Transoral robotic surgery: radical tonsillectomy.

Area of Science:

• Otolaryngology
• Surgical Oncology
• Robotic Surgery

Background:

• Transoral robotic surgery (TORS) offers minimally invasive access for head and neck procedures.
• Radical tonsillectomy is a key procedure for tonsillar region cancers.

Purpose of the Study:

• To describe and demonstrate the feasibility of a novel transoral robotic surgery (TORS) radical tonsillectomy technique.
• To evaluate the initial outcomes and safety of this new TORS approach for tonsil cancer.

Main Methods:

• Prospective, phase 1 clinical trial at an academic, tertiary referral center.
• 27 patients with untreated invasive squamous cell carcinoma of the tonsillar region underwent TORS radical tonsillectomy.
• Outcomes included margin status, tracheotomy/gastrostomy tube needs, and complications at 6-month follow-up.

Main Results:

• Negative final pathologic margins (93%) were achieved in 25 of 27 patients.
• No mortality occurred; complications were generally mild, including bleeding, delirium, temporary tracheotomy, hypernasality, and trismus.
• 96% of patients (26/27) could swallow without gastrostomy tube support.

Conclusions:

• Transoral robotic surgery (TORS) radical tonsillectomy provides excellent access for tonsil cancer resection.
• The technique demonstrates acceptable acute morbidity and promising functional outcomes.
• Further studies will assess long-term oncologic control and functional results.