All head and neck cancer surgery is a balance between making sure that all cancer cells are removed and preserving tissue and a person's ability to speak, breath, swallow or use any affected organ normally. Endoscopic transoral laser surgery is a minimally invasive way to remove tumors in the head and neck. This type of surgery is done through the mouth, enabling surgeons to remove tumors while protecting delicate parts of the body to the greatest extent possible.
When minimally invasive surgery such as endoscopic transoral laser surgery is used, patients tend to recover faster with fewer complications and less pain than with traditional surgery.
Conventional surgery on head and neck tumors involves opening the neck and muscles and working around nerves and blood vessels to expose the affected organ (or organs). It is usually necessary to do a tracheotomy to preserve the airway to the lungs and to insert a feeding tube in the stomach.
Endoscopic transoral laser surgery uses a carbon dioxide laser beam to cut the tumor away from healthy tissue. Special laryngoscopes make it possible for the surgeon to see the tumor during surgery.
The surgeon directs the laser beam with a micromanipulator fixed to a surgical microscope. Special tools are used to move the tumor as needed. The laser is used to divide the tumor into small pieces that are removed in parts until the tumor is gone.
Usually surgeons try to remove tumors as a whole to avoid spreading cancer cells. With a laser beam, however, the laser energy creates heat that seals the tumor's exposed surfaces, sealing in any cancer cells. Because of the high level of visibility this type of surgery offers, a surgeon is often able to determine whether radiation therapy will be needed after the surgery.