A single-centre case-control study comparing readmission rates for robotic and traditional tonsillectomy

Whilst there have been several studies on the complications of Trans-Oral Robotic Surgery (TORS) for oropharyngeal cancer and, to a lesser extent, obstructive sleep apnoea, there is an absence of data on robotic palatine tonsillectomy for benign tonsil disease. This single-centre, case-control study compares procedure duration and rates of readmission, bleeding and return to theatre for robotic tonsillectomies (n = 60) and traditional tonsillectomies (n = 365) performed on adult patients (> 16 years) between 2021 and 2024. Robotic tonsillectomy is shown to have a general trend towards lower readmission (10.0 vs. 16.6%) and secondary haemorrhage rates (6.7 vs. 13.4%) when compared to traditional methods. This is only demonstrated with statistical significance for women and the trend lessens where only consultant surgeons are included. The mean operating time, including time taken to dock and deploy the robot, was 7 min longer (41 vs. 34 min) for the robotic cohort, meaning that for adult tonsillectomy, mode of surgery has little impact on the number of cases that can be performed on an operating list. The cost per case is, however, considerably higher for robotic tonsillectomy. The cost is likely to fall as technology develops and needs to be weighed against the training benefits for robotic surgeons and the potentially lower readmission rates and intra-operative bleeding, if indeed confirmed in further studies.