"I would say 99 percent of patients say chemo and radiation together are harder than any surgery they go through," he says.

About 350 patients have undergone the procedure, designed by Dr. O'Malley and his colleague Dr. Gregory Weinstein in 2004 after seeing the robot at a conference, and being told by one of the presenters that using the device for mouth and neck surgeries was "impossible."


Already, the two doctors have trained physicians from six continents how to perform the surgery using the Intuitive-made device. Since the FDA clearance last week, around 94 physicians from around the nation have already signed up for instruction, Dr. O'Malley says, an unusually high number for a procedure so recently cleared.

Clear-cut results

One reason for the enthusiasm is that according to Dr. O'Malley the technique offers unambiguous results, something not always seen in other robotic surgeries for cancers.

"Everyone agrees they offer faster recovery than open surgery, but outcomes go either way," he says, noting that in many treatments, such as for prostate cancer, evidence for improved results is mixed.

There's also the cost. "Most of the time the robot adds cost to health care," says Dr. O'Malley. "But this could be the only cancer robot that is cheaper."

The robot carries a hefty $2 million price tag, and the disposable operating kits come in at around $200 each. But Dr. O'Malley says that preliminary results from a study he and his colleagues are conducting using Medicare data suggests that with TransOral hospitals could save because rehabilitation is quicker, patients have shorter hospital stays and they receive less radiation and chemotherapy.

"It will be clear-cut in terms of functional outcomes, and soon we hope it will be clear-cut with respect to cost," he says. "We think it will be different than any other robot surgery out there today."

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