Source: speech-language-pathology-audiology.advanceweb.com
Author: Advance, Vol 20, Issue 2

A minimally invasive surgical approach to treat benign tumors and select malignant tumors in adults has been cleared by the U.S. Food and Drug Administration (FDA). The da Vinci Surgical System, developed by head and neck surgeons at the University of Pennsylvania School of Medicine, in Philadelphia, has been cleared for transoral otolaryngologic surgical procedures.

Gregory Weinstein, MD, FACS, and Bert O’Malley, Jr., MD, founded the first TransOral Robotic Surgery (TORS) program in the world at Penn Medicine in 2004. They developed and researched the TORS approach for a variety of robotic surgical neck approaches for both malignant and benign tumors of the mouth, larynx, tonsil, tongue, and other parts of the throat.

Since 2005, approximately 350 patients at Penn have participated in the first prospective clinical trials of TORS. The trials compromise 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, chair of the Department of Otorhinolaryngology-Head and Neck Surgery at Penn Medicine. “It is very exciting that a concept conceived and tested at PENN and taught to surgeons and institutions within the U.S. 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.”

As many as 45,000 Americans and approximately 500,000 people worldwide are diagnosed with head and neck cancer each year. Treatment often involves a combination of surgery, radiation therapy and chemotherapy. Surgery offers the greatest chance of a cure in many cases, but conventional surgery may require making an almost ear-to-ear incision across the throat or splitting the jaw, resulting in speech and swallowing deficits for patients.

In comparison, the minimally invasive TORS approach, which accesses the surgical site through the mouth, has been shown to improve long-term swallowing function and reduce the risk of infection while speeding up the recovery time. When compared to traditional surgeries, after cancer has been removed successfully, patients have been able to begin swallowing on their own sooner and leave the hospital earlier. TORS outcomes improve markedly when compared to standard chemotherapy, radiation or traditional open surgical approaches for oropharyngeal cancer.

“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, vice chair of the otorhinolaryngology department at Penn, director of the Division of Head and Neck Surgery, and president of the Society of Robotic Surgery. “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.”

The Penn TORS program developed an international training program that has trained numerous surgical teams from 12 different countries, many of whom have started establishing TORS programs at their respective institutions. Now that the da Vinci System, by Intuitive Surgical Inc., in Sunnyvale, CA, has received FDA clearance for transoral otolaryngology, Penn Medicine will expand its training program immediately to include surgical teams from the United States.