Head and Neck Cancer: What to Expect from Transoral Robotic Surgery (TORS)

What Is Transoral Robotic Surgery?

Head and neck cancer can be difficult to manage, but thanks to recent developments in medical technology, surgeons now have more effective ways to treat it. In the past, certain tumors in the head and neck could only be removed by either cutting through the neck or opening the jaw.

These rather morbid procedures resulted in poorer functional outcomes and carried a higher risk of complications than their modern-day counterpart, transoral robotic surgery - commonly referred to as TORS.

What Is Transoral Robotic Surgery (TORS)?

TORS is a minimally invasive procedure in which a series of robotic arms are passed through the mouth in order to reach a tumor and resect it. It's most commonly used for tumors in the throat, particularly tonsil and tongue tumors. TORS is a good option for treating head and neck cancers not only because it's minimally invasive, but also because it can reduce the need for additional therapy. Patients who elect to undergo TORS often find that they require a lower dose of radiation --and some can even avoid radiation and chemotherapy altogether.

However, effective as the procedure is, it's important for you to understand what to expect before, during and after TORS, so that you can prepare yourself for the best outcome possible.

Before Surgery

Before undergoing TORS, your surgeon will need to conduct some tests to understand exactly how to approach the tumor. A PET/CT scan is usually necessary to visualize the tumor, and a biopsy to confirm the diagnosis and determine the extent of its development. Preparation for surgery will also include common preparations such as blood testing so that your surgeon may have a thorough understanding of your health.

You may be asked to avoid certain medications during the week prior to the operation, such as aspirin or other anti-inflammatories, as these can cause complications. Your surgeon will advise you on the steps to take prior to your surgery to make sure you are in the best condition possible.

The Day of Surgery

As is common for many surgeries, you will be advised not to eat any food after midnight the night before your TORS. It's important that you arrive two hours before the scheduled surgery so that the nurses, anesthesiologists and surgeons have time to admit you and get everything in place.

Immediately after the operation, you may find that your tongue feels somewhat swollen. This is a common side effect that should subside after a few weeks, and it is unlikely to seriously impair your speech. Either the day of the TORS or the day after, you will have a bedside swallow evaluation to ensure that your throat is functioning well. If necessary, a speech pathologist will be involved to help you along the way.

After Surgery

It's common for patients who undergo TORS to be concerned about whether they will be able to speak or eat. The fact is that TORS results in great functional outcomes, and within just one or two days of the operation, most patients are speaking and eating comfortably. Once you demonstrate that your pain is under control and you are capable of eating and moving around comfortably, you will be able to return home. Hospital stays rarely exceed two or three days.

Although very uncommon, some bleeding may occur around the site of surgery. A sudden case of bleeding in the throat can be dangerous, so be vigilant for the first week or two after your TORS. In the interest of safety, surgeons recommend having someone nearby for that short period after the operation.

Final Thought

TORS is an exciting development for head and neck cancer patients, as it has revolutionized how those diagnoses are treated. Because it is minimally invasive and can reduce the need for further treatment, patients like you are experiencing faster, more complete recoveries. Use this overview of what to expect from the procedure to be more informed when you speak with your doctor.

We are here to help.

If you have questions about the MedStar Georgetown Cancer Network or are ready to schedule a consultation with one of our specialists, call us at 855-546-1815.

Stanley Chia, MD, FACS, is the chairman of the Department of Otolaryngology at MedStar Washington Hospital Center, and is associate professor of Otolaryngology at MedStar Georgetown University Hospital. His areas of clinical interest include transoral robotic surgery (TORS), sinus and nasal disorders, surgical correction of obstructive sleep apnea, head and neck cancer, salivary gland abnormalities, and thyroid and parathyroid disease.