Transoral Robotic Surgery

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For select patients who have collapse of the airway in the base of the tongue at night, Dr. Pasha may suggest using the newest technology, the da Vinci Robot to access the base of tongue. Robotic technology requires special certification. The advantage of utilizing the robot is to allow for better visualization and better access to the deeper portion of the throat.

The robot is utilized in the operating room while you are asleep. The robot is positioned and then using a 3-D image, small “arms” are able to reduce the size of the tongue base using a variety of methods.

For some sleep apneic patients and snorers, the tongue may fall back during sleep causing obstruction and snoring. The purpose of reducing the base of tongue is to prevent the tongue from blocking the airway at night. Using the da Vinci Robot for sleep apnea is a developing technology that has not been FDA approved specifically for sleep apnea.

FAQ

Some of the benefits experienced by surgeons using the da Vinci Robot over traditional approaches include better precision, range of motion, and visualization.

No. Although seated a few feet away from the patient, Dr. Pasha will view an actual image of the surgical field while operating in real-time. At no time does the surgeon see a virtual image outside of the surgeon’s direct, real-time control.

Surprisingly, removal of a portion of the base of tongue for the most part does not significantly change swallowing function once healed.

No. The creation of your voice begins in the voice box while resonance is a function the back of the nose. The tongue and lips participate in articulation but it is the front of the tongue that is functional in speech. Therefore, removal of a portion of the base of tongue has very little effect in voice.

You will be on a soft diet for 10-14 days while your throat and base of tongue heals to avoid bleeding. For most you should anticipate a 5-15 lb. weight loss. It is important to maintain your fluid and electrolyte intake while healing to avoid dehydration. Dehydration is a common cause of increased pain as well as complications after surgery.

Although the FDA has not approved robotic surgery specifically for sleep apnea, there are peer-reviewed literature that supports its technique as safe and effective. Complications are rather rare. The number one complication (<1%) would be bleeding. If this occurs you may require a visit to the operating room to “buzz” the bleeder.

Functional complications (numbness, swallowing, and voice changes) are exceedingly rare.

The office will provide a more comprehensive list of potential complication when you are consented. You will also be given a comprehensive counseling by Dr. Pasha and his staff.

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