Global Health Asia-Pacific Issue 5 | 2022 Issue 5 | 2022 | Page 18

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Minimally Invasive Head , Neck and Thyroid Surgery : What ’ s New ?

Dr Tay Hin Ngan , ENT Head and Neck Surgeon at Mount Elizabeth Hospital , discusses technological advancements in ENT surgery that make procedures less invasive and support faster recovery .
TAY HIN NGAN ENT Head and Neck Surgeon Mount Elizabeth Hospital
Dr Tay is an Ear , Nose , Throat ( ENT or otolaryngology ) Surgeon currently practising in Mount Elizabeth Hospital , Singapore . His clinical interests include using endoscopic and robotic approaches for thyroid surgery , head and neck surgery , advanced sinus surgery , and surgery for sleep apnoea and cancers in the ear , nose and throat .
Traditional surgery of the past There was a time when , if you went in for ear , nose , throat , head or neck surgery , you would wake up with unsightly scars from the huge incisions your surgeon would have had to make to get to the hard-to-reach parts of that area of your anatomy . Incisions as long as 10cm were normal when removing large goiters in the treatment of a thyroid condition , for example .
In some cases , surgery involved highly invasive approaches like splitting the jaw to gain the access the surgeon needed , and , as you can imagine , this could lead to further complications for the patient .
A great deal of normal tissue , including the swallowing muscles and portions of the neck , would have to be cut through to get to the surgery site . You would be patched up with flesh and skin from places like the thigh . In cases of cancer , frequently , the procedures would be followed by radiation and chemotherapy together , increasing the risk of further complications .
Fast forward to today ’ s new techniques Thanks to the advent of endoscopy and technology such as robotic arms , ENT surgery has become much less invasive when treating throat , oral and thyroid cancers and conditions .
With the surgical robot , we are able to perform TORS – trans-oral robotic surgery – which involves putting an endoscope with various robotic arms through the mouth to remove a cancer in the throat , while previously we had to saw open the jaw to reach it .
As a result of such minimally invasive techniques , there is no need to cut through so much normal tissue , so we don ’ t need to transplant tissue from elsewhere on the body . Instead , the wounds heal naturally , contracting to bring the surrounding normal structures together so that nearly normal anatomy is maintained . In addition , you don ’ t lose sensory sensation in the swallowing muscles as you used to do with transplanted tissue .
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