Minimally Invasive Transoral Tongue Cancer Laser Excision assisted by Robot

Case Record:

• TORS (Transoral Robotic Surgery) Resection of Base of Tongue

Clinical History:

• 61 year old male with complaints of painful swollowing.

• Physical exam notes 2 cm mass on left posterior tongue

Other History:

• Previous history of tonsil cancer treated with radiation 11 years ago

Technique description:

1. Placement of retractor for exposure

2. Docking of da Vinci Single Port Robot

3. Lumenis CO2 laser fiber used for excision of tumor (Ultrapulse Duo)

Procedure steps:

1. Laser settings on 10 Watts Ultapulse

2. Cautery/hemostasis with bipolar electrocautery

3. (Maryland dissector)

4. Laster fiber drop in guide held with needle driver

Training Objectives:

• Understand patient positioning and retractor placement for TORS.

• Understand procedure of partial glossectomy.

• Understand energy use of CO2 laser for surgical dissection.