The evolution of oncologic surgical technology has moved towards reducing patient morbidity and mortality without compromising oncologic resection or oncologic outcomes. The goals in treating head and neck cancer are to cure patients, as well as to provide quality of life by improving functional and social outcomes through organ preservation therapies.
Transoral robotic surgery is an emerging technique that provides several benefits over existing treatment regimens and over open surgery for head and neck cancer including reductions in operative times, blood loss, ICU stays and overall duration of patient hospitalization. Transoral robotic techniques allow wide-view, high resolution, magnified three-dimensional optic for visualization of mucosal surfaces of the head and neck. The Robot consists of endoscope, thin tubes with tiny instruments at the tip attached to robotic arms, special camera at the tip of a robotic arm that provides enhanced views of the surgical area, computer console where the surgeon manages the instruments and camera’s every move.
Transoral robotic surgery makes possible greater precision (the robotic arm’s movement are more controlled than a human hand, the arm rotates in the tight spaces of mouth in a way that are not otherwise possible, shorter operating times (an experienced surgeon can quickly and easily carry out procedure. Accessing the surgical area through the mouth causes less trauma to surrounding normal tissue and better visualization (the camera provides magnified, high defined views of the surgical area. It has 3 D capabilities that provide an optimal view of the diseased area of pathology. Other advantages are reduction in extent of cosmetic deformity, reduction in post operative blood loss at surgery, reduction in post operative pain, elimination of the need for post operative tracheotomy, quicker return of speech and swallowing functions, shorter recovery time, reduction in length and amount of general anesthesia used, reduced stay in intensive care unit.
TORS can be recommended in early-stage oropharyngeal cancer (cancer of the tonsil, base of tongue, soft palate, pharyngeal wall), parapharyngeal tumors, supraglottic cancer and hypopharyngeal cancer along with neck dissection. TORS can’t be recommended in advanced stage cancer.
