Transoral Robotic Surgery (TORS)

Brigham and Women’s Hospital (BWH) is one of only a few hospitals nationwide using state-of-the-art robotics to treat benign throat tumors and early-stage throat cancer. The potential of this unique technique to expand the scope of minimally invasive surgery and improve oncology treatment outcomes is motivating more and more of our patients to consider robotic surgery.

What is transoral robotic surgery (TORS)?

Transoral robotic surgery (TORS) is a minimally invasive procedure that uses a combination of high-definition 3D magnification, robotic technology, and miniature instruments – the FDA-approved da Vinci® Surgical System – to enhance a head and neck surgeon’s skills when removing a benign tumor or cancerous tissue from a patient’s throat (pharynx or larynx).

Unlike open surgery for throat cancer, which requires a long ear-to-lip incision to access the tumor – and in some cases also requires breaking the jawbone – no external incision is required for transoral robotic surgery (see image at right). Instead, the slender robotic arms and tiny surgical tools used in transoral robotic surgery are guided to the tumor site through the mouth. There are four available arms – one equipped with a high definition 3-D magnification camera and three that act as the surgeon’s arms – each holding a different instrument, depending on the particular task. The camera gives the surgeon enhanced detail, true depth of field, and a panoramic view, and the robotic hands enable a range of movement far greater than the human hand. This enhanced visualization, precision, and dexterity provide significant advantages when working in difficult-to-reach and delicate areas of the throat, thereby avoiding potential injury.

These capabilities are further enhanced by the surgical console’s unique ergonomics that help ease surgeon fatigue and mechanics that enable steady movements – remotely guiding the robotic arms while a nurse and a pathologist attend to the patient a short distance away. This smooth and effortless motion and the wristed capabilities of the robotic arms are the most significant advantages that robotic surgery has over traditional minimally invasive surgical procedures.

What are the benefits of transoral robotic surgery versus open surgery?

Robotic surgery’s miniaturization, increased range of motion, enhanced vision, and mechanical precision offer significant benefits for our head and neck patients, including:

  • Less blood loss
  • Less post-surgical pain and less medication
  • Quicker recovery and return to normal activities
  • Quicker return to normal speech and swallowing
  • Shorter hospital stay – two- to three-day stay, versus a seven- to ten-day stay with conventional open surgery
  • No visible scarring – no external incision
  • Less likelihood of complications
  • Reduced or eliminated need for chemotherapy or radiation
  • No tracheotomy

Who performs transoral robotic surgery at BWH?

Donald J. Annino, Jr., MD, DMD, Eleni M. Rettig, MD, and Rosh K.V. Sethi, MD, MPH perform transoral robotic surgery for our patients with benign and malignant throat tumors. If you would like to schedule a consultation with Dr. Annino or Dr. Rettig, please call the Patient Referral Service – staffed 8am-5:30pm, Monday through Friday – at 1-800-294-9999, or fill out an online request an appointment form.

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