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MIOT International has successfully performed Transoral Robotic Surgery (TORS) on a 64-year-old patient, removing a tennis ball-sized tumour from her mouth. The advanced robotic surgery enabled surgeons to remove the tumour through the mouth with robotic tools as slender as three straws, preventing severe facial disfigurement. This minimally invasive procedure avoided splitting the jawbone and preserved the muscles and nerves responsible for the patient’s speech, taste, and swallowing. The patient was spared significant pain, her facial structure was preserved, and she experienced a fast recovery. She was discharged in 2 days and returned to her normal life.

64-year-old patient with an oral tumour

Mrs. Shantha Kumari, a 64-year-old patient from Vellore, came to MIOT in July 2025 with a large lump in the mouth suggestive of oral cancer. It all started with a visit to the dentist at a private hospital in May 2025. During the examination, the dentist noticed a lump in the upper palate of her mouth and referred her to an ENT specialist at the same hospital. The ENT specialist advised her to undergo MRI and CT scans, which revealed a large tumour. Given its location and size, the doctors suspected malignancy, recommended a biopsy, and informed her that it needed to be surgically removed immediately.

Startled by the news, the family wanted to seek a second opinion from an oncology expert. A friend referred them to MIOT International. Determined to ensure the best treatment for Mrs. Shantha Kumari, the family visited MIOT and consulted with the Head and Neck Oncosurgeon.

Consulted MIOT’s Head & Neck Surgery Experts

On examination by the specialist, a swelling was noted inside her mouth, in front of the left tonsillar region. During the detailed history, Mrs. Shantha Kumari mentioned that she had noticed the lump about two years ago. She experienced mild discomfort while swallowing and increased snoring, which disturbed her sleep. Given its location, the specialist reassured her that it was likely non-cancerous and advised further investigations to confirm the diagnosis.

Diagnosis at MIOT

An MRI scan at MIOT revealed a well-defined mass located beneath the soft palate in the left parapharyngeal space. Given its location and imaging characteristics, the tumour was suspicious for a minor salivary gland tumour, measuring 5 x 5.5 cm, almost the size of a tennis ball.

Tumour under the left soft palate tonsillar region

Treatment options

Such deep-seated tumours in the mouth will pose a significant risk if untreated, as it could increase in size, obstruct the airway and oesophagus (food pipe), and potentially extend towards the brain. The specialist, therefore, advised surgical removal. There are two surgical options to remove this tumour: Conventional Open surgery (OR) Transoral Robotic Surgery.

Conventional Open Surgery

The conventional technique to access such a deep-seated tumour typically involves splitting open the mandible (lower jawbone) to reach the parapharyngeal space. While this approach allows the surgeon to access the tumour, it leaves the patient with a facial scar and requires a long recovery period.

Surgical incision from lower lip to jaw

Splitting open lower jawbone to access the tumour

Jaw reconstruction with metal plate

Scar post-surgery

Postoperative Considerations and Complications due to Conventional Open Surgery

Advanced Surgical Approach: Transoral Robotic Surgery (TORS)

Given the tumour’s deep-seated location in the parapharyngeal space and its proximity to major blood vessels, the case was reviewed at the MIOT Tumour Board. To avoid the complications with the conventional method, a minimally invasive Robotic Surgery (TORS) was advised by the experts from MIOT Institute of Robotic Surgery.

The treatment plan was explained to Mrs. Shantha Kumari and her family. Having full confidence in the specialist, they gave their immediate consent for the procedure.

Removal of Tumour with Robotic Surgery

On July 22nd, Mrs. Shantha Kumari got admitted and was taken for surgery on July 23rd. The tumour was accessed through the mouth opening itself, ensuring no incisions on the face. A small incision was made inside the mouth (mucosa over the palate) to access the tumour site. The tumour was carefully removed through the mouth, without rupturing the outer layer of the tumour, preventing the spreading of cells and recurrence of the tumour.

Using Robotic surgery’s high precision, the tumour was removed accurately without damaging the surrounding tissues. This preserved the patient’s vital structures, such as muscles involved in speech and swallowing, cranial nerves responsible for taste and swallowing, and blood vessels supplying the face, neck, and brain. After tumour removal, the surgical site was cleaned and sutured using the robotic system. The removed mass was sent for biopsy, which revealed it was non-cancerous.

How does the patient benefit from Transoral Robotic Surgery?

Conventional Open Surgery vs. Minimally Invasive Transoral Robotic Surgery

Transoral Robotic Surgery not only provides excellent surgical access with minimal invasiveness, but also significantly improves patient outcomes, enabling faster recovery, less pain, earlier return to normal diet, and shorter hospital stays.

Mrs. Shantha Kumari recovered soon without any facial scars or complications

With no external scars, minimal discomfort, and no postoperative complications, Mrs. Shantha Kumari was able to return home within a few days after the procedure. The advanced, robotic surgery at MIOT not only ensured complete tumour removal but also preserved her speech and swallowing functions, allowing her to resume a normal diet within 2 days. This technology also eliminated the scar on her face, enabling her to lead a life with confidence. She was discharged within days, free from complications, and returned to her normal life. This outcome underscores how robotic surgery can make even complex procedures less invasive, allowing the removal of a tumour the size of a tennis ball through the mouth with instruments as slender as three straws, while minimising pain and preventing disfigurement.