Initial clinical experience with the da Vinci 5 in transoral robotic surgery

To describe early clinical experience using the multi-port da Vinci 5 (DV5) system for transoral robotic surgery (TORS) reporting perioperative outcomes. We retrospectively reviewed all DV5 TORS procedures performed at a single institution. Demographics, tumor characteristics, operative metrics, complications, adjuvant therapy, and early follow-up were extracted from electronic records and operative/pathology reports. Seven DV5 TORS cases were performed: five HPV-associated oropharyngeal squamous cell carcinomas (OPSCC), one diagnostic tonsillectomy for suspected lymphoma, and one benign parapharyngeal hemangioma. Among malignant resections (n = 5), the pT stage was T1 (n = 2) and T2 (n = 3), and all were HPV-related. Across all seven cases, there were no tracheotomies, and one postoperative hemorrhage (14.3%) required embolization. All patients were discharged on the first postoperative day after starting a liquid oral diet. Final margins were negative in all patients with one patient having positive margin requiring re-resection. DV5-assisted TORS was feasible and safe in this initial experience. Perioperative outcomes were comparable to those of historical MP and SP series. Prospective multi-center studies are critical to clarify comparative oncologic and functional outcomes between different surgical robots.