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Published on: September 15, 2023
Transoral robotic surgery: does the ends justify the means?
Gregory S Weinstein1, Bert W O'Malley, Shaun C Desai
1Department of Otorhinolaryngology - Head and Neck Surgery, the University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA. gregory.weinstein@uphs.upenn.edu
Summary
Transoral robotic surgery (TORS) shows promising early results for head and neck cancer, demonstrating feasibility, safety, and improved swallowing function compared to traditional treatments.
Area of Science:
- Head and Neck Surgery
- Robotic Surgery
- Surgical Oncology
Background:
- Head and neck surgical science has advanced significantly, emphasizing organ preservation techniques.
- Organ preservation surgeries include selective neck dissections, supracricoid partial laryngectomies, and transoral laser surgeries.
- Transoral robotic surgery (TORS) is an emerging innovative technique in this field.
Purpose of the Study:
- To review key questions regarding the feasibility, safety, efficacy, teachability, and cost-effectiveness of TORS.
- To assess the current role and potential of TORS in head and neck cancer treatment.
Main Methods:
- Systematic review of existing literature on transoral robotic surgery.
- Point-by-point analysis of data concerning TORS feasibility, safety, efficacy, and cost.
Main Results:
- Early findings for TORS are consistently encouraging, despite the absence of long-term oncologic outcomes.
- Training programs for TORS have demonstrated success, with multiple institutions establishing robust programs.
- Clinical outcomes for TORS are excellent, and early studies indicate superior swallowing function compared to chemoradiation for similar lesions.
Conclusions:
- Transoral robotic surgery programs can be successfully established, yielding excellent clinical outcomes.
- TORS demonstrates potential for improved functional results, particularly in swallowing, compared to other treatment modalities.
- While long-term oncologic data is pending, current evidence supports the encouraging trajectory of TORS in head and neck surgery.
