PATIENT INFORMATION - TRANS-ORAL LASER SURGERY
 

Contents

1.  Introduction  

2.  What is a laser? 

3.  What does “trans-oral” mean?

4.  What are the side effects of trans-oral laser surgery?

5. What happens when I come into hospital?

6.  Who will look after me during my stay in hospital?

7.  How will I be followed up? 

 

1.  Introduction

This webpage has been designed to help you understand trans-oral laser surgery and contains answers to many frequently asked questions.

 If you have any questions that the booklet does not answer, or would like further explanation, please ask one of the Team.

 2.  What is a laser?

A laser is a beam of light.  It can be used in different ways as a surgical tool.  The surgeons at this hospital use a laser attached to a microscope to remove tissue instead of using a scalpel.

3.  What does “trans-oral” mean?

“Trans-oral” means “across the mouth”.  Using this route of entry means there are no external cuts or scars after the operation.

The site and size of the tumour will influence how long the operation takes. The doctors will explain to you which area will be removed.

 
4.  What are the side effects of trans-oral laser surgery?

There are some risks in having this treatment, which you should consider before consenting for the operation. These potential complications are rare, but you should discuss them with your doctor when you visit the hospital.

Side effects will depend on the amount of tissue taken during the operation.  They can also be quite individual and may vary from person to person.  These may include:

Pain – immediately after the operation you may not feel much pain because the laser seals off nerves so they are numb.  It can then take 2-3 days for the feeling to return.  Once the feeling has returned, you may have some pain.  Sometimes there will be increased pain 2-3 days after the surgery, but we will monitor this closely and give you painkillers (analgesics).  It may, however, take time to find the most effective analgesic for each person.  The clinical nurse specialist, the ward nurses, and the doctors will give advice on pain management.

Burning sensation in the throat – this has been noticed by some patients and should you experience this please ask for advice.

Bleeding – sometimes the area can bleed after the surgery.   We will monitor you closely in hospital for this and advise you on what to do should it happen when you are back at home.

Speech and swallowing difficulties – these will be mentioned later in this booklet.

 
5.  What happens when I come into hospital?

After the operation, you may spend one or two nights on the Intensive Care Unit where you will have your own nurse and will be monitored closely.  Once you are medically fit you will go back to the ward.

During this time, various team members will be involved in your care and help you with the different parts of your recovery.

The extent of your operation will determine when you can go home.

Before you go home we will arrange community support, if you need it, and give you advice on all aspects of your care.


6.  Who will look after me during my stay in hospital?

There is a whole team ready to look after you.  As well as the doctors, there are:

Speech and Language Therapists

The speech and language therapy team can help you with speech, voice and swallowing problems that can arise before or after surgery.

You will have the opportunity to meet one of the therapists before your operation to discuss the possible changes to your speech, voice and swallowing, and rehabilitation after surgery.  If you are already experiencing difficulties, we will assess and help you manage these problems before your operation.

The effect of the trans-oral laser surgery depends on the position and size of the tumour.  For example, trans-oral laser surgery performed on the larynx (voice box) can result in short- or long- term voice changes, such as hoarseness.  Surgery involving the tongue can cause speech and swallowing changes.  The speech and language therapy team will assess your voice and swallowing after the surgery.

If your swallowing is affected, we will give you advice about the safest and easiest foods and fluids to take, and the most effective way of swallowing.  We may give you some exercises to carry out that are designed to improve your swallowing, so making it easier and safer for you to eat and drink.

We may give you exercises to improve your speech and voice, and we will ensure that you can communicate effectively with the staff and your family and friends during your stay on the ward.  In cases of trans-oral surgery to the larynx, we may recommend a short period of total voice rest (no voice use) immediately after surgery.  This is to give your larynx time to heal.

Dieticians

The dieticians will assess your daily eating pattern, nutritional status and requirements.  Advice will be provided on the most suitable foods to eat and how to achieve a balanced intake.  We will talk through adding extra nourishment to your food and the use of supplements, if required.  Your progress and changing needs will be monitored. 

You may already be having difficulty with eating or drinking and have lost weight.  It is particularly important that you are as strong as possible and that your wounds heal afterwards, so you need to get sufficient nutrition and fluids.  The trans-oral laser surgery that you are going to have may affect your swallowing.  It may be necessary for you to have a feeding tube before and/or after the operation, as well as to support you during any further treatment. 

A feeding tube will not interfere with your ability to eat and drink, and the dietician will explain it in more detail to you.  The tube will be removed when you are able to eat and drink enough to maintain or gain weight without needing to use the tube.  You may have to go home with a feeding tube.  If this is the case, it will be discussed with you during your stay.

Clinical Nurse Specialists

The clinical nurse specialists will answer your questions and work with the ward nurses to ensure that you have no symptoms, for example pain or discomfort, before or after your surgery. The clinical nurse specialists promote a healthy lifestyle and can assist with stopping smoking and can advise on alcohol intake. They can also offer psychosocial and emotional support, and can liaise with community nurses when necessary.

Ward nurses

The ward nurses will look after you on a day-to-day basis during your stay.  They will also help plan your discharge home so you have support if you need it.

 
7
.  How will I be followed up?

You will come back to outpatients to see the doctors and the rest of the team.  If any further treatment is needed, it will be explained and discussed with you.  If no further treatment is needed, you will continue to have regular outpatient appointments for a number of years to monitor your progress.


Contact Us
UCH Head and Neck Services
If you have any questions, please contact us at University College Hospital.

Postal address

Head and Neck Services,
First Floor East 250,
Euston Road,
London NW1 2PG

Telephone via Departmental Secretariat

Sally Zalita    020 7380 9755
Jill Wellard    020 7380 6949
Marlene Bell  020 7380 9859
Allied Health Professionals 020 7380 6948

Your message will be taken and passed on to the appropriate person or department.

e-mail headandneckcentre@uclh.nhs.uk

Fax referrals  020 7380 6952
Links
Cancer Backup (Cancer Information Website)
http://www.cancerbackup.org.uk/Cancertype/Larynx
http://www.cancerbackup.org.uk/Cancertype/Headneck
0808 800 1234   (freephone helpline)

Changing Faces
http://www.changingfaces.co.uk

The Health Professions Council
http://www.hpc-uk.org  

National Association of Laryngectomee Clubs   http://www.nalc.ik.com/  

Macmillan
http://www.macmillan.org.uk

Macmillan CancerLine
0808 808 2020
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