Transoral Robotic Surgery for Head and Neck Cancer

Transoral robotic surgery (TORS) has rapidly changed the field of head and neck surgery since its initial FDA approval in 2009. By combining excellent visualization and multiple degrees of freedom, robotic surgical systems allow precision surgery in areas that were previously only accessible through open approaches associated with high morbidity. In this chapter, we will review the history of TORS and its expanding application for minimally invasive surgical resection of the upper aerodigestive tract. The use of the robotic system requires specialized training for the surgeon as well as trained staff to maintain efficiency throughout the case. This includes availability of consistent room setup, ergonomic interior layout, wide range of available retractors and instruments, and personnel such as a surgical assistant and operating room staff. Operative techniques used in common TORS surgeries are introduced in this chapter. We conclude the chapter by illustrating the postoperative course, complications, and a clinical case example.