THE TOUSS FOUNDATIONS
TOUSS comprises the concept of Minimally Invasive Surgery
Minimally Invasive Surgery (MIS) is the generic term that includes all the surgical procedures whose intention is to reduce damage on healthy tissue, compromising the technique. This is aimed to provide with the same therapeutic results as the more aggressive alternatives. Under this “umbrella concept”, we can find the procedures done through the natural openings as well as those which work with incisions minimizing the physical aftermath (with or without visual technology). It is a concept that means to reduce the morbidity of the interventions and score a quicker recovery for the patient.
TOUSS’s foundational concept
Following on the philosophy behind the laparoscopic surgery, a single incision procedure, the transoral surgery is a take on the same concept. It is designed as an alternative to the Transoral Endoscopic Robotic Surgery (TORS), and to the transoral microscopic laser surgery in specific anatomical regions. The video-endoscope is the main tool to view the area and is essential to make progress in transoral surgery. The endoscope is now considered the future of transoral surgery, with noticeable improvements in terms of the area display. The retraction device has been developed by Kastembauer and Feyh, also used in transoral robotic surgery (later being oversized to attend the robot arm’s space needs). This device is very convenient combined with the video-endoscope.
The endoscopes with a deflecting tip specifically allow a continuous control over the resection. This is due to the precision of the placement of the camera. We consider unnecessary that the robotic platform is used to connect the instruments when the access point is so close to the medical area being treated.
The ultrasound forceps together with the appropriate technique for the removal of pharyngeal tumours will offer enough autonomy to perform any surgery. These forceps are a cutting and coagulating tool based in the friction generated by an electric mechanism, which is able to seal vessels as wide as 6-7mm. This coagulation function is way superior to that of the laser tools. This implies that there’s no bleeding during the procedure, thus improving the visual conditions for an ever so precise control of the surgical margins
TOUSS, one step further in the endoscope’s incorporation
The transoral endoscopic surgery is now a reality, and constitutes one step further in the incorporation of the endoscope as a tool in our field. This has already been done in cases such as the endoscopic nasal or otologic surgeries. The possibility of developing an endoscopic surgical technique with the pros of TORS but without its cons – economic and certification difficulties – allows us to offer an alternative to the classic methods and the new ones to come. TOUSS is the development and simplification of transoral endoscopic surgery in the treatment of head and neck cancer.