Redefining Minimally Invasive Head and Neck Surgery without Robotics: the First Romanian TOUSS Experience

Area of Science:

• Otolaryngology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Transoral ultrasonic surgery (TOUSS) is an emerging minimally invasive technique for head and neck cancers.
• It provides oncologic outcomes similar to robotic-assisted surgery.
• TOUSS offers advantages in cost and accessibility.

Purpose of the Study:

• To evaluate clinical and functional outcomes of TOUSS in a single-institution cohort.
• To report the first cases of total transoral laryngectomy using TOUSS in Romania.

Main Methods:

• Retrospective observational analysis of 39 patients (2018-2024).
• Inclusion criteria: T1-T3 squamous cell carcinomas of oropharynx, oral cavity, supraglottis, or larynx.
• Data collected: demographics, tumor characteristics, perioperative outcomes, and 3-year follow-up.

Main Results:

• Most tumors were in the oropharynx (n=21) or tongue base/lateral (n=14).
• Two total laryngectomies were performed; no tracheostomies were needed.
• At 3 years, 79.5% were disease-free; average hospital stay was 7 days.

Conclusions:

• TOUSS is a safe and effective alternative to robotic surgery for head and neck malignancies.
• Favorable oncologic and functional outcomes were achieved.
• Feasibility for total laryngectomy and cost-effectiveness suggest wider adoption potential, especially in low-resource settings.