.
  • A small drain is usually placed for a few days.
  • Most people return to normal activities sooner than after open surgery, but recovery varies from person to person.

For referring doctors

Technique

RIA-MIND is performed with the da Vinci Xi system through ports placed in the infraclavicular region. A working space is created with CO₂ insufflation in the subplatysmal plane, allowing clearance of neck levels I to V from a single access site. Neck dissection can be combined with management of the primary tumour as clinically appropriate.

Published results

  • Khan et al., 2023: first description of the technique (Journal of Minimal Access Surgery).
  • Ramakrishnan et al., 2026: retrospective cohort of 62 patients treated between July 2018 and May 2025 (Frontiers in Oncology). Dr. Suraga is a co-author. The study reported:
    • adequate nodal yield
    • no documented complications in 87.1% of patients
    • a local recurrence rate of 8.1%, with no regional (neck) recurrences
    • a structured learning curve on CUSUM analysis

The authors note that longer-term prospective studies are needed.

Referring a patient

Share the clinical summary, imaging and biopsy report on WhatsApp or by email. Dr. Suraga will advise on suitability. See information for doctors.

Common questions

Who is RIA-MIND suitable for?

Selected patients with head and neck cancer who need lymph nodes removed from the neck. Suitability depends on the stage of the cancer, the size of any lymph nodes and your general health. Dr. Suraga will assess this at your consultation.

Is it as thorough as a conventional neck dissection?

The aim is the same, complete removal of the lymph nodes at risk. The 2026 study of 62 patients found adequate lymph node yields and no cancer recurrence in the neck during follow-up. Long-term studies are still needed.

Will there be any scar?

There will be a few small scars below the collarbone. Ordinary clothing covers them, and the neck itself is left without a visible scar.

References

  1. Ramakrishnan A, Nayak SP, Khan A, Sadhoo A, Gangadhara B, Reddy S, Munisiddaiah D, Belakawadi S, et al. Robotic infraclavicular approach for minimally invasive neck dissection: an evaluation of safety, oncologic efficacy, and learning curve dynamics in head and neck cancer surgery. Front Oncol. 2026;16:1806241. Read the paper
  2. Khan A, Reddy VS, Gangadhara B, Mayur M, Barad A, Munisiddaiah D, Ramakrishnan A, Sadhoo A, Nayak SP. Robotic infraclavicular approach for minimally invasive neck dissection in head-neck cancers. J Minim Access Surg. 2023;19(3):395-401. Read the paper