概述
经口机器人手术是一种使用计算机系统来引导手术工具的手术类型。医生将这些手术工具放入口腔或经口腔放入咽喉。
经口机器人手术是治疗口腔癌和喉癌的一种方案。
借助经口机器人手术，医生可以更好地查看癌细胞和周围组织。通过使用机器人系统来引导手术工具，医生可以在口腔和其他区域的狭窄空间内进行更精确的操作，并且有助于覆盖拐角处。
与多年来一直使用的手术方法相比，经口机器人手术可以使口腔癌和喉癌患者更快康复，并减少并发症。
目的
Transoral robotic surgery can be used to treat mouth cancer and cancer that affects the part of the throat that's behind the mouth. Cancer that happens in this part of the throat is called oropharyngeal cancer. Transoral robotic surgery often is used for early-stage tonsil cancer and cancer that affects the base of the tongue.
This type of surgery also may be used to remove tumors in the mouth and throat that aren't cancer. And it can be useful when part of the voice box needs to be removed, a procedure called a supraglottic partial laryngectomy. Transoral robotic surgery also may be used when the thyroid needs to be removed, a procedure called thyroidectomy.
Transoral robotic surgery sometimes may play a role in the treatment of sleep disorders such as obstructive sleep apnea.
风险
As with any surgery, transoral robotic surgery has risks. These risks include bleeding, blood clots and infection. It's also possible to have a bad reaction to medicines called anesthetics that prevent pain during surgery.
Other possible risks of transoral robotic surgery include:
- Injury to teeth and lips.
- Tongue swelling.
- Problems with swallowing, speech or taste.
- An unusual opening or hole that forms between the area of the surgery and the skin of the neck. The medical term for this is a pharyngocutaneous fistula.
- Bleeding right after surgery or bleeding that happens days after surgery.
如何进行准备
To prepare for transoral robotic surgery, follow any instructions you receive from your healthcare team. You may need to stop taking aspirin or other blood-thinning medicines several weeks before surgery. These can include warfarin (Jantoven), heparin and other medicines such as ibuprofen (Advil, Motrin IB, others). Do not stop taking any medicines without talking to a member of your healthcare team first.
You will need to stop eating or drinking for a certain amount of time before surgery. Your healthcare team gives you directions to follow before the procedure.
Most people stay in the hospital for several days after transoral robotic surgery. Arrange for a ride home when you leave the hospital and for someone to stay with you the first night you are at home.
可能出现的情况
Before the procedure
Before transoral robotic surgery, you meet with a surgeon to talk about the procedure. That meeting typically includes a review of your medical history. It's important to tell the surgeon if you smoke or if you have smoked in the past. Smoking can make a difference in the risks the surgery may have.
Imaging tests often are done before transoral robotic surgery to help with surgery planning. Imaging tests may include computerized tomography scans, also called CT scans, and magnetic resonance imaging scans, also called MRI scans. Tests also may include an imaging test that combines a positron emission tomography scan, also called a PET scan, with a CT scan.
During the procedure
During transoral robotic surgery, the surgeon sits at a remote-control console a short distance from the operating table. Surgical instruments are passed through the mouth to the area of the body where surgery is needed. The instruments are attached to a surgical robot that is controlled by the surgeon at the console. The surgeon precisely controls the motion of the surgical instruments using two control devices. The console displays a large 3D view of the surgical area that lets the surgeon see that area in much greater detail than is possible with other kinds of minimally invasive surgery.
After the procedure
A hospital stay is required after transoral robotic surgery. Most people are not able to eat anything by mouth for several days after surgery.
The area involved in transoral robotic surgery typically heals on its own over several weeks. It's common to have some pain when you swallow or to have trouble swallowing after transoral robotic surgery. But the pain often can be controlled with pain medicine. Difficulty swallowing typically goes away within about two weeks.
结果
Compared with other types of surgery, transoral robotic surgery generally offers excellent cure rates, shorter hospital stays and fewer complications. Ask your healthcare team what kind of results you can expect after transoral robotic surgery.