Robotic ENT

The introduction of Transoral Robotic Surgery (TORS) has fundamentally changed this landscape. By utilising the natural opening of the mouth as the surgical gateway, we have eliminated the need for external incisions. This is not just a cosmetic improvement. It represents a total shift in how we approach head and neck oncology and obstructive sleep apnoea.

In Dr Crawford’s practice, TORS is used to provide patients with a "functional" cure. This means our goal is not only to remove the cancer or obstruction but to do so in a way that preserves your ability to enjoy life, eat your favourite foods, and speak clearly with your loved ones.

Not every throat condition requires a robotic approach. However, it has become the gold standard for several specific issues. Dr Crawford typically recommends TORS for patients with early-stage cancers of the tonsils or the back of the tongue. It is also an excellent option for those suffering from severe obstructive sleep apnoea caused by an enlarged tongue base. During your consultation, we look at the size and location of the tissue to ensure the robotic instruments can be positioned safely.

There has been a significant rise in oropharyngeal cancers in Australia, often linked to the Human Papillomavirus (HPV). These cancers frequently appear in the tonsils or at the base of the tongue. Because these tumours are often sensitive to treatment and located in highly functional areas, TORS is the ideal tool for removal.

When we use the robot for cancer removal, we focus on achieving "clear margins." This means we remove a small layer of healthy tissue around the tumour to ensure no cancer cells are left behind. Because the robot is so precise, we can take much smaller margins than we would with open surgery, which saves more of your natural throat function.

For many patients, sleep apnoea is caused by an oversized tongue base that collapses into the airway during sleep. When CPAP machines or dental splints are not tolerated, surgery may be the best path forward.

A robotic lingual tonsillectomy allows Dr Crawford to thin out the excess tissue at the back of the tongue. By creating more space in the airway, we can significantly reduce the severity of sleep apnoea and improve your quality of life and long-term cardiovascular health.

The shift toward robotic techniques is driven by patient outcomes. The most immediate benefit is the lack of a visible scar. Because we go through the mouth, there are no neck incisions.

Beyond aesthetics, the internal benefits are even more important. Traditional open surgery often requires a tracheostomy (a temporary breathing tube in the neck) or a feeding tube. With the robotic approach, these are rarely necessary. Most patients can swallow and speak almost immediately after they wake up.

Your journey starts with a detailed discussion of your symptoms and a physical examination. Dr Crawford will use a flexible nasendoscopy, a tiny camera passed through the nose, to view your throat in real-time. This is a quick and painless procedure performed in the clinic that provides vital information about the location and size of any issues.

For patients with cancer, Dr Crawford does not work in isolation. Every case is presented to a Multi-Disciplinary Team (MDT). This team consists of:

Together, this group of specialists reviews your scans and biopsy results to create a bespoke treatment plan. This ensures you receive the highest standard of care available in Sydney.

Most patients stay in the hospital for two to three nights. The primary goals during this time are:

The first two weeks at home are focused on healing.

Some patients may notice that their swallowing feels "different" after surgery. This is often due to the removal of tissue or temporary swelling. Dr Crawford works with expert speech pathologists who provide tailored exercises to help you swallow and speak with confidence.

There is a small risk (around 3 to 5%) of bleeding from the surgical site during the first two weeks as the scabs heal. If this occurs, it may require a brief return to the hospital for observation or a quick procedure to stop the bleed.

Because the robotic tools must move past the tongue, some patients experience temporary numbness or a change in taste. This almost always resolves within a few weeks as the nerves settle.

To perform the surgery through the mouth, we use a retractor to keep the mouth open. While we use protective guards, there is a very small risk of a chip to a tooth or dental work.