Transoral Robotic Surgery (TORS)
In March of 2010, OHSU's Department of Otolaryngology - Head & Neck Surgery, led by Dr. Neil Gross, became the first in the Northwest to use the daVinci surgical robot for transoral robotic surgery. TORS (transoral robotic surgery) is a minimally invasive surgical option for patients with oral (mouth, throat, and neck) cancers. Its precise wrist-like actions allows freedom of movement for the surgeon in the tight spaces, allowing the surgeon to perform more accurately and safely. The cameras project a 3-D image to the surgeon, who guides the surgery from a command console in the operating room. The top of the instruments go into the patient's mouth and are able to reach tumors that would otherwise require an open incision (cut), which might normally include splitting the lip and jaw.
In the United States, approximately 45, 000 people are diagnosed with head and neck cancers every year. The number is 500,000 worldwide. Head and neck cancer tumor treatments often involve a combination of surgery, radiation therapy, and chemotherapy. In most cases, surgery offers the greatest chance of cure, although traditional surgery may require a much more involved operation, including cuts into the lip and jaw while creating an incision line from ear to ear, resulting in speech and swallowing problems. TORS, the minimally invasive surgical approach, allows access to the tumor site through the mouth. Because the surgeon needs a smaller area to perform the operation, TORS has dramatically improved our ability to get to the tumor while preserving the patient's speech and swallowing ability and maintaining good quality of life.
Benefits of TORS
TORS has revolutionized our approach to oral cancers and has provided patients with the benefits of no visible scarring, significantly less blood loss, possibility of avoiding a tracheotomy, shorter hospital stays, and faster recovery to normal speech and swallowing. Most patients treated with the transoral robotic surgery leave the hospital within three days and are able to swallow two weeks after surgery, compared to spending a week in the hospital and months regaining the ability to swallow after traditional surgery. In addition, TORS could minimize or eliminate the need for chemoradiation therapy, which could leave the patient with dry mouth, loss of taste, and difficulty swallowing.
Treating cancer requires a team approach with various specialties. Our medical and radiation colleagues at OHSU are part of our team. We work with them in a collaborative team that includes radiology and pathology to determine the best possible course of treatment for each patient. With TORS, many of the post-operative treatments, such as chemotherapy and radiation, can be lessened or eliminated because the cancer can be more easily removed totally.
The surgical TORS team is headed by Dr. Neil Gross and Dr. Peter Andersen. First assistant is Teresa Kochanowski, ANP-C. This team approach provides consistency in surgery and after care. The team also includes highly skilled nurses who have been extensively trained in TORS surgery and in the daVinci system, providing excellent patient care.
We take personal interest in creating a unique and medically appropriate individualized plan for each and every one of our patients. With TORS, the ability to remove the tumor in a complete block form helps to improve the ability for the radiation and pathology team to develop a more precise post surgical plan for our patients, while attempting to preserve quality of life.