Mount Sinai offers transoral robotic surgery for sleep apnea treatment

The Center for Minimally Invasive and Robotic Surgery at The Mount Sinai Medical Center—a pioneer in robotic surgery—now offers the procedure to patients with sleep apnea, whose obstructive breathing prevents them from sleeping normally. Mount Sinai is one of only a few programs in the world to use transoral robotic surgery (TORS) to remove excess tissue or fix a collapsed airway that causes sleep apnea.

Through the robotic procedure, a laser removes the extra tissue in the throat that contributes to the airway obstruction in sleep apnea patients. Patients typically return home the next day, and are back to work in 10 days, sleeping and breathing normally.

During sleep apnea, a person's breathing is blocked and then restored when the brain sends a signal that awakens the patient to a lighter level of sleep. This process can happen hundreds of times each night, leaving the patient exhausted during the day and at risk for many health complications, including cardiovascular disease and hypertension.

Many patients opt for a treatment called continuous positive airway pressure (CPAP), delivered through a mask that the patient wears at night to force his or her airway open for the duration of sleep. However, some feel the mask hinders their quality of life, and look for better options.

"Over time many patients grow frustrated with CPAP or stop using the device, causing their sleep apnea to return and leaving them anxious for a better solution," said Fred Lin, MD, Assistant Professor of Otolaryngology and Director of the Mount Sinai Sleep Surgery Center. "In the past, surgery had been a last resort. Now, using robotic surgery, we can remove the tissue that contributes to the airway blockage in a brief procedure with no external incisions and have patients home the next day, sleeping healthfully."

During the robotic procedure, a surgeon sits at a console directly controlling a robotic arm that extends a small surgical instrument through the patient's mouth. Using a high-powered 3-D camera, he or she has a clear view of the surgical field.

The previous surgical technique was less precise and potentially less effective because the surgeon was only able to use one hand, and had limited maneuverability.

"Mount Sinai is one of the original adopters of robotic surgery and we have seen first-hand the dramatic quality of life improvements it provides our head and neck cancer patients," said Eric Genden, MD, Professor and Chair of Otolaryngology, Mount Sinai School of Medicine. "This minimally invasive procedure has the potential to fundamentally change the treatment paradigm for people battling sleep apnea."