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Transoral resection is surgery to help control or cure oral cancer. During surgery, an oral tumor is removed through the mouth. The tumor could be on the tongue, under the tongue, inside the cheek, or elsewhere inside the mouth. Some healthy tissue around the tumor is also removed, to help make sure that no cancer cells remain. This sheet explains transoral resection and what to expect. After surgery, more cancer treatment may be needed, such as chemotherapy and radiation. Your doctor will discuss your treatment plan with you.
Prepare for the procedure as you have been instructed. Be sure to tell your doctor about all medications you take. This includes over-the-counter drugs. It also includes herbs and other supplements. You may need to stop taking some or all of them before surgery. Also, follow any directions you’re given for not eating or drinking before surgery.
The surgery takes 1-3 hours. Before the surgery begins:
An IV line is put into a vein in your arm or hand. This line delivers fluids and medications.
You will be given medication (anesthesia) to keep you pain free during the surgery. You will have general anesthesia. This puts you into a state like deep sleep during the surgery.
An endoscope is inserted into the mouth. This is a flexible tube with a lighted camera.
Incisions are made inside the mouth and the tumor is removed.
Some healthy tissue around the tumor is also removed. This is sent to a lab, where it’s checked for cancer cells.
The cut pieces of tissue are joined together with sutures (stitches). These dissolve on their own over time. In some cases, a small graft of skin is used to help fill in the area that was removed. The graft is stitched in place with sutures.
Depending on the tumor’s location, you may need a tracheostomy (trach) tube to help you breathe, or a feeding tube to help you eat. If one or both of these are needed, they will be inserted at the end of the surgery. Your doctor will tell you more.
You will be taken to a recovery room to wake up from the anesthesia. You may feel sleepy and nauseated. You will receive pain medication. Let your providers know if your pain is not controlled. When you are ready, you will be taken to your hospital room to stay for one or more nights. When it’s time for you to be released from the hospital, have an adult family member or friend ready to drive you. If you’re going home with a trach tube or feeding tube, you will be shown how to care for these before you’re discharged.
Once at home, follow the instructions you have been given. Be aware that the surgery may affect your ability to swallow and to speak. You may be referred to a speech therapist, who can help you with these skills starting soon after surgery. During your recovery:
Take all antibiotics and pain medication as directed.
Gargle as often as prescribed.
Resume your normal diet slowly. To protect your healing mouth, avoid spicy or acidic foods such as hot peppers, oranges, and tomatoes. Also avoid sharp, hard foods such as nuts and chips. Smooth soups, puddings, milkshakes, and blended fruit drinks will be easiest on your mouth.
Return to your normal daily routine when the doctor says it’s okay. This includes work and exercise.
Be sure you have a contact number for your doctor. After you get home, call if you have any of the following:
Chest pain or trouble breathing (call 911 or other emergency service)
Fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider
Pain that gets worse or is not relieved by pain medications
Bleeding in the mouth
Choking on food or liquids
Severe nausea or vomiting
Pain or swelling in the legs
During follow-up visits, your doctor will check on your healing. You will discuss treatment with radiation or chemotherapy, if needed. Regular checkups are very important. These help ensure that the cancer has not returned. Regular dental exams may be needed. If you smoke, talk to your doctor about quitting. Smoking makes oral cancer treatment less effective. And it increases your risk for another tumor.
Risks of transoral resection include:
Blockage of the airway
Changes in taste
Trouble swallowing or speaking after healing (if part of the tongue is removed)
Nerve injury, causing numbness of the lip or tongue (may be temporary or permanent)
Aspirating (breathing in) food or liquids
Risks of anesthesia (you will discuss these with the anesthesiologist)
Return of the cancer