What is an endoscopic resection and transoral laser microsurgery (TLM)?

If you have early-stage laryngeal cancer, your surgeon may be able to remove the cancer through your mouth. This type of surgery is called transoral surgery. You will not have a wound in your neck afterwards.

This type of surgery is called transoral surgery. You will not have a wound in your neck afterwards.

Sometimes, your surgeon uses high powered laser (heat) to remove the cancer. This is called transoral laser microsurgery (TLM).

The main aim of this surgery is to remove the cancer completely.

Before you have the operation, your surgeon will explain what will happen before, during and after the surgery. You will have some tests to make sure you are well enough for the operation. These usually include:

You may have these done at a pre-assessment clinic before you go into hospital.

You have this operation under general anaesthetic, and you only need a short stay in hospital.

Having an endoscopic resection and transoral laser microsurgery (TLM)

The surgeon passes a thin, flexible tube with a camera at the end (endoscope) into your mouth and down into your throat.

They use the camera to see images of the larynx. These appear on a screen in the operating theatre. This lets your surgeon see the cancer clearly.

They then guide small surgical instruments through the endoscope to remove the cancer.

Sometimes, your surgeon uses TLM to remove the cancer. The surgeon points the laser beam at the tumour to remove it.

They also remove a small amount (margin) of healthy tissue around it. This is to try to make sure they have removed all the cancer cells. They also use the laser to stop any bleeding during surgery.

Sometimes, instead of holding the surgical instruments themselves, the surgeon uses a machine (robot) to hold them. The surgeon controls the robotic arms.

These arms can move very steadily and precisely to remove the tumour through the mouth. This is called transoral robotic surgery (TORS).

After an endoscopic resection and transoral laser microsurgery (TLM)

You may have some pain in your throat and difficulty swallowing for about 2 days afterwards. Your doctor or nurse can tell you what painkillers to take until this gets better.

If the surgery involved a vocal cord, your voice may be hoarse. Your doctor might ask you to rest it for a few days.

For some people, the surgery may cause a permanent change to their voice. If this happens, your speech and language therapist (SLT) can give you advice and support. They may also suggest voice therapy.

Rarely, side effects of an endoscopic resection include:

  • bleeding
  • infection
  • damage to your teeth.

Your cancer doctor or specialist nurse will give you more information about this before you go home.

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