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Updated: Jun 11, 2026

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

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

Published on: October 24, 2025

Enhanced Recovery After Surgery Protocol in Transoral Robotic Surgery: A Case-Control Study.

Jonathan Daniel^1,2, Raguwinder Bindy Sahota^1,3,4,5, Mark David Wilkie¹

¹Royal Adelaide Hospital, Adelaide, Australia.

Clinical Otolaryngology : Official Journal of ENT-UK ; Official Journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery

|June 10, 2026

Summary

This summary is machine-generated.

Implementing an Enhanced Recovery After Surgery (ERAS) protocol for Trans-Oral Robotic Surgery (TORS) significantly reduced patient length of stay. This study highlights the protocol

Keywords:

enhanced recovery after surgery protocol length of stay return of swallow surgery surgical complications trans oral robotic surgery (TORS)

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Area of Science:

Robotic Surgery
Surgical Oncology
Anesthesiology

Background:

Enhanced Recovery After Surgery (ERAS) protocols optimize surgical outcomes, including reduced Length of Stay (LoS).
Trans-Oral Robotic Surgery (TORS) enables earlier patient discharge compared to open procedures.
Limited research exists on ERAS protocol application in TORS.

Purpose of the Study:

To evaluate the impact of a TORS ERAS protocol on key perioperative metrics.
To specifically assess the effect of the ERAS protocol on Length of Stay (LoS) in TORS patients.

Main Methods:

Retrospective cohort study comparing patients before (p-ERAS) and after (w-ERAS) ERAS protocol implementation in 2021.
Protocol included pharyngocutaneous risk stratification and comprehensive perioperative assessments.
Key outcomes analyzed: LoS, cost per patient, return to swallow, and complication rates.

Main Results:

90% adherence to the ERAS protocol in the w-ERAS group.
Statistically significant reduction in median LoS by 3.5 days for the w-ERAS group (p=0.03).
Trends observed towards decreased cost per patient and faster return to oral intake in the w-ERAS group.

Conclusions:

An easily implementable ERAS protocol for TORS oncological surgery was demonstrated.
The ERAS protocol led to a significant reduction in patient LoS.
Findings suggest ERAS protocols are beneficial for TORS perioperative management.