Advancing head and neck cancer surgery through transoral robotic approaches

Abstract

Transoral robotic surgery (TORS) has revolutionized head and neck surgery since its first human application 20 years ago. This minimally invasive technique offers superior visualization, dexterity, and precision. TORS is utilized for lesions in the oral cavity, oropharynx, hypopharynx, larynx, parapharyngeal and retropharyngeal spaces, and those extending to the skull base and thyroid. Robot-assisted procedures enable minimally invasive approaches even in complex cases, such as advanced neck dissections and free flap reconstructions, accommodating patients with challenging anatomy. Multiple meta-analyses have confirmed TORS’s benefits over traditional surgical and non-surgical treatments, underscoring the critical role of appropriate patient selection. Future advancements in TORS will likely focus on robotics, augmented reality, and artificial intelligence, combined with refined patient selection strategies and robust clinical evidence from randomized trials.