Robot assisted surgery: how new technology creates opportunities in head and neck surgery

Written by: Professor Neil Tolley
Edited by: Jay Staniland


What is Robotic Head and Neck Surgery?

Robotic head and neck surgery is one of the latest technological advances in surgery. This novel technology helps overcome restrictions present with conventional surgical techniques.

Surgery is not performed by a robot but by the surgeon using robotic technology. Robotic surgery permits access to small spaces and removes all natural hand tremor. It permits precision surgery in real time using a 3D visual field.



Why is robotic surgery used?


The da Vinci robot permits surgery on the tongue base and tonsils for cancer and obstructive sleep apnoea. The robot can be used to remove the thyroid or parathyroid gland in patients in selected patients wishing to avoid a scar in the neck. It is not suitable for all thyroid or parathyroid surgery.

  • Surgery to the tongue base (cancer and sleep apnoea)
  • Surgery to the tonsils (cancer)
  • Removal of the thyroid (avoiding a neck scar)
  • Selective parathyroid surgery where patients have a tendency to heal poorly and wish to avoid a neck scar

What are the benefits to using this procedure?


  • Avoidance of a neck scar in thyroid and parathyroid surgery.
  • Sleep apnoea where obstruction is at the base of tongue.
    Suitable for patients where CPAP has failed or been refused and the patients BMI is not over 30. It is not possible to perform precision surgery of the tongue base by other surgical techniques either because they are too invasive or line of sight issues which occur with laser treatment.
  • No flaps (tissue grafts) are required for cancer surgery where inpatient stay is reduced from 3 weeks to 7 days.
  • Permits less chemotherapy and radiotherapy when treating cancer. This leads to superior swallowing outcomes for the patient.
  • Robotic head and neck surgery for tonsil and tongue base cancer reduces inpatient stay from 3 weeks to 7 days. This is better for patients and reduces the demand on healthcare resources.

What complications can occur with this procedure?


As with any surgical procedures there are risks such as bleeding and infection. However, the postoperative recovery is significantly helped by using robotic techniques.

By Professor Neil Tolley
Otolaryngology / ENT

Professor Neil Tolley has an international reputation in thyroid and robotic head & neck surgery. He is an ENT expert that pioneered head & neck robotic surgery in the UK, and was the first surgeon in the UK to use the Da Vinci Robot for head & neck cancer, obstructive sleep apnoea and thyroidectomy, along with being the first surgeon in the world to perform robotic parathyroid surgery. Professor Neil Tolley treats a wide range of ENT conditions and has a special interest in surgery of the thyroid and parathyroid glands. Robotic surgery is used in selected patients to avoid a scar in the neck with an equivalent hospital length of stay. He has a national reputation in education, training and research and lectures widely at national and international meetings. He has in excess of 160 peer-reviewed publications. He serves as lead for ENT training in North Thames, Chairman of the London Consultants’ Association and an executive board member of the British Association of Endocrine and Thyroid Surgeons.

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