OP166: TORS, A new surgical tecnique in the ENT field

Abstract

In the ENT field some of the most common procedures for benign diseases and benign and malignant lesions of the oropharynx, hyporharynx and larynx are tonsillectomy, uvulopharyngopalatoplasty and Transoral Laser Surgery. The disadvantages of these methods have to do with the recovery time, the hospitalization, postop pain, severe discomfort for the patient due to difficulty in swallowing and also possible complications such as postop bleeding and oedema. TORS is a safe, feasible and minimally invasive alternative to classic open surgery or TLS in patients with early cancer of the head and neck, and in benign diseases such as hypertrophy of the tonsils, uvula-soft palate-lingual tonsils that cause sleep apnea syndrome. The main advantages of the TORS are: • The 360° motion of the robotic instruments provided excellent access to cutting and suturing, a property that it is not available in standard TLS. • Avoidance of tracheostomy. • Quicker return to normal speech and swallowing. • less pain-Less blood loss. • Shorter hospital stay. • Shorter recovery time. • Minimal scarring. • 3D HD visualization. • Maximum preservation of function and enhanced definition of safe margin complete tumor removal. Patients and methods Since November 2010, 14 patients underwent TORS. ∘ 5 pt: tonsillectomy due to severe snoring. ∘ 4 pt: UPPP due to sleep apnea syndrome. ∘ 2 pt: lingual tonsillectomy for hypertrophy of the lingual tonsils. ∘ 1 pt: supraglottic laryngectomy for T2N0M0. ∘ 1 pt: vertical hemilaryngectomy for T2N0M0. ∘ 1 pt: T1N0M0 of the left pyriform sinus. Results The results from the follow up are very encouraging and promising, because they are in full agreement with the available data. TORS allows the surgeon to provide the patient with procedures equivalent to traditional transoral surgery, but with the advantage of 3D HD visualization of the laryngopharyngeal structures and the precision and dexterity afforded by robotic instrumentation.