Comparable outcomes with improved esthetics: da Vinci-assisted neck dissection for early stage oral cancers

Abstract

This study compares the retro-auricular robotic-assisted approach using two or three robotic instruments with conventional open neck dissection in patients with early N stage oral cavity cancer. Twenty-six patients with T1-3N0-1M0 disease underwent supraomohyoid neck dissection between 2018 and 2023 (13 robotic, 13 open). Perioperative outcomes, including hospital stay, drainage duration, complications, and lymph node yield, showed no significant differences (median lymph nodes: 20 vs. 21; p = 0.950). During a median follow-up of 743 days, no recurrences or deaths occurred. In the last five robotic cases, a third instrument (ProGrasp Forceps) was added without increasing operative time (p = 0.803). Robotic-assisted neck dissection via the retro-auricular route is a safe and effective alternative for early stage oral cavity cancer patients, particularly those with clinical N0 disease, preserving oncologic outcomes while improving cosmetic appearance.