Question

Applications of trans-oral robotic surgery (TORS).

Hint:

TORS allows for more precise resection of tumors, reducing postoperative complications and improving recovery times, making it ideal for head and neck cancer treatment.

Answer 1

Trans-oral robotic surgery (TORS) is a minimally invasive surgical technique that uses robotic systems, like the da Vinci Surgical System, to perform surgeries through the mouth (oral cavity) without external incisions. It is particularly beneficial in the treatment of head and neck cancers, offering several advantages over traditional surgery.
Applications of TORS:
1. Oropharyngeal Cancer:
- TORS is primarily used in the treatment of cancers located in the oropharynx, including the tonsils, base of tongue, and soft palate.
- It allows for precise tumor resection with minimal damage to surrounding tissues, helping preserve speech and swallowing function.
2. Laryngeal Cancer:
- TORS can be used in early-stage laryngeal cancers, especially for vocal cord lesions, where it helps to preserve the vocal cords and improve functional outcomes.
- It is also beneficial in salvage surgery after radiation failure in the laryngeal area.
3. Base of Tongue and Tonsil Tumors:
- TORS is effective for resecting tumors in the base of the tongue and palatine tonsils, especially for patients with HPV-related oropharyngeal cancers.
- It allows for clearance of the tumor while minimizing morbidity associated with more traditional open surgery.
4. Minimally Invasive Neck Dissection:
- TORS is utilized in neck dissection procedures for the removal of lymph nodes in the neck. The procedure is minimally invasive, leading to quicker recovery and reduced hospital stay.
5. Salvage Surgery:
- TORS is used in salvage surgeries for recurrent or residual head and neck cancers after radiation therapy, particularly in the oropharynx and larynx.
- It is beneficial for removing small recurrences while preserving the function of the oral cavity and pharynx.
6. Sleep Apnea Surgery:
- TORS has applications in surgical treatment of obstructive sleep apnea, especially in resecting the soft tissue of the palate or base of the tongue that contributes to airway obstruction during sleep.
7. Robotic-Assisted Resection of Benign Lesions:
- TORS can be used to remove benign lesions in the mouth and throat, such as fibromas, hemangiomas, or papillomas, with precision and minimal morbidity.
Benefits of TORS:
- Precision: Robotic systems provide high-definition visualization and precision in surgery, allowing for better outcomes.
- Minimally Invasive: The trans-oral approach avoids external incisions, reducing the risk of complications and improving recovery time.
- Reduced Blood Loss: The robotic system's precision minimizes tissue damage, leading to less bleeding during surgery.
- Faster Recovery: Patients typically have a shorter hospital stay and quicker return to normal activities compared to traditional open surgery.