A new robotic surgical technique called Transoral Robotic Surgery (TORS) seems to show some promise in fight against tonsil cancer. Researchers at the University of Pennsylvania, Philadelphia say that this technique has been seen to remove cancer involving the tonsil region.
A research team led by Dr. Gregory S. Weinstein carried out tests to check the feasibility of the new technique, involving 27 patients undergoing radical tonsillectomy for cancer between May 2005 and April 2007.
In a report on their study, published in the Archives of Otolaryngology-Head & Neck Surgery, one of the JAMA/Archives journals, the researchers have revealed that surgeons trying to remove tonsils of patients with cancer through the mouth often have limited access to the area.
If the cancer has spread to any of the surrounding tissues, an open approach involving cutting through the skin is needed, says the report. It further states that these procedures take a long time, can cause long-term difficulty swallowing, and usually require the placement of a tracheotomy tube.
Dr. Weinstein has revealed that the surgical system consists of a console, where the surgeon sits at a distance from the patient. The system also comprises of a surgical cart, three instrument-holding arms, and a central arm with an endoscope.
Two video cameras installed with the system offer a three-dimentional view of the inside of the body. The surgical arms are controlled by the surgeon's movement of handles in the console.
During the procedure, the patient's mouth is held open, and incisions are made in the gums, soft palate, tongue and throat muscles to reach and remove the tonsils and any surrounding cancerous tissue.
"The surgeons successfully performed TORS in all cases. All robotic arms functioned optimally during the procedures, and no interference between robotic arms was noted," the authors write.
With TORS, the surgeons were able to remove all cancerous tissues in 25 patients (93 per cent). The average length of surgery was one hour and 43 minutes.
After the operation, 26 out of the 27 patients were able to swallow without having to depend on a stomach tube.
The surgery did not result in any deaths. Though some complications occurred in five of the 27 patients (19 per cent), most were resolved without significant consequences.
"The early complication rate is comparable to the rates reported for the alternative therapies of non-robotic transoral surgery, open surgical resection and concurrent chemoradiation treatments," the authors write.
Complications including death, pneumonia or fistula, an opening or passage in the skin or organs that are usually reported during these other types of procedures did not occur in the TORS patients.
"Radical tonsillectomy using TORS is a new technique that offers excellent access for resection of carcinomas of the tonsil with acceptable acute morbidity or complications," the authors write.
"Future reports will focus on long-term oncologic and functional outcomes," they add.