Our Summary

This research paper is a review of the method of using robots to perform surgery on the voice box, specifically a procedure called a total laryngectomy. The researchers looked at five studies that involved 27 such surgeries. They found that this type of surgery is mainly used for certain types of cancer of the voice box that keep coming back, a non-functioning voice box, and certain other types of voice box cancer. One of the complications they found was that 20% of the patients developed a hole between the throat and skin. However, in all the cases of cancer they looked at, the entire tumor was successfully removed. The average time for this procedure was about 282.6 minutes. The researchers concluded that this robotic surgery is safe and very useful. They also found that it has the advantage of preserving certain muscles and bones and removing less of the moist lining of the mouth and throat compared to traditional surgery, which reduces the risk of certain complications and improves swallowing after surgery.

FAQs

  1. What are the main indications for transoral robotic surgery total laryngectomy?
  2. What is the average time taken for the transoral robotic surgery total laryngectomy procedure?
  3. What are the benefits of transoral robotic surgery total laryngectomy compared to traditional techniques?

Doctor’s Tip

One helpful tip a doctor might tell a patient about laryngectomy is to follow a strict swallowing rehabilitation program post-surgery to improve swallowing function and reduce the risk of complications such as aspiration pneumonia. This program may include exercises, dietary modifications, and working with a speech therapist.

Suitable For

Patients who are typically recommended for laryngectomy include those with selected recurrent laryngeal squamous cell carcinomas, dysfunctional larynx, and specific primary non-squamous cell carcinoma laryngeal cancers. It is important for these patients to have negative surgical margins and to be suitable candidates for the procedure. Additionally, patients who may benefit from transoral robotic surgery total laryngectomy are those who may benefit from the preservation of strap muscles and hyoid bone, as well as the reduced risk of certain complications and improved swallowing outcomes compared to traditional techniques.

Timeline

  • Before laryngectomy:
  1. Patient is diagnosed with laryngeal cancer, dysfunctional larynx, or other specific primary non-squamous cell carcinoma laryngeal cancers.
  2. Patient undergoes various tests and evaluations to determine the best course of treatment.
  3. Patient may undergo chemotherapy or radiation therapy prior to surgery.
  4. Patient is informed about the procedure and potential risks and complications.
  5. Patient undergoes pre-operative preparations and instructions from healthcare providers.
  • After laryngectomy:
  1. Patient undergoes transoral robotic surgery total laryngectomy procedure, which involves excising the larynx and surrounding tissues.
  2. Recovery period begins, which may involve pain management, swallowing therapy, and speech therapy.
  3. Patient may experience temporary or permanent changes in speech and swallowing abilities.
  4. Patient may require a tracheostomy tube for breathing.
  5. Patient may need to adjust to the physical and emotional changes following the surgery.
  6. Patient undergoes follow-up appointments and monitoring for recurrence or complications.
  7. Patient may require ongoing support and rehabilitation to adjust to life after laryngectomy.

What to Ask Your Doctor

  1. What are the indications for transoral robotic surgery total laryngectomy?
  2. What are the specific benefits of this procedure compared to traditional techniques?
  3. What are the potential complications of transoral robotic surgery total laryngectomy?
  4. How long does the procedure typically take?
  5. What is the success rate for achieving negative surgical margins with this procedure?
  6. How long is the recovery process after transoral robotic surgery total laryngectomy?
  7. What is the likelihood of developing a pharyngocutaneous fistula after the procedure?
  8. How will my swallowing function be affected after the surgery?
  9. Are there any long-term effects or risks associated with this procedure?
  10. Are there any alternative treatment options available for my condition?

Reference

Authors: Poutoglidis A, Forozidou E, Fyrmpas G, Vlachtsis K, Karamitsou P. Journal: J Laryngol Otol. 2024 Sep;138(9):878-883. doi: 10.1017/S0022215124000641. Epub 2024 Apr 23. PMID: 38651375