Transoral robotic surgery is safe and effective in treating some throat cancers

A new Mayo Clinic study found that the use of transoral robotic surgery for the treatment of tonsil and base of tongue cancers is safe, effective and enables faster recovery times.

An estimated 24,000 people in the US are diagnosed with throat cancer each year. One type, oropharyngeal cancer, begins in the oropharynx, the part of the throat that is directly behind the mouth. Tonsil tumours and base of tongue tumours are both oropharyngeal cancers.

Transoral robotic surgery is a new use of the da Vinci robotic surgical system to remove hard-to-access tumours in the throat. Robotic surgery has previously been proven effective for prostate, gynaecologic and cardiac surgery.

"The results of this research were even more positive than we expected. We found great advantages to using transoral robotic surgery for tonsil and base of tongue cancers," says Eric Moore, MD study author and a head and neck surgeon at Mayo Clinic in Rochester. "There were no major complications, no tumour recurrence and, when compared to traditional surgeries, patients began swallowing on their own sooner and left the hospital sooner."

Dr Moore and his team performed transoral robotic surgery to remove tumours in 45 patients. These patients were followed and data was recorded on surgical time, blood loss, surgical complications, tracheotomy tubes, feeding tubes and resumption of oral diet, speech, swallowing and tumour recurrence. Twenty-six patients had base of tongue primary tumours and 19 patients had tonsillar fossa tumours. There were no major complications and no procedure was stopped due to inability to remove the tumour. The average hospital stay for these patients was 2.3 days, as compared with seven to 10 days for traditional surgery. Additionally, the removal of feeding tubes in patients undergoing transoral robotic surgery occurred an average of seven to 10 days after surgery, compared with two to three months for traditional surgery.

"We now have experience with transoral robotic surgery in more than 100 patients, and based on the outstanding results, it is our technique of choice for removing tumours of the tonsils and base of tongue," says Dr Moore. "Our next steps with this research are to expand the use of transoral robotic surgery to the voice box and other regions that are difficult to access through the mouth."

(Source: Mayo Clinic: March 2009)