Single-Port Transoral Robotic Surgery for Head and Neck Lesions and Obstructive Sleep Apnea: A Prospective Real-World...

To assess the clinical practicality, procedural characteristics, and short-term recovery outcomes of single-port transoral robotic surgery (SP TORS) for diverse head and neck pathologies, including malignancies, benign tumors, and obstructive sleep apnea, in a regional hospital setting in Taiwan.

A prospective case series was conducted at a regional teaching hospital from May to July 2025. Twelve patients underwent SP TORS utilizing the da Vinci SP system. Indications spanned oncologic, nononcologic, and functional conditions. Detailed perioperative data were collected, including exposure management, docking and console durations, blood loss, and complication profiles. Postoperative recovery trajectories, such as ICU admission, nasogastric support, and hospitalization length, were analyzed.

All operations were successfully completed using the single-port platform without conversion or reoperation. Docking was efficient, with a median time of 4.5 min (range 4-11 min) and median console time of 71 min (range 18-150). Most procedures involved minimal intraoperative bleeding; only two required more substantial hemostasis. Enhanced workspace around the oropharynx was noted, improving assistant access. Postsurgical outcomes were favorable: no tracheostomies were needed and half of the patients avoided nasogastric tube insertion. Hospital stays varied by case complexity, with no major adverse events reported.

SP TORS can be effectively introduced in mid-volume institutions, demonstrating technical reliability, ergonomic benefits, and safe patient recovery. Its versatility across a spectrum of indications suggests broad clinical utility, warranting further multicenter studies to define long-term outcomes and expand implementation.

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