When oral cancer has spread to involve the jaw bone and the neck, a composite resection removes the tumour, the affected segment of jaw and the neck lymph nodes together in one operation — followed by reconstruction to restore form, the bite and function.
Has Your Doctor Recommended a Commando Operation for Oral Cancer?
Hearing that you or a loved one needs a composite resection, historically referred to as a commando operation, can feel overwhelming. This procedure is a highly specialized surgery designed to treat advanced oral cancer that has begun to involve the jawbone. Our goal is to guide you through this process with clarity, compassion, and the highest level of surgical expertise.
A composite resection involves the removal of the primary oral tumour, a portion of the jawbone (as in a mandibulectomy or maxillectomy), and the lymph nodes in the neck. While this sounds extensive, modern oral & maxillofacial surgery (OMFS) techniques allow us to perform this procedure safely while planning for immediate reconstruction to preserve your facial structure, speech, and swallowing abilities.
Composite resection: A surgical procedure that removes an oral tumour along with a segment of the jaw bone and neck lymph nodes.
Commando operation: The historical term for a combined mandibular resection, neck dissection, and glossectomy.
When is a Composite Resection Surgery in Chennai Necessary?
Advanced mouth cancer surgery Chennai patients undergo is typically required when an oral tumour has progressed beyond the superficial lining of the mouth. In India, chronic exposure to risk factors like chewing tobacco, gutka, areca-nut, and heavy alcohol consumption often accelerates this progression. These habits frequently cause oral potentially malignant disorders (OPMD) like oral submucous fibrosis (OSMF), which can transition into aggressive cancers if left untreated.
When a tumour grows near the lower jaw, it can invade the periosteum, which is the outer membrane of the bone, or the bone itself. Once cancer cells enter the mandible, a simple local excision is no longer sufficient. To ensure complete removal of the disease, a segment of the jawbone must be removed along with the tumour to achieve clear, cancer-free margins.
Comprehensive Staging and Planning Before Your Surgery
Before proceeding with composite resection surgery in Chennai, a meticulous diagnostic phase is essential. Dr. Pradeep S. and Dr. Kalpa Pandya personally evaluate every patient to map the exact boundaries of the tumour. This planning involves advanced imaging, such as contrast-enhanced computed tomography (CECT) or magnetic resonance imaging (MRI) scans, to visualize how deeply the cancer has penetrated the bone and whether it has spread to the neck lymph nodes.
A tissue biopsy is performed to confirm the exact pathological diagnosis. We also assess your overall physical fitness, cardiac health, and nutritional status to ensure you are fully prepared for the surgical procedure. This comprehensive pre-operative workup minimizes risks and helps us customize a reconstruction plan tailored to your specific facial anatomy.
Understanding the Steps of Advanced Oral Cancer Surgery
The actual surgical procedure is a highly coordinated effort led by Dr. Pradeep S. and Dr. Kalpa Pandya. The surgery is performed under general anesthesia and is divided into three primary phases: ablation, neck dissection, and preparation for reconstruction. If the tumour is located near the back of the jaw, the dissection may extend close to the temporomandibular joint (TMJ), requiring precise preservation of joint function.
During the ablation phase, the oral tumour is carefully excised with a wide margin of healthy tissue around it. If the cancer has invaded the lower jaw, we perform a mandible and tumour removal, taking out the affected segment of bone. Concurrently, a neck dissection is performed to remove lymph nodes that may harbor microscopic cancer cells, reducing the risk of recurrence.
Tumor Ablation: The precise surgical removal of the primary oral cancer with safe margins.
Segmental Mandibulectomy: Removal of a segment of the lower jawbone involved by the tumour.
Neck Dissection: Surgical clearance of lymph nodes in the neck to prevent cancer spread.
Composite Resection with Reconstruction: Restoring Form and Function
Once the cancer is completely removed, the focus shifts immediately to composite resection with reconstruction. Restoring the defect left by the removal of the jawbone and oral tissue is critical for maintaining your quality of life. Without reconstruction, a patient would struggle with chewing, swallowing, speaking, and maintaining facial symmetry.
For complex reconstructions, we utilize advanced tissue transfer techniques. A pectoralis major myocutaneous (PMMC) flap, which uses chest muscle and skin, is a reliable option for closing large soft tissue defects. When highly complex microvascular free-flap reconstruction, such as using a fibula bone flap to rebuild the jaw, is required, the procedure is coordinated with the wider surgical team at our affiliated Apollo / partner hospital. This collaborative approach ensures the highest standards of microvascular precision.
What to Expect During Your Recovery and Rehabilitation
Recovery after advanced oral cancer surgery is a gradual, step-by-step process. In the immediate post-operative period, patients are closely monitored in the intensive care unit. A temporary feeding tube and a breathing tube are often placed to protect your airway and ensure you receive adequate nutrition while the oral tissues heal.
Over the first two to three weeks, as swelling subsides, our team works closely with speech and swallowing therapists. We gradually transition you from tube feeding to a liquid diet, and eventually to soft foods. If bone reconstruction was performed, we may use titanium plates for open reduction and internal fixation (ORIF) to stabilize the new jawbone during the healing phase. Long-term follow-up is maintained by both of our surgeons to monitor your healing and speech rehabilitation.
Dedicated Oral and Maxillofacial Oncology Care in Chennai
Choosing the right surgical team is paramount when facing a diagnosis of advanced oral cancer. Dr. Pradeep S. and Dr. Kalpa Pandya offer a unique dual-surgeon care model, meaning both specialists collaborate on your diagnosis, surgical planning, operation, and long-term follow-up. This continuous, personalized oversight ensures that no detail of your recovery is overlooked.
Our practice is committed to providing compassionate, accessible, and highly specialized oral oncology care. While our primary clinical hubs are located in Chennai, our reach extends far beyond the city limits. Patients regularly travel to our Chennai practice from across Tamil Nadu and the wider South India region seeking expert surgical care and comprehensive second opinions for complex oral cancer presentations.
What to expect
1Imaging & surgical planning
2Tumour + mandible segment resection
3Neck dissection
4Reconstruction (flap)
5Recovery & rehabilitation
Microvascular free-flap reconstruction for composite defects is coordinated with the wider surgical team at our affiliated Apollo / partner hospital.
Composite resection — watch & learn
Oral Cancer Staging: What You Need to Know & Why It's Crucial
An explainer on how oral cancer is staged and why accurate staging is crucial for planning treatment.
Oral Cancer Treatment Guide: Diagnosis, Surgery, Recovery — Dr. Pradeep S.
Dr. Pradeep S. walks through the full oral cancer journey — diagnosis, surgery and recovery — in this Apollo 24|7 feature.
Does Mouth Cancer Spread Due to Biopsy?
Part of the myth-busting series — addressing the fear that a biopsy spreads mouth cancer.
Composite resection — patient guides
Doctor-written explainers — authored by one surgeon and medically reviewed by the other.
What is a composite resection or commando operation?
A composite resection, historically called a commando operation, is an advanced surgical procedure used to treat oral cancer that has spread to the jawbone. It involves removing the primary oral tumour, a segment of the mandible (jawbone), and the lymph nodes in the neck to ensure complete clearance of the cancer.
Why is it called a commando operation?
The term commando operation was historically coined because of the highly complex, aggressive, and highly coordinated nature of the surgery, resembling a specialized military operation. Today, we refer to it clinically as a composite resection with immediate reconstruction.
How much does composite resection surgery cost in Chennai?
The cost of composite resection surgery in Chennai varies based on the extent of the tumour, the type of reconstruction required (such as a PMMC flap or microvascular free flap), and the hospital stay. Most health insurance policies cover this oncology procedure. We assist with pre-authorization and documentation.
What is the recovery time after a composite resection?
Initial hospital recovery typically takes 10 to 14 days. Complete healing and adaptation to speech and swallowing rehabilitation generally take 6 to 12 weeks. Dr. Pradeep S. and Dr. Kalpa Pandya provide structured post-operative guidelines to support your recovery.
How soon can I get an appointment or second opinion?
We prioritize urgent oncology consultations. You can typically secure an appointment or a remote second opinion with Dr. Pradeep S. or Dr. Kalpa Pandya within 24 to 48 hours. Please share your biopsy reports and scans for an expedited review.
Will I be able to speak and eat normally after this surgery?
While speech and swallowing will be temporarily affected, immediate reconstruction and targeted speech therapy help restore these functions over time. Our team coordinates closely with specialized therapists to help you regain normal eating and speaking abilities.
What are the main risks associated with composite resection?
As with any major surgery, risks include infection, bleeding, delayed wound healing, or flap complications. Dr. Pradeep S. and Dr. Kalpa Pandya minimize these risks through meticulous surgical planning, advanced techniques, and dedicated post-operative monitoring.
Is jawbone reconstruction performed during the same surgery?
Yes, reconstruction is almost always performed during the same surgical session. This immediate reconstruction helps maintain facial symmetry, supports the remaining jaw structure, and facilitates faster functional rehabilitation.
Who performs the microvascular reconstruction during the surgery?
The tumour removal and neck dissection are performed by Dr. Pradeep S. and Dr. Kalpa Pandya. Complex microvascular free-flap reconstructions are coordinated with the wider specialized surgical team at our affiliated Apollo or partner hospitals.
Composite resection in Chennai
Our practice provides comprehensive oral oncology consultations across Chennai. Dr. Pradeep S. and Dr. Kalpa Pandya consult at Apollo Main Hospital on Greams Road. This central location ensures that patients from across Chennai have direct access to specialized oral & maxillofacial surgery (OMFS) expertise.
