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Robotic surgery has become a mainstream tool for removing an ever-increasing variety of head and neck tumors. Now, a team of surgeons from Mayo Clinic has found robotic surgery can treat cancer in narrow, hard-to-reach areas beyond the tongue at the top of the voice box.Some patients were able to avoid further treatment with chemotherapy or radiation, and most could resume normal eating and speaking.
“We’ve known it’s useful for tongue base and tonsil cancers, but we wanted to assess its effectiveness in the larynx,” says Kerry Olsen, otolaryngologist and study co-author at Mayo.
The investigation of trans-oral robotic surgery (TORS) followed a group of patients for up to three years following removal of tumours affecting the area of the larynx above the vocal cords. Most of the patients had advanced-stage disease, according to a Mayo statement.
The results showed TORS effectively removed cancer, with “clean,” disease-free margins, and was easier to perform than the approach of trans-oral laser microsurgery via a laryngoscope.
The patients also underwent the surgical removal of their adjacent neck nodes at the same operation.
“We were pleased with the cancer outcomes,” Olsen says. “We also found patients had minimal trouble after surgery, in most cases resuming normal eating, swallowing and speaking.”
With TORS, the robotic arms that enter the mouth include a thin camera, an arm with a
cautery or laser, and an arm with a gripping tool to retract and grasp tissue.
The surgeon sits at a console, controlling the instruments and viewing the three-dimensional surgical field on a screen. “The camera improves visibility,” Olsen says.
“We also gain the ability to manoeuver and see around corners and into tight spaces, and we believe we’ll now be able to take out more throat tumours than with traditional approaches of the past.”
These findings were presented at the Combined Otolaryngological Spring Meetings in Chicago.
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