Trans-Oral Robotic Surgery (TORS)

Trans-Oral Robotic Surgery (TORS) - What it is

Transoral robotic surgery(TORS) is a surgical procedure where the surgeon operates a roboticspecialized computer system to remove a tumour or "growth" in your throat.

TORS is done through the mouth and enables the surgeon to operate in the "deeper" parts of the pharynx (throat).
During TORS, the doctor is able to get a magnified "close-up" view of the tumour with a 3-dimensional perspective from the camera. There are also specialized surgical instruments with increased maneuverability . These instruments are controlled from outside your body by your surgeon at the operating console within the operating room.
The robotic system allows the doctor to operate in tight areas in the throat which are difficult to reach. Previously, these growths would require larger, more invasive methods to remove them including splitting the jaw for adequate exposure.

Trans-Oral Robotic Surgery (TORS) - Treatments

Why do I need to undergo TORS?

Your doctor may recommend that you undergo TORS for any of the following reasons.

You have a growth of the base of tongue, larynx (voice box) or throat
You have a diagnosed cancer of tonsils, base of tongue, larynx(voice box) or throat.

What can I expect after the surgery?

Depending on the nature of the surgery, you may have a breathing tube (tracheostomy) and/or a feeding tube after the surgery.
Depending on your condition, an additional procedure may be required to remove the lymph nodes in your neck, called a neck dissection.
The expected length of stay will be about 5-7days, and may be longer for cancer related cases.

What are the risks of surgery?

Pain—You may experience throat pain when you wake up from the surgery as it involves removing the tumour and its surrounding tissue. This may make it difficult for you to swallow after the surgery.

We will provide you with painkillers to help reduce the pain. The pain is expected to improve within 5-7 days after the procedure.

Bleeding— Bleeding may sometimes occur after the surgery. Rarely, this may require a second surgery to stop the bleeding.

Swallowing difficulties – This is likely to occur as the surgery involves removing the growth in your throat and mouth region. You will be seeing our speech therapist before the procedure who will guide you through the recovery process.

Speech difficulties/ voice change – This may occur after the surgery due to the swelling at the back of the throat. You will be seeing our speech therapist who will guide you through the recovery process. (See Below)

Damage to the teeth, lips or jaw— Occasionally, the teeth or lips may be injured during the operation as all the surgical tools are nearby in the mouth. Some patients may experience some pain in the jaw.

Will I be able to eat and drink after the surgery?

It may be difficult to eat or drink normally immediately after the operation. A temporary feeding tube may be put in through your nose into your stomach until oral feeding can be safely resumed (5-7 days). This tube is usually removed before discharge from hospital.

Our dietitian will ensure that you are getting sufficient nutrition with the liquid feeds until oral feeding is resumed

The speech therapist will evaluate your swallowing and advise you on the consistency of the food and drink that would be most suited for you.

Will my speech be different after the surgery?

Your voice and speech may sound different after the surgery due to the swelling that occurs after the surgery. This will likely improve over time. The speech therapist will help you with exercises to help with your speech.

Benefits of TORS

Shorter hospital stay from conventional open surgery
Faster recovery time for swallowing and speech
No external scarring
Less blood loss
Less pain post-surgery

Home care after the surgery

Avoid strenuous activities until advised by your doctor
Avoid smoking as this is bad for wound healing and may increase your risk of bleeding.
Take your medications as advised by your doctor.
You may be on a modified diet as advised by the speech therapist.