TORS for oral and oropharyngeal tumor
Feature Summary
Transoral robotic surgery (TORS) is a new technique using daVinci robotic system mainly for excision of oral and oropharyngeal tumor via the natural orifice of mouth opening.
Overview
Transoral surgery is a minimally destructive surgery for oral cavity and oropharyngeal tumors which removes tumors without disruption of normal tissue or bony structures. Early recovery and oral feeding is efficient after transoral surgery in 4-10 days, but maintaining clear surgical view for posterior part of oral cavity and oropharynx remain a challenge in tranoral surgery.
Features
The daVinci robotic system, equipped with 3-D magnified imaging, allows tumor excision at the deeper, posterior part of oral cavity and oropharynx by providing high quality surgical view. The design of endowrist instruments with tissue holding and hemostasis capacities further facilitates excision with greatest precision. Our new daVinci Xi system further facilitates efficient and easy docking with optimal flexibility, and expands the ability of transoral excision to lesions that in the past require mandibulotomy or mandibulectomy.
Procedure
Under general anesthesia with oral or nasal intubation, proper mouth gag system was applied to open the oral cavity. The daVinci Robotic system would be docked through the mouth opening without any skin wound. The 3-D magnified endoscope is placed at the middle, and most commonly, electrosurgical spatula and Maryland bipolar would be applied over bilateral robotic arms. One assistance at the patient site will assist surgical exposure, hemostasis and tissue manipulation with hand held instruments, such as suctions or hemoclips, during the TORS procedures, while the surgeon control the robotic arms to perform TORS at the surgeon console. After the surgery, a short observation of 3-7 days would be arranged before the start of oral feeding and discharge from the hospital.
Notification
- Adequate mouth opening (> 4 cm) is required for TORS.
- Bleeding after TORS has been reported below 5 %.
- Fistula formation is rare but possible, when TORS is performed simultaneously with neck dissection.
- Short period (3-7 days) of feeding tube placement is require to reduce pain or bleeding events.
- Gastrostomy or tracheostomy are rarely required, only for larger/advanced tumors.
Estimated Cost
For estimated medical costs, please contact International Medical Services Center.