Transoral Laser Microsurgery (TLM) was first introduced in the 70s when the CO2 laser was developed for voice box cancer. Over the following decades TLM has grown into a subspecialty that offers tremendous advantages over traditional open surgery. TLM is performed by one thoroughly trained surgeon, with the laser delivered via a high resolution microscope, down into the throat through metal tubes (endoscopes) that are designed to give the best possible visualization of the tumor. By using long, skinny precision instruments the surgeon can manipulate the tumor into positions where the laser can safely and extremely accurately cut it out. By removing the tumor from inside the patient¹s throat instead of cutting through the skin and the neck to get to it, as done in most cancer centers, TLM results in much less trauma to the tissue, less risk for swallowing and breathing difficulties afterwards and much better cosmetic outcome (no scars). TLM takes many years for a fellowship trained surgeon to master and it is therefore only offered in very few high quality centers. TLM of any size throat cancers is offered at St Joseph Mercy as the only hospital in the northern states, by Professor Jan Akervall, MD, PhD.