New Advances in Otorhinolaryngology – Head and Neck Surgery

Otorhinolaryngologists at Penn Medicine continue to make advances in robotic-assisted procedures, taking the techniques learned through the development of TORS and applying them to new treatments.

Robotic-Assisted Thyroidectomy

In the past, thyroid surgery left patients with a scar on their throat. Advances in endoscopic surgery resulted in a slightly smaller scar, but for many patients even a small scar can present issues. The introduction of the robotic surgical system allowed otorhinolaryngologists to take advantage of what they learned from the endoscopic procedure and develop a new option.

“We began looking for other ways to access the thyroid,” said Jason Newman, MD. “Working with the surgical robot, we were able to modify a technique that provides access from under the arm. It gave us perfect access and we are seeing good results.”

Previously, some surgeons had successfully accessed the thyroid from under the arm, but it was a challenging and difficult procedure. In classic endoscopic surgery, the movement of the instruments is counter-intuitive — to move the tools right, the surgeon has to move to the left. When using the robotic surgical system, the robotic arms mimic the surgeon’s every movement and the optics provide a clear, three-dimensional image that corresponds exactly to the surgery.

Like all robotic-assisted procedures, robotic thyroid surgery is not appropriate for all patients. Dr. Newman said physicians are establishing the guidelines for patients whose lifestyle and condition make the robotic-assisted procedure a good option.

“This procedure is only being performed in a few centers around the world,” Dr. Newman said, “so the research is still new. But our outcomes so far are similar to or better than endoscopic and traditional open procedures.”

Treating Sleep Apnea

Sleep apnea is an interruption in breathing during sleep. The muscles that hold the airway open relax during sleep and when this loose tissue vibrates, it produces the sound of snoring. If the tissue in the back of the throat actually collapses during sleep, it blocks the airway and prevents air from getting to the lungs. It is one of the most common sleep disorders in the country.

Surgery to minimize or remove the excess tissue in the throat is one of the treatment options for patients with sleep apnea.

“In surgical management of sleep apnea we can trim the palate and uvula and remove the tonsils,” said Erica Thaler, MD. “Now with the introduction of TORS we can also help patients who have issues with the base of the tongue.”

Penn is at the forefront of beginning the study of this new procedure for a potentially life-threatening condition.