Transoral Robotic Surgery (TORS) in Head and Neck Reconstruction

Abstract

Background/Objectives: Transoral robotic surgery (TORS) has advanced treatment for complex oropharyngeal cancers (OPC) by offering minimally invasive, precise approaches, initially for ablative and now for reconstructive procedures. This review examines TORS in OPC reconstruction, comparing it to traditional methods and presenting a TORS case with free flap reconstruction in recurrent OPC. Methods: A PubMed review assessed TORS-based reconstruction outcomes, technical challenges, and innovations. Additionally, a recurrent OPC case was treated with TORS resection and lateral arm free flap. Surgical techniques and outcomes were detailed. Results: TORS is associated with reduced morbidity and length of hospitalization, and showed positive functional outcomes in primary, salvage, and post-radiation cases. Our case achieved favorable oncologic and functional outcomes, such as preserved speech and swallowing. Conclusions: TORS-based reconstruction represents a major advancement in minimally invasive head and neck oncology, providing comparable oncologic outcomes to open surgery with fewer complications. Although technically demanding, TORS is promising for complex reconstructions, warranting further research to refine techniques and standardize protocols.