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Friday, October 22, 2010

TransOral Robotic Surgery (TORS). An Update from A Symposium at Johns Hopkins on 10/16/10.

Trans Oral Robotic Surgery (TORS) is a new surgical technique that offers several advantages over the traditional surgical approaches to remove head and neck cancer. It was developed for surgery at all body sites and the robotic equipment is available in many medical centers. It is often used for prostatic surgeries.

TORP was pioneered in head and neck cancer surgery by Drs G. Weinstein and B. O’Malley from the Department of Otolaryngology Head and Neck Surgery in the University of Pennsylvania in Philadelphia. Currently other medical centers are also using this method in Head and Neck Surgery including John Hopkins and Greater Baltimore Medical Center.

This is a minimally invasive surgery where the surgeon uses robotic equipment. The surgeon controls the movement of the robot’ arms and delicate surgery is done by the robot’s arms. 

TORS offers significant advantages:
It significantly shortens the length of surgery, a more accurate handling of the patient’s tissues, a more accurate and agile instrumentation, ability of the surgeon to see better, use of an endoscope, and better ability to control the surgical motions. 

Other advantages are: quicker return of the patient to normal activities, shorter hospitalization, reduced risk of swallowing problems, fever complications, less scarring, less risk of infection, less risk of blood transfusion, and less use of tracheostomy compared to traditional surgery. In some patients the use of TORS obviates the need for radiation and/or chemotherapy treatment. 

The surgeon sees the operated area by a highly magnified three dimensional optic device.

TORS shortens the time of surgery, reduces damage to the normal tissues around the cancer as well as the operated tissues, the surgeon can reach where present endoscopy can not go, and it may improve cancer treatment outcome.

Results of studies done up to now by Weinstein and O’Malley show reduction in side effects compared to regular surgery, improved swallowing, and potential for improved overall survival compared to existing treatments strategies.

TORS received FDA approval for several head and neck cancer types of surgeries and awaits other indications. Newer instruments are under development that will enable surgeries at site that are difficult to reach using the current ones. It is good to be aware of this approach that can offer important benefit for patients who require head and neck surgery.