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Updated: Apr 19, 2026

Identification and Protection of the Recurrent Laryngeal Nerve during Transoral Robotic Thyroidectomy
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Identification and Protection of the Recurrent Laryngeal Nerve during Transoral Robotic Thyroidectomy

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A Modified Delphi UK Consensus to Develop a Surgical Safety Checklist for Transoral Robotic Surgery.

Keshav Kumar Gupta1, Anthony Simons2, Sean Mortimore3

  • 1Department of Otorhinolaryngology, Birmingham Children's Hospital, Birmingham, UK.

Clinical Otolaryngology : Official Journal of ENT-UK ; Official Journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery
|April 17, 2026
PubMed
Summary

A new surgical safety checklist (SSC) specifically for transoral robotic surgery (TORS) was developed. This novel checklist aims to enhance patient safety in TORS procedures.

Keywords:
DelphiTORSchecklistsurgical safety checklisttransoral robotic surgery

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Area of Science:

  • Robotic Surgery
  • Surgical Safety
  • Healthcare Innovation

Background:

  • Transoral robotic surgery (TORS) is increasingly used for benign and malignant conditions.
  • Robotic surgery introduces new variables into healthcare, which has a high rate of preventable adverse events.
  • Surgical safety checklists (SSC) are proven to improve outcomes and reduce complications.

Purpose of the Study:

  • To introduce a novel surgical safety checklist (SSC) specifically designed for transoral robotic surgery (TORS) operating theatres.
  • To enhance patient safety during TORS procedures by standardizing safety protocols.

Main Methods:

  • A modified Delphi process was employed to achieve expert consensus on the checklist items.
  • An initial checklist was created based on a literature review.
  • Seven TORS experts participated, rating proposed items using a Likert scale over two rounds.

Main Results:

  • Consensus was reached on the items to be included in the TORS-specific SSC after two rounds of expert review.
  • The study successfully developed a novel SSC tailored for TORS procedures.

Conclusions:

  • This is the first surgical safety checklist developed exclusively for transoral robotic surgery (TORS).
  • The TORS SSC was created using robust Delphi methodology with input from UK-based TORS experts.
  • The checklist is intended for use alongside the World Health Organization (WHO) SSC and requires further validation through long-term, multi-center adoption.