Transoral robotic surgery (TORS)
We provide transoral robotic surgery for the treatment of head and neck cancer and a range of ear, nose and throat conditions. This pioneering treatment allows our surgeons to perform operations with greater accuracy than open surgery, leading to many benefits for patients.
Trans-oral Robotic Surgery (TORS) is a modern surgical technique that seeks to remove head and neck cancers by accessing the mouth with the use of a robotic device.
With this latest robotic technology, surgery can be more precisely targeted, reducing unwanted side effects, particularly in relation to swallowing and speech.
Convential treatment for these cancers would normally involve radiotherapy, chemotherapy, surgery or a combination of all of these options.
Transoral surgery in the mouth and throat can be extremely complex, and the surgeon needs to consider where the cancer is located and how aggressively it behaves.
TORS addresses the challenge faced by a surgeon who has to work within a tight operating area space, striving to avoid delicate nerves and major blood vessels.
What is TORS used to treat?
Rates of throat cancer have increased by approximately 30% in the past 25 years. Much of this rise may be attributed to particular variants of the human papillomavirus (HPV). HPV can also cause skin or genital warts, while other strains cause anal and cervical cancers.
Until a tumour occurs, the infection is typically symptomless. Sometimes a patient with HPV may present with a cancerous neck lump when the primary site is not immediately obvious. This is despite a specialist head and neck assessment and multiple imaging investigations.
TORS is used by surgeons to treat:
- tonsil and tongue cancer
- salivary gland tumours
- metastatic retropharyngeal thyroid cancer and malignant melanoma,
- recurrent throat cancers (which were previously treated by chemoradiotherapy)
TORS has also been used in situations where the patient's primary cancer is 'unknown’, helping to identify the source.
TORS specialists have used the robotic technique to remove an orbital tumour while preserving the patient's eye and their vision. Conventional surgery would have had an impact on the patient's sight.
What happens during the surgery?
With the patient asleep under general anaesthetic, the surgeon controls the robot with his hands and feet.
One of the robot arms holds a 3D camera, while two other arms hold tiny instruments that are passed through the mouth into the throat, voice box or to the top of the food pipe.
The surgeon sits in a console in the operating room with an immersive, magnified, three-dimensional view of the target region and manipulates the instruments in ways impossible with the human hand alone.
This allows the surgeon to hone in on the tumour and remove it more precisely, which may reduce the amount of radiotherapy subsequently needed. In some instances, it completely avoids the need for chemotherapy and radiotherapy altogether.
Why choose The London Clinic
Excellence in one place
We operate as teams of experts with world-class resources dedicated to maintaining the highest standards of medical care. You are surrounded by the latest treatments and advice with everything you need to get back to your best health.
Personal care, every time
Exceptional patient care is a way of life for us. Our nurses, clinicians and support teams are dedicated to the care of a very small number of patients, so have more time for you. They’ll be with you every step of the way, tailoring your care around you and giving the peace-of-mind that comes with knowing you’re in the best hands.
We work together as one to guide you through each step of your experience, with complexities unravelled and answers readily to hand. Your personal treatment plan will be laid out for you, with all the details taken care of so you can focus on you.
What's included in your package?
Choosing The London Clinic means your treatment plan will be laid out for you, with all the details taken care of so you can focus on you.
Your treatment package will include:
- Enhanced pre-admission assessment
- Your treatment with our complete care team at your fingertips
- Personalised aftercare and follow-up
We want you to be in control of your health. That’s why we also offer optional services such as comprehensive recovery packages and extra touches for you to choose from during your stay with us.
How to pay
- You can use private medical insurance (PMI) to access this treatment. We work with all major PMI providers in the UK and many internationally
- You can pay for yourself (self-pay)
- If you’re paying for yourself, we have finance options available with Chrysalis
Book an appointment
Our dedicated appointments team will arrange for you to meet with one of our renowned consultants.
Diagnosis and treatment plan
Your consultant will review your medical history, carry out tests such as scans and blood tests, and then discuss your treatment options.
You’ll have an enhanced pre-operative assessment appointment to review your general health to check you're ready for robotic surgery.
The day of your surgery
Your care team will welcome you, talk you through the day ahead and get you ready for your surgery.
Afterwards, your surgeon will find out how you’re feeling, tell you how your treatment went and discuss your recovery plan.
You'll stay at The London Clinic until you've recovered well from your surgery. We’ll also give you advice about pain medication, dressing changes and possible side effects.
You'll have follow-up appointments with your consultant to check everything is going as expected and you're recovering well.
We use the state-of-the-art da Vinci surgical robot to perform transoral robotic surgery. The robot has one robotic arm with a high-definition camera on it and three arms that feature surgical instruments.
In the operating theatre, your surgeon sits close to you in front of a special, wraparound screen. The screen gives them a magnified, three-dimensional view of what the camera is seeing.
Your surgeon controls the robotic arms and passes them through your mouth to the area of concern in your body.
Looking at their screen, your surgeon precisely moves the surgical instruments to perform the required operation.
Because transoral robotic surgery is so precise, it has many benefits for patients compared to conventional open surgery. These include:
- Less pain
- Less scarring
- Smaller wounds
- Shorter hospital stay
- Less blood loss
- Fewer infections
- Lower chance of complications
If you’re being treated for cancer, transoral robotic surgery may also mean you require lower doses of radiotherapy and chemotherapy.
As a result, you may experience fewer side effects of chemotherapy and radiotherapy. These include hair loss, sickness and tiredness (fatigue).
Your consultant will discuss with you any side effects you may experience and how they’ll be managed. The main side effects of transoral robotic surgery are:
The area of your body operated on may bleed after surgery. We’ll closely watch for this while you stay with us.
We’ll also give you advice about what to do if bleeding starts after you return home.
Straight after your surgery you may not feel any pain because surgery may have caused numbness in the areas that have been operated on.
But the numbness will gradually wear off after 24 to 48 hours, which is when you may start to feel pain. We’ll give you painkillers to help you manage your pain.
Speech and swallowing difficulties
Depending on the type of surgery you’ve had, your speech may be affected by swelling and discomfort. You may also struggle to swallow liquids, food and medication.
If you are affected in this way, one of our specialist speech and language therapists will give you exercises to help you improve your speech and swallowing.
World-leading surgeons who have extensive training in the latest robotic surgery techniques will oversee your treatment at The London Clinic.
Before your surgery, your dedicated care team will guide you through what to expect, talk about your recovery plan and answer all your questions.
As one of our patients, you’ll also benefit from extra touches such meals that are tailored to support your recovery.
You’ll have your own nurse, supported by an entire nursing team, who’ll help you get back on your feet quickly and safely.
You can choose additional therapies to help you make the most of your recovery and reduce any discomfort, such as reiki and acupuncture.
Once you’re ready to leave The London Clinic, we’ll give you advice to follow at home to help you have a speedy recovery.
We’ll also keep in contact with you over the following weeks to ensure everything is going smoothly.