Transoral Robotic Surgery (TORS)

Minimally invasive treatment for tumors of the throat and voice box using robotic technology

With transoral robotic surgery (TORS), fellowship-trained head and neck surgeons use advanced robotic technology to treat throat and voice box tumors. The technology allows surgeons to access hard-to-reach areas in the back of the throat and voice box.

What is transoral robotic surgery (TORS)?

TORS is a robotic surgery technique that allows for removal of tumors in difficult-to-reach areas of the back of the throat and voice box. It is a minimally invasive procedure with access through the mouth. The procedure is performed under general anesthesia where you will be completely asleep.

A surgeon operates the specialized robotic arms. This allows for grasping and precise incisions (small cuts) in the tissue. It also gives 3D and magnified views of the affected area.

Surgeons at IU Health are the first in Indiana to perform this surgery using the newest state-of-the-art robotic platform that uses a single port for the robotic instruments. This procedure is performed at the IU Health Schwarz Cancer Center in Carmel as well as IU Health University Hospital in Indianapolis.

What is TORS used to treat?

  • Oropharynx cancer, including tumors of the tonsil, tongue base and upper throat
  • Larynx cancer, including tumors of the upper part of the voice box
  • Hypopharynx cancer, including tumors of the lower throat
  • Lingual tonsil hypertrophy, over-enlarged tonsil tissue at the tongue base that can affect breathing and swallowing

What are the benefits of TORS?

Benefits of TORS include:

  • Shorter operative times for patients compared to open surgery
  • Faster recovery and shorter hospital stay
  • Decreased risk of long-term swallowing and speech issues
  • Reduced amount of radiation and chemotherapy needed, and sometimes even no need for it after the procedure

What are the risks of TORS?

Risks of the procedure include:

  • Postoperative bleeding
  • Difficulty breathing
  • Pneumonia
  • Difficulty swallowing

What is HPV-positive oropharynx cancer, and how does it relate to TORS?

Currently close to 70% of throat cancers in the U.S. are caused by HPV infections. It is more common in men. HPV-positive throat cancer affects men four times more than women.

HPV-positive throat cancer surpassed cervical cancer as the most common HPV-related cancer in the U.S. Fortunately, HPV-positive oropharynx cancer is very treatable. For qualified patients, TORS allows reduced radiation treatments and ends the need for chemotherapy.

The IU Robotic Head and Neck Surgery Program is conducting a clinical trial to study the effects of the reduced radiation after surgery. It is one of the few head and neck surgical trials in the nation, and the only one primarily done in Indiana.

What to Expect with Transoral Robotic Surgery (TORS)

What is transoral robotic surgery (TORS)?

TORS is a robotic surgery technique that allows for removal of tumors in difficult-to-reach areas of the back of the throat and voice box. It is a minimally invasive procedure with access through the mouth. The procedure is performed under general anesthesia where you will be completely asleep.

A surgeon operates the specialized robotic arms. This allows for grasping and precise incisions (small cuts) in the tissue. It also gives 3D and magnified views of the affected area.

Surgeons at IU Health are the first in Indiana to perform this surgery using the newest state-of-the-art robotic platform that uses a single port for the robotic instruments. This procedure is performed at the IU Health Schwarz Cancer Center in Carmel as well as IU Health University Hospital in Indianapolis.

What is TORS used to treat?

  • Oropharynx cancer, including tumors of the tonsil, tongue base and upper throat
  • Larynx cancer, including tumors of the upper part of the voice box
  • Hypopharynx cancer, including tumors of the lower throat
  • Lingual tonsil hypertrophy, over-enlarged tonsil tissue at the tongue base that can affect breathing and swallowing

What are the benefits of TORS?

Benefits of TORS include:

  • Shorter operative times for patients compared to open surgery
  • Faster recovery and shorter hospital stay
  • Decreased risk of long-term swallowing and speech issues
  • Reduced amount of radiation and chemotherapy needed, and sometimes even no need for it after the procedure

What are the risks of TORS?

Risks of the procedure include:

  • Postoperative bleeding
  • Difficulty breathing
  • Pneumonia
  • Difficulty swallowing

What is HPV-positive oropharynx cancer, and how does it relate to TORS?

Currently close to 70% of throat cancers in the U.S. are caused by HPV infections. It is more common in men. HPV-positive throat cancer affects men four times more than women.

HPV-positive throat cancer surpassed cervical cancer as the most common HPV-related cancer in the U.S. Fortunately, HPV-positive oropharynx cancer is very treatable. For qualified patients, TORS allows reduced radiation treatments and ends the need for chemotherapy.

The IU Robotic Head and Neck Surgery Program is conducting a clinical trial to study the effects of the reduced radiation after surgery. It is one of the few head and neck surgical trials in the nation, and the only one primarily done in Indiana.

After your procedure, you will stay in the hospital for a few days. You may need a temporary feeding tube for nutrition and hydration until swallowing recovers. This usually happens within a few days to 1-2 weeks.

You will need to take it easy for a couple weeks, but you should be able to return to everyday activities within a few weeks.

After Your Procedure

After your procedure, you will stay in the hospital for a few days. You may need a temporary feeding tube for nutrition and hydration until swallowing recovers. This usually happens within a few days to 1-2 weeks.

You will need to take it easy for a couple weeks, but you should be able to return to everyday activities within a few weeks.

FAQs

This will depend on several factors including the size and location of the tumor, the amount of lymph node spread in the neck, and overall health of the patient. In general, smaller tumors in the throat are ideal for TORS, but patients will need to be evaluated in the office to see if the surgery is right for them.

Most patients who are candidates for TORS will be candidates for the clinical trial, but this will have to be determined in a consultation visit.

Fortunately, HPV-associated throat cancer is very treatable. Both nonsurgical treatment via chemotherapy and radiation and surgical treatment via TORS are highly effective treatment methods.

At IU Health, patients are evaluated by head and neck cancer surgeons. Their cases are then presented to a team of head and neck cancer experts across many specialties. These providers come to an agreement about the best treatment options for patients. This allows for the highest level of care possible for best outcomes.

Jun 18

Patient is cancer free thanks to advanced robotic surgical technology

After problems in his throat, Chris Smith learned he had cancer. Thanks to Dr. Michael Sim and IU Health North’s robotic surgery program, he is now cancer free.

Patient is cancer free thanks to advanced robotic surgical technology image.

Patient Stories for Transoral Robotic Surgery (TORS)

Jun 18

Patient is cancer free thanks to advanced robotic surgical technology

After problems in his throat, Chris Smith learned he had cancer. Thanks to Dr. Michael Sim and IU Health North’s robotic surgery program, he is now cancer free.

Patient is cancer free thanks to advanced robotic surgical technology image.