Transoral Endoscopic Non-Robotic Access to the Oropharynx: Technical Report

Minimally invasive transoral approaches have transformed the management of T1-T2 and select T3 oropharyngeal malignancies by reducing morbidity while maintaining oncologic adequacy. However, access to transoral robotic surgery (TORS), lasers, or other advanced platforms remains limited in many settings. The objective of this manuscript is to describe the feasibility, technique, and outcomes of a transoral endoscopic approach to the oropharynx using routinely available instruments.

We report a technical description and clinical outcome of a 35-year-old male with a sarcomatoid squamous cell carcinoma arising from the base of tongue. Following elective tracheostomy and ipsilateral neck dissection, the primary tumour was excised transorally using a 30-degree 4-mm nasal endoscope and standard laparoscopic instruments under endoscopic guidance. Key anatomic, airway, and tumour-related selection criteria were considered before adopting this approach.

Complete transoral excision with adequate three-dimensional margins was achieved without mandibulotomy or pull-through approaches. Postoperative recovery was uneventful, with early initiation of oral feeds and decannulation by postoperative day 7. At 9-month follow-up, there was no evidence of residual or recurrent disease, and functional outcomes for swallowing were excellent.

Transoral endoscopic approach using commonly available endoscopic and laparoscopic instruments is a feasible, cost-effective alternative for carefully selected oropharyngeal tumours. This technique may expand access to minimally invasive oncologic surgery in centres lacking robotic or laser technology.

The online version contains supplementary material available at https://doi.org/10.1007/s13193-026-02626-3.