Robot-Assisted Trans Oral surgery was successfully performed to remove a large parapharyngeal space tumour by Indraprastha Apollo Hospitals, Delhi.

In a case of a large parapharyngeal space tumour, (tumour in the deep tissues of the neck, nerves, lymph nodes, and parts of the salivary gland) a 21-year-old boy underwent a successful robot-assisted Trans – Oral surgery at Indraprastha Apollo Hospitals. Mr. Prince Kumar was having complaints of dysphagia and dyspnea (difficulty in swallowing and breathing) and muffled speech

With his condition deteriorating, the boy was referred to Indraprastha Apollo Hospitals, New Delhi on 18th November 2022. He was admitted under Dr Kalpana Nagpal, Senior Consultant and Robotic Surgeon, ENT Head and Neck Surgery and Dr Anil Sharma, Senior Consultant, Anaesthesia, Indraprastha Apollo Hospital.

Upon, further tests, it was found that patient’s tumour required a surgery and we gave him the option of Trans – Oral robot-assisted surgery. Robot-assisted surgery helps provide a better view of tumour around it and uses more precise movements in tiny spaces of the mouth. It also prevents excessive blood loss and nerve damage. No external cuts are given. The other option is the conventional surgery that requires external cut on the neck.

Speaking about this procedure, Dr Kalpana Nagpal, Senior Consultant and Robotic Surgeon, ENT Head and Neck Surgery, Indraprastha Apollo Hospitals, Delhi said, “Prince was facing difficulty in swallowing and breathing. The patient underwent robot-assisted Trans – Oral surgery to remove a very large parapharyngeal space tumour from the side of the throat. Prince was provided awake- anaesthesia using a fibre optic laryngoscope as conventional general anaesthesia by nose or throat without a tracheostomy was nearly impossible. Additionally, it was difficult to deliver such a large tumour without any external cuts. Prince underwent surgery on 19th November 2022 and it was performed under 3D vision with ten times the magnification using the new Xi Da Vinci robot. The tumour was removed in two parts. This was managed without a tracheostomy and a feeding tube.

Both anaesthesia and Trans Oral removal was a challenge. He was discharged in less than 24 hours on 21st November, 2022 in a stable condition.