Transoral robotic surgery is a procedure to remove mouth and throat cancers in which a surgeon uses a sophisticated, computer-enhanced system to guide the surgical tools. When compared with more traditional methods, Transoral robotic surgery tends to result in a quicker recovery and fewer complications for people with mouth and throat cancers.

Dr Sandeep Nayak – a renowned oncologist of India, stated below the facts and process of the Transoral robotic surgery.  Dr Nayak and his team now have experience with nearly a hundred patients with Transoral robotic surgery, and their patient list is currently growing actively. They have adopted this as their technique of choice for patients with tumours of the tonsil and base of the tongue. They are expanding this to see if they can take out tumours in the larynx or voice box and other regions that have typically been difficult to access through the mouth.

Let’s First Understand the Process of Transoral Surgery Stated by Dr Sandeep Nayak:

• Transoral robotic surgery for cancers of the tonsil palate base of tongue and throat or pharynx. Transoral robotic surgery is a new use of an existing instrument – The Da Vinci robotic. This instrument has been used regularly for prostate surgery and GYN surgery and cardiac surgery. Few other centres are developing a technique to move tumours from the base of tongue and throat that are hard to access with other modalities. They have had some success in patients in decreasing their hospital stay and getting them to return to work and also the functions of the mouth and throat quicker than surgeons have been able to with other treatments.
• When the patient comes into the operating room for Transoral robotic surgery, several things are immediately different from routine surgery of the head and neck. The patient is positioned on the table and anaesthetized just like they would for other procedures. Still, then surgeons move in the robotic instrument and place an oral retractor into the mouth which allows them to open the mouth widely and move the structures of the tongue that are not interested in seen or which they need to get out of our way to access the tumour.
• Once this is done surgeons, then move the robotic in storms, and the arms typically have graspers and cautery cutting instruments. That they can position around the tumour and a unique dual telescope that they can move into a place which gives the surgeon a 3d depth of field by knocking the view of the surgical site.

The surgeon sits at a remote console away from the patient who is vastly different from other surgical procedures. There’s an assistant at the head of the patient to provide emergency care or suction or assistance or attraction, but the majority the operation is done at that console.

• So while the surgeon looks on a video monitor at the scene of the operation and manipulates the robotic arms with graspers on the console, then they initiate a Transoral robotic surgery because this technique was new and there was not a lot of experience with it and because it was not originally FDA – approved.

So back then surgeons initiated a protocol where they would enrol 50 patients into a trial these were patients that they thought would be great candidates for Transoral surgery that had tumours that they thought were appropriate to access this way. Their interest was to decrease the operating time, improve their rate of recovery of function, take them out of the hospital and back to their jobs or home or work sooner and these were the main in points of that trial. So they did enrol 50 patients with tonsil and basin tongue tumours into this trial, and our results were even more optimistic than they initially expected.

Now let’s Understand What Happens After the Surgery:

• Surgeons also said that the average hospital time in these patients was 2-.3 days after the surgery. Even in the recovery process patients did not incur any significant complications such as bleeding, inability to access the tumour and incur any tumour recurrences. And most importantly, the patients were able to return to swallowing sooner that made them able to get home sooner. All of the patients were eventually able to return to an oral diet and everyday speech which surgeons thought was a great advantage of this technique.

Surgeons think that the vast majority of patients with oral pharyngeal carcinoma are candidates for this, and they together with a couple other innovative institutions can make their cancers cure with the help of this Transoral robotic surgery.