Transoral robotic surgery(TORS)has emerged as a technique thatallows head and neck surgeons to safely resect large and complex oropharyngeal tumors without dividing the mandible or performing a lip-split incision. These resections provide a reconstructive challenge because the cylinder of the oropharynx remains closed and both physical access and visualization of oropharyngeal anatomy is severely restricted. Transoral robotic reconstruction (TORRS) of such defects allows the reconstructive surgeon to inset freeflaps or perform adjacent tissue transfer while seeing what the resecting surgeon sees. Early experience with this technique has proved feasible and effective. Robotic reconstruction has many distinct advantages over conventional surgery,and offers patients a less morbid surgical course. Robotic-assisted head and neck cancer surgery is an alternative approach for the management of oropharyngeal tumors, but necessitates the development of appropriate reconstructive methods. TORR represents a bourgeoning robotic transoral reconstructive technique and may eventually be a critical part of any robust TORS program rational approach to the use of the robot in transoral reconstruction will help guide the development of this field.

1. PRESENTED BY
S.NAGARAJAN,
RAGAS DENTAL COLLEGE.
TRANSORAL ROBOTIC
SURGERY- A REVIEW

2. WHAT IS TORS ?
HOW IS IT DONE ?
APPLICATIONS OF TORS
ADVANTAGES AND
DISADVANTAGES
CONCLUSION
SYNOPSIS

3. INTRODUCTION
TORS is a surgery done by using robots with oral cavity as
a portal of entry.

4. ROBOTIC MACHINE
WORKING
PART
Cautery with hook tip
Cautery with spatula tip
Needle drivers
Debakey forceps
Round tip scissor
Curved scissor
5fr introducer for laser
Maryland dissector

5. SURGEON THE CONTROLLER

6. ROOM SETUP

7. ROOM SETUP..cont..

8. INSTRUMENTS AND ACCESSORIES
MOUTH GAG
CART
INSTRUMENT
CART
BEDSIDE
POUCH

9. PATIENT POSITIONING

10. PATIENT PREPARATION

11. SAMPLE PICTURE SHOWING REMOVAL OF
TONGUE BASE TUMOUR

12. OROPHARYNX
AND SKULL
BASE
Base of tongue
Tonsil
Palate
Pharyngeal Wall
Para pharyngeal wall
Retromolar pad
LARYNX AND
HYPOPHARYNX Supraglottis
Glottis
Pyriform sinus
APPLICATIONS

13. ADVANTAGES
Enhanced Visualization
Elimination of Physiologic Tremors
Reduces surgeon fatigue
Surgical outcome is far more superior
Telesurgery
Training
ADVANTAGES

14. PATIENT BENEFITS
PATIENT
BENEFITS
Minimally invasive
Avoidance of disfiguring mandibulectomy
Avoidance of tracheostomy
Significantly less pain
Less risk of wound infection
Minimal scarring
Quicker return to normal speech and swallowing

15. PATIENT BENEFITS..cont..

16. DISADVANTAGES
DISADVANTAGES
Cost of the Device
Unproven Benefit

17. CONCLUSION
THIS IS AN EVOLUTION
REVOLUTIONS YET TO HAPPEN

18. REFERENCES

19. REFERENCES..cont..

20. REFERENCES..cont..