Flexible robot for tongue base surgery

[Guest]

Hello,

Wondering if anyone has heard where a new robot called Flex robot is being used for tongue base surgery. Anybody know of Doctors on the West coast?

Thanks all!

John

[Goofproof]

It was renamed the Tongue Terminator after Sky Net reprogrammed it to completely remove tongues completely. The patient no longer said: "I'll Be Back"! Jim

[ChicagoGranny]

Hello,

Wondering if anyone has heard where a new robot called Flex robot is being used for tongue base surgery. Anybody know of Doctors on the West coast?

Thanks all!

John

- Are you CPAP intolerant?

- Have you been examined by an ENT who is familiar with surgeries for sleep apnea? Did he perform a Nasal Endoscopy & Laryngoscopy (http://www.tampaent.com/treatments-nasa ... el-fl.html)?

[Too tall]

I had the radio frequency ablation to reduce the size of the base of the tongue. pretty harmless and painless. I've read where it sometimes requires more than one treatment which can be done in the office however my doctor says only one is necessary. I can't say get as I'm still recovering and evaluating the results.

[manoflamatzah]

I would NOT rush to get surgery - I have seen too many people who had UPPPs (removing the back of the soft palate, including the uvula) who were not helped by surgery and also had problems. I know you are referring to a different procedure, but surgery may botch things up in unexpected ways.

[sickwithapnea17]

I think I'm going to have surgery again. Why isn't UPPP good besides the food regurgitating? Some people post online that UPPP does help them

[49er]

Hello,

Wondering if anyone has heard where a new robot called Flex robot is being used for tongue base surgery. Anybody know of Doctors on the West coast?

Thanks all!

John

John,

According to this promotional piece, it looks like Dr. Jesse Tan has done the procedure at Long Beach Memorial Hospital. If that location isn't good, maybe if you call his office, they can recommend places that would be more convenient.

http://www.memorialcare.org/about/stori ... -she-loves

Manoflamatzah, of course surgery should be the last option. But if someone has tried everything possible to make pap therapy work to no avail and the other conversative options like using a dental device and or Provent are not options, then it is a matter of systematically choosing the best option for the person's situation. Obviously, not addressing the apnea is not an option.

Getting an in office exam of the airway is the first step as CG has advised so the ENT can see where the obstructions may be and as a result, hopefully make appropriate recommendations. If someone is interested in the Inspire Procedure, a sleep endoscopy is required to make sure the collapse is specific to the tongue. I pursued this option first because it seemed the least invasive to me but unfortunately, I didn't qualify.

In researching other surgical options for myself (yes, I have given pap therapy a long try), it is my understanding that the problem with the UPPP is many sleep apnea surgeons seem to advise it as a one size fits all procedure when there are more conservative forms of it that might do the job as well. Additionally, Dr. Steven Park, (whom I realize is just one surgeon's opinion) claims that many times, the reason UPPPs fail more than they succeed is because all the obstructions are not addressed at the same time. However, to be honest, I would still be very reluctant to have a UPPP unless the "million" questions I asked were addressed to my satisfaction.

According to my research and a sleep doc I have corresponded with, the MMA Jaw Advancement Surgery has the best success rate of all the surgeries. But it is a very grueling surgery so anyone considering that has to keep that in mind.

Regarding the surgery that John asked about, if I were to pursue this surgery, besides asking the typical questions that one would ask about any operation, since the procedure only seems to address the tongue area, I would want to know why the surgeon felt the obstructions were limited to that area because if they aren't, it seems this operation would not be very successful.

And as is the case with any surgery, I would get more than 1 opinion.

And if the surgeon wants to operate when the person has not tried pap therapy for at least 6 months (maybe longer), I would run from his/her office. The reputable ones will not usually offer surgery as a first option.

49er

PS - Manoflamatzah, I just read in another post after posting this message that you are an internist. If I had known that, I wouldn't have changed my main points but would have phrased things differently keeping in mind your medical background. I am curious, how would you advise patients who have tried diligently to make pap therapy work to no avail? Not a trick question by the way as I am interested in hearing your perspective.

[ChicagoGranny]

I would NOT rush to get surgery - I have seen too many people who had UPPPs (removing the back of the soft palate, including the uvula) who were not helped by surgery and also had problems. I know you are referring to a different procedure, but surgery may botch things up in unexpected ways.

Why did you throw in the red herring of UPPP?

[Guest]

are you going to lose your sense of taste with base of tongue surgery? I've heard that the tongue can collapse backward and the surgery fails?
does MMA alter your facial appearance? I have a friend who had it done

[NoCPAP4me]

You can have a test called a "Sleep Endoscopy" which will select ENT doctors can perform. This test will sedate you to sleep and the ENT can video to view your obstruction points on video and provide a report. It's an excellent test to additional information to detail where your obstructions are. This test is frequently performed for patients interested in the Inspire implant device to see if they are considered a candidate. I used this test to further corroborate where my obstructions were and the severity.

As for the Robotic Surgery, which ENT I read is called "TORS" as well (Trans Oral Robotic Surgery), I've read the recovery can be quite painful although short. However, outcome success varies and finding a qualified doctor difficult. I live on the East Coast (Florida) and found one highly regarded surgeon who performs this (Dr. Magnuson at Florida Hospital)

As for MMA surgery, it is regarded as the most successful outcome in all the literature and studies, hence it is covered by many insurance companies. The robotic method for tongue based reduction is many times not covered (at least it wasn't for my insurance but the MMA surgery was).

MMA surgery will alter the appearance to the person who had the surgery and family, friends, or loved ones who see you regularly. You're talking 10-12 millimeters added to the maxilla or mandible, so the movement is less than an inch forward. Additional chin work may be required for this surgery as well for proper aesthetics and conformity (genioplasty). However, it in many cases is minimal and unnoticeable to anyone else and even enhances appearance in many cases.

[sickwithapnea17]

I have a friend who had MMA and she wasn't happy with it and said it wasn't effective and had trach.