The surgical treatment of cancer is difficult even in the best of circumstances, but when you combine the additional obstacle of operating in small spaces such as the throat, tongue or tonsils – surgery can be extremely challenging.
What makes these particular procedures so challenging is the small, confined nature of the anatomy of our mouth and throat that are both difficult to see and get to. Due to the nature of this particularly tricky part of our anatomy, surgeries are typically invasive – requiring long recovery times and an increased risk of complications.
Luckily, there have been tremendous strides in surgical robotics technology that are making surgeries minimally invasive and highly effective – particularly the advancements in transoral robotic surgery.
Transoral Robotic Surgery (TORS)
Transoral robotic surgery (TORS) is a procedure to remove oral cancers in which a surgeon uses a sophisticated, computer-enhanced system to guide the surgical tools using an enhanced view of the cancer and surrounding tissue. Using a robotic system to guide the surgical tools allows for more-precise movements in tiny spaces and the capability to work around corners.3
New robotics systems are able to use sophisticated, guided endoscopes that can provide the surgeon with high resolution three-dimensional image of the back of the mouth and throat – the same areas previously very difficult area to both reach and visualize without these tools. The system then allows for two robotically-guided instruments to act as a surgeon’s arms, helping to make it much easier to operate in these difficult-to-reach areas.
Traditionally, these types of surgeries require large incisions through the neck and sometimes opening the bottom jaw, resulting in long hospital stays, painful rehabilitation and complications that can include difficulty swallowing, decrease or loss of speaking ability and sleep apnea.
Surgical centers like Presbyterian/St Luke’s in Denver, Colorado are a leading the way in robotic surgery techniques that help eliminate some of the challenges and complications from invasive surgeries, particularly in laryngeal surgery.
PSL’s Robotics program, led in laryngeal surgery by Dr. David A Opperman, is home to the latest in transoral robotic surgery technology for ear, nose and throat head and neck surgery. The program’s Medrobotics Flex(R) System robot is the first system from Medrobotics West of the Mississippi and is the first training center for Medrobotics for laryngeal robotic surgery in the world.
“The Flex® Robotic System gives physicians the ability to access anatomical locations that were previously difficult or impossible to reach minimally invasively. And because it is affordable and efficient, the Flex® Robotic System allows hospitals to expand the patient population that they serve and improve the productivity of their facilities.”2
Robotic surgery applied in the field of otolaryngology allows for surgeons to see better, which means they can be more precise and ultimately, produce better outcomes for patients in treatment for common head and neck pathology, including benign and malignant disease, treatment for sleep apnea, and common laryngeal procedures that include:
- Radical tonsillectomy
- Uvulopalatopharyngoplasty (UPPP) for sleep apnea
- Tongue-base resection for sleep apnea
- Tongue-base tumor resections
- Parapharyngeal space tumor resections
- Supraglottic laryngectomy
- Subglottic stenosis excision and repair
- Treatment of laryngeal papillomas
Dr David A Opperman, the first fellowship-trained laryngeal surgeon trained in the Medrobotics system, says:
“We are able to visualize tumors and pathology more completely, plan dissections more precisely, and with the optics capability and 3D systems that are now available, we can make more precise cuts and spare more healthy tissue in the resection of malignant disease.”
The advancements in transoral robotic surgery not only help with navigating the difficult surgical procedures, but also allow surgeons to correct or prevent scarring and offer treatment options for abnormalities that would otherwise be impossible to treat.
“The future of robotics is limitless. The machines are getting smaller and the instruments more precise. We are able to access tumors that we used to approach outside-in, in an inside-out approach, allowing us to solve issues with cosmetic deformities and lowering overall morbidity and mortality. This leads to better outcomes, shorter hospital stays, faster recoveries, and less pain. All because of robotic technology.”
More procedures using transoral robotic technology are being discovered every day.
Flex® Robotic System: Expanding the reach of surgery®
The system being put to use by surgical teams around the country, including the team at PSL, is an incredible step forward in surgical tech. The main advantages to the system are that it allows surgeons to visualize the anatomy using magnified HD views not possible with other minimally invasive procedures, reach more by navigating a nearly 180 degree path to reach challenging surgical targets and treat more patients by being able to overcome the limitations of straight surgical tools.2
The future looks incredibly bright in the field of robotics and we can’t wait to see what is next. Keep an eye on the blog for more on the ever-changing world of robotics in the healthcare industry.
If you have questions about these procedures or any questions involving ear, nose, or throat conditions please contact your local physician. If you live in Colorado, you can get in touch with Dr. David A Opperman by visiting ColoradoVoiceClinic.com.