Outcomes of Transoral Robotic Surgery: Initial Experience

Abstract

Objectives: Transoral robotic surgery (TORS) has gained importance in the resection of head and neck tumors. The use of robotics in this field has provided surgeons with the ability to access anatomic locations that were previously only managed via open techniques. This has resulted in decreased overall morbidity, excellent functional results and the promise of equivalent oncologic outcomes. TORS provides access to the oropharynx, hypopharynx, larynx, oral cavity and parapharyngeal space vial the oral aperture. We aimed to assess the initial experience for TORS, as observed in the BNCI TORS group. Methods: Forty-four consecutive patients who were scheduled for TORS between March 2012 and January 2013 were included in this single institutional prospective cohort study. The operative times, conversion rates, morbidity, feeding tube rates, and tracheotomy were evaluated. Results: Most patients (55.5%) had squamous cell carcinoma of the tonsils, and 44.5% had SCC of the tongue base. Tumor resection with free margins was achieved in all cases. No patient needed conversion to an open approach. There were 6.8% postoperative hemorrhages and tracheotomy was performed in 9 patients. 43.2% of patients needed a feeding tube after TORS. The median setup and procedure times were 21 ± 18 and 61 ± 45 minutes, respectively. All patients underwent a neck dissection one week after TORS. The extent of neck dissection depended on neck nodes status. The average hospital stay was 4.5 days. Conclusions: Based on our initial experience, TORS appears to be safe and feasible, with minimal complications and favorable clinical and functional outcomes.