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.
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Transoral robotic surgery (TORS)
Also known as: Trans-oral robotic surgery, transoral robotic assisted surgery, robotic assisted trans-oral surgery
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What is it for?
To remove head and neck cancers
Transoral robotic surgery (TORS) consultation at The London Clinic
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.
FAQs
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.
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.
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:
Bleeding
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.
Pain
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.
We offer Fixed Price Packages
Where possible, we’ll provide a fixed-price package for your hospital care. This covers your hospital stay, nursing, and use of our facilities, giving you a clear guide to what those costs will be.
- Pre-op assessment
- Hospital stay, nursing care and meals
- Tests, scans and physio during your stay
- Take-home medication (up to 5 days)
- Post-op follow-up appointments
- Standard equipment or prosthesis (if needed)
- Unplanned extended stay or ITU (if clinically required)
- Initial consultation and any tests done during it
- Consultant and anaesthetist fees (quoted separately)
- Physio or therapy before or after your stay
- Diagnostics before admission (unless agreed in your plan)
- Specialist medication beyond 5 days
- Ambulance transport or bespoke prosthetics
Your consultant’s fees are quoted separately and shared directly by their office after your consultation. These professional fees cover the time, expertise, and care provided by your consultant before, during, and after your treatment. See our full terms and conditions
Timeline
We aim to get you treated without delay and back to your normal life as quickly as possible. Typically, this involves the following steps:
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.
Pre-operative assessment
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.
Aftercare
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.
Follow-up
You'll have follow-up appointments with your consultant to check everything is going as expected and you're recovering well.
Why choose The London Clinic?
Trusted for over 90 years, The London Clinic is an independent charitable hospital that reinvests into care, research, and support for those who can’t easily access private treatment.
The UK’s largest independent hospital
More patients choose The London Clinic than any other.
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Full intensive care on-site
World-class 13-bed ICU for expert support if your care becomes complex.
Investing in clinical excellence
Backed by Northwestern, we equip our teams with cutting-edge medical equipment.
0% Finance Options
We’ve teamed up with Chrysalis to offer you funding options that allow you to spread the cost of your treatment.
If you choose to pay for your treatment at The London Clinic over 12 months, you can make use of a great 0% interest option and pay nothing extra. Or you can choose to pay over two to five years at 14.9% APR.
Trustees of the London Clinic Ltd trading as The London Clinic is an Appointed Representative of Chrysalis Finance Limited, which is authorised and regulated by the Financial Conduct Authority. The London Clinic is a credit broker, not a lender. The provider of a payment scheme which is not offered through or by Chrysalis Finance Limited may not be so authorised and regulated. Cancer treatments or transplants aren’t covered by finance packages. Finance options are only available for UK patients.