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[News] Mount Sinai offers transoral robotic surgery for sleep apnea treatment
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Dreamcatcher Offline

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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."

Source The Mount Sinai Medical Center
06-26-2012 12:33 PM
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BabyDoc Offline

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Post: #2
RE: Mount Sinai offers transoral robotic surgery for sleep apnea treatment
I wonder whether the success rate with this robotically performed procedure is significantly better than that obtained manually. It sounds promising, but what are they promising? How do they define success?
06-26-2012 03:29 PM
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zonk Offline

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RE: Mount Sinai offers transoral robotic surgery for sleep apnea treatment
(06-26-2012 12:33 PM)Dreamcatcher Wrote:  "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.
I,m not anxious for a better solution and nothing has changed the surgery still the last resort and if the professor wants to assert such a claim he is better to come up with a proof otherwise its a lots of nonsense.
CPAP is the golden standard for treatment of OSA
06-26-2012 04:08 PM
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BabyDoc Offline

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RE: Mount Sinai offers transoral robotic surgery for sleep apnea treatment
I am not blowing off this as nonsense until more patients are studied and the results are published in a medical journal, rather than in just a newspaper.

Surgery for obstructive apneas, should not always be a last resort. I had a mother call me yesterday about her 15 year old son, who had surgery done for his cleft palate and pharyngeal muscle weakness at age 4. He was having obstructed breathing and the surgery did help. She was warned that as he got older, he might need more surgery. Well, he is now having significant, severe obtructive apneas. While the parents aren't eager to go back for more surgery, the thought of being hooked to a BiPaP machine at age 15 years is even less apealing. While the surgery may not be successful, I see surgery for him to be a first resort and not a last resort.
06-29-2012 09:54 AM
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mjbearit Offline

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RE: Mount Sinai offers transoral robotic surgery for sleep apnea treatment
I believe the surgical approach is a very personal decision to make. Everyone is different and everyone views things differently. Personally I do not view the surgery as an option. I had the turbinade/deviated septum thing done many years back and I will never do that again. I found that to be miserable! And a few years down the road I had obstructed breathing again. I just use nasal sprays now. Because of this experience, I have no desire at all to experience the OSA surgery. But a would also never try to dissuade a 15 year old from having it! He's got a whole lot more life ahead of him than I do and if the potential exists for him to not be strapped to a machine for the rest of his life, I think it needs careful consideration.

As always, YMMV! You do not have to agree or disagree, I am not a professional so my mental meanderings are simply recollections of things from my own life.

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06-29-2012 10:18 AM
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Sleepster Offline
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RE: Mount Sinai offers transoral robotic surgery for sleep apnea treatment
(06-29-2012 09:54 AM)BabyDoc Wrote:  While the parents aren't eager to go back for more surgery, the thought of being hooked to a BiPaP machine at age 15 years is even less apealing. While the surgery may not be successful, I see surgery for him to be a first resort and not a last resort.

Why?! I would think a 15-year-old would be far more adaptable to CPAP therapy than a middle-aged adult. The older we get, the harder it for us to adapt to new things. CPAP therapy is just a simple bother to most people, and it would seem to me that the younger you are the easier it is to adapt to something like that.

If the young adult is not able to adapt, then surgery is another option. Why should it be any different than for a middle-aged, or older, adult?

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
06-29-2012 12:12 PM
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Sleepster Offline
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Post: #7
RE: Mount Sinai offers transoral robotic surgery for sleep apnea treatment
A few months ago there was piece on one of the major network news shows featuring a young police offer who underwent this robotic surgery. The alternative for this severe OSA patient would have been a tracheometry. It wasn't clear whether or not this patient was still undergoing CPAP therapy after the surgery, as they showed him in his bedroom with a machine on his bedside table.

What I'd like to know are the statistics. How many patients have had this surgery? What was their AHI before? What was it afterwards? And what are the side effects?

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
06-29-2012 12:18 PM
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BabyDoc Offline

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RE: Mount Sinai offers transoral robotic surgery for sleep apnea treatment
(06-29-2012 12:12 PM)Sleepster Wrote:  
(06-29-2012 09:54 AM)BabyDoc Wrote:  While the parents aren't eager to go back for more surgery, the thought of being hooked to a BiPaP machine at age 15 years is even less apealing. While the surgery may not be successful, I see surgery for him to be a first resort and not a last resort.

Why?! I would think a 15-year-old would be far more adaptable to CPAP therapy than a middle-aged adult. The older we get, the harder it for us to adapt to new things. CPAP therapy is just a simple bother to most people, and it would seem to me that the younger you are the easier it is to adapt to something like that.

If the young adult is not able to adapt, then surgery is another option. Why should it be any different than for a middle-aged, or older, adult?

Sleepster, I guess you forgot what it was like to be a teenager. I have to deal with these kids all of the time. They don't want to be different from other kids. They don't want to take medications, let alone cpap. And they certainly would never want to be a hose-heads. Could you imagine, as a teenager, going to a camp as a hose-head. You wouldn't go, fearful of dying of humiliation. They would rather die from their OSA, if that were possible, rather than from humiliation.
06-29-2012 01:07 PM
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