Transoral Robotic Surgery for Oral Cancer

Overview

Transoral robotic surgery is a new treatment option at Mayo Clinic for patients with oral cancers. Mayo Clinic is one of the few facilities in the world with extensive experience in transoral robotic surgery to treat tongue cancer and tonsil cancer. Mayo surgeons are using this technique on about 80 patients each year. It is offered at Mayo locations in Minnesota and Arizona.

Learn more about robotic surgery at Mayo.

Mayo Clinic surgeons adapted the da Vinci surgical robot system, used at the clinic for other procedures, to access oral tumors through the mouth (transoral). The robot's precise wristlike action allows freedom of movement in tight spaces. Binocular cameras project a 3-D image to the surgeon, who guides the surgery from a command console in the operating room. Various tools (cautery, ultrasonic vibration and laser) attached to the robotic arms are used to remove the cancers.

Most patients treated with the transoral robotic surgery leave the hospital within three days and are able to swallow two weeks after surgery, compared to spending a week in the hospital and months regaining the ability to swallow after conventional surgery.

At Mayo Clinic, a pathologist works with the head and neck surgeon during the operation, examining tissue to ensure that all cancer is removed. Many patients also receive chemotherapy or radiation if necessary to stop the spread of cancer.

Patients usually have a follow-up visit every three months after treatment to confirm that they are tumor-free. In a study of Mayo's experience, more than 80 percent of patients who had tonsil cancers removed with transoral surgery had no cancer recurrence in the five years following surgery.

Cancers of the tonsil or base of the tongue are among the most common oral cancers, and their incidence is rising. Oral cancer tends to affect otherwise healthy people in their 20s through 50s and is often in an advanced stage when diagnosed. Standard chemotherapy and radiation treatments are only moderately successful in treating oral cancers and can cause such complications as difficulty swallowing, impaired speech and extended feeding via gastric tube. The transoral approach offers improved cure rates and fewer complications.