Surgical Innovation

Transoral Robotic Surgery

Transoral robotic surgery (TORS) is a minimally invasive technique used to treat benign and malignant tumors of the throat that are difficult to reach with traditional techniques. Traditionally, tumors of these areas were removed with open approaches that required tracheostomy and gastrostomy tubes as well as reconstruction of the defect. With minimally invasive TORS, patients often have shorter hospital stay and quicker recovery.

The main tumors removed with TORS are those of the oropharynx (tonsils and base of tongue). These tumors are most commonly related to the human papillomavirus (HPV) but can also be HPV negative or salivary tumors. Other tumors that are amenable to TORS are those of portions of the larynx or hypopharynx. In addition, TORS may be useful in certain aspects of the treatment of obstructive sleep apnea.

Our TORS program is successful secondary to the multidisciplinary nature of patient selection. Our patients often consult with a surgical, medical and radiation oncologist. In addition, the treatment team also consists of skilled nursing staff and speech and language pathologists who are very familiar with these procedures. 

Microvascular Reconstruction

Washington University head and neck surgeons are highly trained both in cancer removal as well as cancer-associated reconstruction.  Our group performs approximately 200 microvascular free flap reconstructions annually. These complex surgeries require transplantation of healthy tissue from a different part of the body in order to reconstruct areas of the head and neck affected by cancer removal.  Reconstruction of the jawbone, for example, is often achieved using the fibula bone from the leg of the shoulder blade bone.  Reconstruction of the tongue can be achieved using skin and muscle form the forearm or the leg.  These complex surgeries require coordinated care that includes surgeons, nurses, speech therapists, and nutritionists in order to achieve the best outcomes.