Transoral Robotic Surgery for Head and Neck Cancer: Practical Considerations

Abstract

Transoral robotic surgery (TORS) has gained acceptance for treating a variety of head and neck benign and malignant pathologies. Some TORS advantages are great 3D visualization, shorter operative times, increased range of movement in narrow spaces, getting a complete pathological specimen, and improved life quality (LQ), resulting in well-validated functionality and oncological outcomes. This is a retrospective case series of patients treated with TORS between 2013 and 2019. Preoperative, intraoperative, and postoperative variables were collected. Descriptive statistics were used to report medians and ranges for continuous variables. The number of cases and percentages were used to describe categorical variables. Fifteen patients have been treated for oncological pathologies with TORS in two Colombian health centers. Lateral oropharyngectomy was the most common surgery comprising 80% of surgeries. Three patients receiving this surgery also had one tongue base resection, one soft palate resection, and one retromolar trigone resection. Bilateral lingual and palatine tonsillectomy was performed in 13.3% of patients and supraglottic laryngectomy in 6.7%. Twelve patients (80%) had secondary wound healing, and three (20%) needed free flap reconstruction. After reviewing these initial experiences, we concluded that TORS is a versatile procedure for resection of tumor located in the oropharynx, supraglottis, and retromolar trigone. TORS is also useful for the reconstruction of subsequent defects with free flaps. We believed that some practical considerations must be published to help head and neck surgeons during the preoperative, intraoperative, and postoperative stages.