Frequently Asked Questions (FAQs) about TransOral Robotic Surgery (TORS)
Who is a candidate for TransOral robotic surgery (TORS)?
Whether the patient's doctor has suggested TransOral robotic surgery as a treatment for their cancer, or if they have not mentioned this cutting-edge treatment, the next step is to be evaluated by a physician member of the Penn Medicine TransOral Robotic Surgery (TORS) Team. They will review the patient's records, meet with them to assess their candidacy for the procedure, and advise of all treatment options available and the risks and benefits of each approach.
When will the patient start swallowing again after TransOral robotic surgery?
Naturally this depends on the patient, but many patients begin to swallow by mouth in hospital, shortly after TransOral robotic surgery. While many patients go home swallowing without any additional supplemental tube feeding (nasogastric tube from the nose to the stomach), others will go home swallowing some food and drink by mouth and have the tube removed as an outpatient, typically within ten days of surgery.
Is it difficult to manage tube-feeding through a nasal tube?
The nursing staff at Penn Medicine pride themselves on their ability to provide excellent patient education. Prior to leaving the hospital the patient and their family will be well versed in the management of tube feeding, which will be delivered right to the patient's home following discharge from the hospital. The results for long-term swallowing have been shown to be far superior following TransOral robotic surgery compared to alternatives such as chemotherapy and radiation alone.
If the patient may need to have radiation or chemoradiation afterwards anyway why should they undergo TransOral robotic surgery? Why not just proceed to chemoradiation and skip TransOral robotic surgery?
The rationale for adding radiation or chemoradiation after TORS is almost always based on presence or absence of cancer in the lymph nodes. Almost half the patients who undergo TORS do not have the need for chemotherapy as a postoperative treatment. After the patient undergoes the TORS procedure, the Penn Medicine team is able to decrease the intensity of the radiation or chemoradiation in almost all patients, so they receive less of a dose than they would have if they did not have TORS. Long-term swallowing function has been shown to be far better with TORS when compared to patients treated with full intensity chemoradiation as reported in the medical literature for patients with oropharyngeal cancer (tonsil and tongue base cancer).
Why choose Penn Medicine for TransOral robotic surgery (TORS)?
Drs. Gregory S. Weinstein and Bert W. O'Malley, Jr., of Penn Medicine were the first in the world to perform TransOral Robotic Surgery (TORS) and developed all of the major techniques done in this area. Experience counts. Penn continues to lead in the number of cases performed which means that the entire team has the most experience, world-wide in these new revolutionary techniques.
