roboticRobotic ENT Surgery Introduced

An advanced approach means less trauma, faster recovery.

Last summer, otolaryngologist Dr. Howard Boey performed MidState’s first robotic ear, nose and throat surgery. Using an advanced procedure known as transoral robotic surgery, or TORS, Boey removed enlarged and uncomfortable lingual tonsils from the back of the tongue of a 26-year-old woman. The condition, in which lingual tonsils enlarge years after a routine tonsillectomy, is fairly common. In the past, patients who didn’t obtain relief with medication had no other options. TORS, however, allows specially trained physicians to treat this and a range of cancerous and noncancerous conditions of the throat without the extensive surgery that used to be required. TORS is performed through the patient’s mouth instead of through large incisions.

“There are areas at the back of the throat that were always inaccessible, typically at the back of the tongue and near the voice box,” Boey says. “The only way to reach them was to use more radical approaches, such as dividing the patient’s jaw. The robot allows
us to perform surgery in those areas without having to use such a radical approach.”

Since that first surgery, Boey has performed TORS for another half-dozen patients. They ranged in age from 23 to 70 and had a variety of malignant and benign conditions.

The da Vinci® TORS system used at MidState features a magnified 3-D high-definition vision system and special instruments with “wrists” that bend and rotate far greater than the human wrist. The surgeon controls the robot, which translates his or her hand movements into precise movements of its tiny instruments.

Because it reduces trauma to the body, Boey says, the robotic approach means an easier, faster recovery for patients. All of the patients Boey has treated with the robotic technique at

MidState have gone home the day after surgery. Pain is easily managed with oral medications, and patients typically return to work in two weeks. Another benefit is that patients who have early-stage cancerous lesions completely removed may not need radiation therapy after surgery.

MidState is one of few community hospitals to offer TORS, and Boey is one of fewer than 10 physicians in Connecticut qualified to perform it. Physicians who want to perform TORS must complete a da Vinci® online tutorial, travel to an off-site laboratory for hands-on practice and perform the procedure under expert supervision. “The credentialing process,” Boey says, “is quite elaborate and requires a number of methodical steps and stages.”