What Is Transoral Robotic Surgery?
Though robotic surgery has existed since around 2000, transoral robotic surgery (TORS) is a new and innovative way of treating head and neck cancer. This type of surgery is performed transorally, which is defined as "through the mouth," using a flexible instrument called a Flex Robot.
If you have been diagnosed with certain types of head and neck cancer, you may benefit from TORS.
The goal of TORS is to remove all of the cancer, or as much as possible, while leaving healthy tissues undisturbed. This type of surgery is called "minimally invasive" for two reasons:
- It does not require large cuts or incisions on the outside of the body to reach the areas that need surgery.
- The tools are very precise, so surgeons can avoid cutting healthy tissue.
Risks and Benefits of Transoral Robotic Surgery
Because transoral robotic surgery, or surgery with the Flex Robot, is minimally invasive, patients experience fewer complications than with traditional surgery. Complications of any type of surgery include bleeding, infection, and scarring. Head and neck surgery complications also may include damage to nerves, blood vessels, and lymph tissue.
Surgery with the Flex Robot can provide the following benefits:
- Reduced scarring (especially when removing lymph nodes from the neck)
- Shorter hospital stays — one or two days instead of seven
- Lower chance of needing radiation or chemotherapy after surgery
- Shorter recovery period
Head and Neck Cancers We Treat With Transoral Robotic Surgery
Since 2016, UPMC has offered TORS for treating head and neck cancer. Surgery with the Flex Robot was developed by a member of our own surgical team to perform delicate procedures in the small, hard-to-reach spaces of the head and neck. We are currently the only surgical center using this technique to remove lymph nodes from the neck, a procedure that traditionally requires large incisions on the neck.
We treat the following conditions using TORS:
- Hypopharyngeal cancer
- Laryngeal cancer
- Nasal cavity cancer
- Nasopharyngeal cancer
- Oral cavity cancer
- Oropharyngeal cancer
- Salivary gland cancer
How to Prepare for Transoral Robotic Surgery
Our team will explain how to prepare for your surgery. Some of the things we will discuss with you include:
- What time your surgery is scheduled, and how early you should arrive
- If and when you will need any additional tests before your surgery
- How far in advance of the surgery to stop eating or drinking
- Whether you should take other medicines you normally use before surgery
- What you should wear and bring to the hospital
What to Expect Before Surgery
After you arrive at the hospital, the surgical team will prepare you for surgery. You will have a brief exam to make sure your health is good that day. You will be placed under general anesthesia for the surgery, which should last between one and two hours.
What Happens During Transoral Robotic Surgery?
During your surgery, the surgeon will insert small surgical tools and a camera into your mouth; the surgeon views a monitor (like a television screen) to see inside your body and moves the surgical tools with a set of hand controls. The robot uses flexible instruments that can move more like hands than other types of robotic instruments. Because they bend and flex, these instruments are better-suited to performing surgery in small areas like the head and neck.
What to Expect After Transoral Robotic Surgery
After your surgery, you will probably spend one to two days in the hospital. Our team will monitor you closely, making sure that your pain is under control. When you are discharged, you will receive instructions about what activities you can and cannot do, and when you need to return for check-ups. You may find it helpful to have someone stay in your home with you while you recover.
If you need additional treatments like chemotherapy or radiation, your doctor will discuss this with you. If your cancer was removed completely during surgery, your doctor will discuss a follow-up plan. Most patients, even if the cancer is removed completely, need to have regular check-ins with their doctor for about two years.
Learn More About Head and Neck Surgery at UPMC
Watch a video by UPMC's Dr. Duvvuri [link to video], who helped to develop the Flex Robotic instrument for head and neck surgery.
To make an appointment for head and neck cancer care at UPMC Hillman Cancer Center, call 412-647-2811.