TransOral Robotic Surgery (TORS), the revolutionary, minimally-invasive robotic surgery technique developed by head and neck surgeons at Penn Medicine has been cleared by the U.S. Food and Drug Administration (FDA).
TORS is the world’s first group of minimally-invasive, transoral otolaryngologic surgical procedures to treat benign tumors and select malignant tumors of the mouth and throat in adults. Utilizing the daVinci® Surgical System (Intuitive Surgical, Inc., Sunnyvale California), this landmark breakthrough results in shorter, virtually scarless head and neck surgery. Designed to avoid incisions for primary site resection, TORS is performed through the patient’s mouth and provides unprecedented access to the small and often difficult-to-reach areas of the mouth and throat.
An Historic Legacy
Bert W. O’Malley, Jr., MD, Gabriel Tucker Professor and Chairman, and Gregory S. Weinstein, MD, Professor and Vice Chair of Penn Medicine’s Department of Otorhinolaryngology – Head and Neck Surgery, are pioneers in the field of robotic surgery. In 2004, they founded the world’s first TransOral Robotic Surgery (TORS) program at Penn, where they developed and researched the TORS approach for a variety of robotic surgical approaches for both malignant and benign tumors of the mouth, voice box, tonsil, tongue and other parts of the throat. Drs. O’Malley and Weinstein invented the TORS technique, and have performed more TransOral Robotic Surgery (TORS) procedures than any other physicians in the world.
Revolutionizing and Redefining the Treatment of Head and Neck Cancer
Since 2005, approximately 370 Penn Medicine patients have participated in the world’s first prospective clinical trials of TORS. These research trials comprise the largest and most comprehensive studies of the technology on record. “TORS has dramatically improved the way we treat head and neck cancer patients, completely removing tumors while preserving speech, swallowing, and other key quality of life issues,” said Dr. O’Malley.
The standard surgical and non-surgical approaches to the management of laryngeal, hypopharyngeal and oropharyngeal cancers, while in many ways successful, had significant limitations. Head and neck tumor treatments often involve a combination of surgery, radiation therapy, and chemotherapy. In many cases, surgery offers the greatest chance of cure; yet conventional surgery may require an almost ear-to-ear incision across the throat or splitting the jaw, resulting in speech and swallowing deficits for patients.
In comparison, TORS outcomes are markedly improved when compared to standard chemotherapy, radiation or traditional open surgical approaches for oropharyngeal cancer. When compared to traditional surgeries, after their cancers have been removed successfully, patients have been able to begin swallowing on their own sooner and leave the hospital earlier.
Additional benefits to patients that undergo transoral robotic surgery (TORS) can include shorter hospitalization, a quicker return to normal activity, fewer complications compared to traditional open surgery, less scarring than traditional open surgery, less risk of blood transfusion when compared to open surgery, and no routine use of tracheostomy during surgery compared to routine use for open surgery.
“Based on our data and patient outcomes, coupled with the national and international enthusiasm and interest for TORS, we are changing the way oropharyngeal cancer and tumors will be treated now and in years to come,” noted Dr. Weinstein. “We are already investigating new TORS treatments for other conditions such as sleep apnea, and collaborating with colleagues in Penn Neurosurgery to use TORS to remove skull base tumors and repair cervical spine disease.”
Teaching the Teachers
The TORS program benefits not only patients seeking state-of-the-art care, but also physicians who come from around the world to observe and learn about this groundbreaking procedure. Drs. Weinstein and O’Malley created the first and only training program in TransOral Robotic Surgery (TORS) in the world. They have trained numerous surgical teams from 12 different countries, many of whom have started TORS programs at their respective institutions. With the FDA approval (December, 2009) of the daVinci System for transoral otolaryngology, Penn Medicine has expanded its well-established training program to include surgical teams from the United States.
“It is very exciting that a concept conceived at Penn, evaluated in pre-clinical experimental models at Penn, tested in clinical trials at Penn, and then taught to key surgeons and institutions both within the US and internationally has been officially recognized by our federal governing agencies and peers around the world as a new and improved therapy for select neck cancers and all benign tumors,” Dr. O’Malley concluded.
For more information about the Penn TORS Program, please visit pennmedicine.org/ent or call 800-789-PENN.