Top

Published in:

01-12-2021 | Tonsillectomy | Review Article

Transoral Robotic Surgery

Published in: Indian Journal of Surgical Oncology | Issue 4/2021

Abstract

Transoral robotic surgery (TORS) became a valuable new head and neck surgery approach from the past decade since its approval. TORS was initially conceived for oropharyngeal squamous cell carcinoma (OPSCC); now, the indications are gradually extrapolated into other subsites. There have been numerous studies comparing the outcomes following surgical and non-surgical treatment, especially for oropharyngeal cancers. TORS for laryngeal cancers is in its infancy, and only a few reports are describing it. Many report suggestive of better functional outcomes following TORS, but level 1 evidence is still lacking. With the further development of novel, flexible, miniaturized robots, it is highly likely to expand TORS indications further. This article provides an overview of TORS in head and neck cancers.

Strong MS (1975) Laser excision of carcinoma of the larynx. Laryngoscope 85(8):1286–1289CrossRef

Hockstein NG, Nolan JP, O’Malley BW, Woo YJ (2005) Robot-assisted pharyngeal and laryngeal microsurgery: results of robotic cadaver dissections. Laryngoscope 115(6):1003–1008CrossRef

Golusiński W, Golusińska-Kardach E (2019) Current role of surgery in the management of oropharyngeal cancer. Front Oncol [cited 2020 Dec 19];9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6542993/

Elrefaey S, Massaro MA, Chiocca S, Chiesa F, Ansarin M (2014) HPV in oropharyngeal cancer: the basics to know in clinical practice. Acta Otorhinolaryngol Ital 34(5):299–309PubMedPubMedCentral

Sim FW, Xiao HD, Bell RB (2017) Margin analysis: squamous cell carcinoma of the oropharynx. Oral Maxillofac Surg Clin N Am 29(3):269–280CrossRef

Alicandri-Ciufelli M, Bonali M, Piccinini A, Marra L, Ghidini A, Cunsolo EM et al (2013) Surgical margins in head and neck squamous cell carcinoma: what is “close”? Eur Arch Otorhinolaryngol 270(10):2603–2609CrossRef

Weinstein GS, O’Malley BW, Magnuson JS, Carroll WR, Olsen KD, Daio L et al (2012) Transoral robotic surgery: a multicenter study to assess feasibility, safety, and surgical margins. Laryngoscope 122(8):1701–1707CrossRef

Weinstein GS, O’Malley BW, Snyder W, Sherman E, Quon H (2007) Transoral robotic surgery: radical tonsillectomy. Arch Otolaryngol Head Neck Surg 133(12):1220–1226CrossRef

Yeh DH, Tam S, Fung K, MacNeil SD, Yoo J, Winquist E et al (2015) Transoral robotic surgery vs. radiotherapy for management of oropharyngeal squamous cell carcinoma - a systematic review of the literature. Eur J Surg Oncol 41(12):1603–14CrossRef

10.

Mahmoud O, Sung K, Civantos FJ, Thomas GR, Samuels MA (2018) Transoral robotic surgery for oropharyngeal squamous cell carcinoma in the era of human papillomavirus. Head Neck 40(4):710–721CrossRef

11.

White HN, Moore EJ, Rosenthal EL, Carroll WR, Olsen KD, Desmond RA et al (2010) Transoral robotic-assisted surgery for head and neck squamous cell carcinoma: one- and 2-year survival analysis. Arch Otolaryngol Head Neck Surg 136(12):1248–1252CrossRef

12.

de Almeida JR, Byrd JK, Wu R, Stucken CL, Duvvuri U, Goldstein DP et al (2014) A systematic review of transoral robotic surgery and radiotherapy for early oropharynx cancer: a systematic review. Laryngoscope 124(9):2096–2102CrossRef

13.

Dabas S, Gupta K, Ranjan R, Sharma AK, Shukla H, Dinesh A (2017) Oncological outcome following de-intensification of treatment for stage I and II HPV negative oropharyngeal cancers with transoral robotic surgery (TORS): A prospective trial. Oral Oncol 69:80–83CrossRef

14.

Lee SY, Park YM, Byeon HK, Choi EC, Kim S-H (2014) Comparison of oncologic and functional outcomes after transoral robotic lateral oropharyngectomy versus conventional surgery for T1 to T3 tonsillar cancer. Head Neck 36(8):1138–1145CrossRef

15.

Iseli TA, Kulbersh BD, Iseli CE, Carroll WR, Rosenthal EL, Magnuson JS (2009) Functional outcomes after transoral robotic surgery for head and neck cancer. Otolaryngol Head Neck Surg 141(2):166–171CrossRef

16.

Haughey BH, Hinni ML, Salassa JR, Hayden RE, Grant DG, Rich JT et al (2011) Transoral laser microsurgery as primary treatment for advanced-stage oropharyngeal cancer: a United States multicenter study. Head Neck 33(12):1683–1694CrossRef

17.

Roets E, Tukanova K, Govarts A, Specenier P (2018) Quality of life in oropharyngeal cancer: a structured review of the literature. Support Care Cancer 26(8):2511–2518CrossRef

18.

Chen AM, Daly ME, Luu Q, Donald PJ, Farwell DG (2015) Comparison of functional outcomes and quality of life between transoral surgery and definitive chemoradiotherapy for oropharyngeal cancer. Head Neck 37(3):381–385CrossRef

19.

More YI, Tsue TT, Girod DA, Harbison J, Sykes KJ, Williams C et al (2013) Functional swallowing outcomes following transoral robotic surgery vs primary chemoradiotherapy in patients with advanced-stage oropharynx and supraglottis cancers. JAMA Otolaryngol Neck Surg 139(1):43–48CrossRef

20.

Van Abel KM, Quick MH, Graner DE, Lohse CM, Price DL, Price KA, et al (2019) Outcomes following TORS for HPV-positive oropharyngeal carcinoma: PEGs, tracheostomies, and beyond. Am J Otolaryngol

21.

Sethia R, Yumusakhuylu AC, Ozbay I, Diavolitsis V, Brown NV, Zhao S et al (2018) Quality of life outcomes of transoral robotic surgery with or without adjuvant therapy for oropharyngeal cancer. Laryngoscope 128(2):403–411CrossRef

22.

Fu TS, Foreman A, Goldstein DP, de Almeida JR (2016) The role of transoral robotic surgery, transoral laser microsurgery, and lingual tonsillectomy in the identification of head and neck squamous cell carcinoma of unknown primary origin: a systematic review. J Otolaryngol Head Neck Surg [cited 2020 Dec 19];45. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4855481/

23.

Farooq S, Khandavilli S, Dretzke J, Moore D, Nankivell PC, Sharma N et al (2019) Transoral tongue base mucosectomy for the identification of the primary site in the work-up of cancers of unknown origin: systematic review and meta-analysis. Oral Oncol 91:97–106CrossRef

24.

Meccariello G, Montevecchi F, D’Agostino G, Iannella G, Calpona S, Parisi E et al (2019) Trans-oral robotic surgery for the management of oropharyngeal carcinomas: a 9-year institutional experience. Acta Otorhinolaryngol Ital 39(2):75–83CrossRef

25.

Fu TS, Foreman A, Goldstein DP, de Almeida JR (2016) The role of transoral robotic surgery, transoral laser microsurgery, and lingual tonsillectomy in the identification of head and neck squamous cell carcinoma of unknown primary origin: a systematic review. J Otolaryngol Head Neck Surg [cited 2019 Aug 10];45. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4855481/

26.

Nagel TH, Hinni ML, Hayden RE, Lott DG (2014) Transoral laser microsurgery for the unknown primary: role for lingual tonsillectomy. Head Neck 36(7):942–946CrossRef

27.

Karni RJ, Rich JT, Sinha P, Haughey BH (2011) Transoral laser microsurgery: a new approach for unknown primaries of the head and neck. Laryngoscope 121(6):1194–1201CrossRef

28.

Winter SC, Ofo E, Meikle D, Silva P, Fraser L, O’Hara J et al (2017) Trans-oral robotic assisted tongue base mucosectomy for investigation of cancer of unknown primary in the head and neck region. The UK experience. Clin Otolaryngol 42(6):1247–51CrossRef

29.

Abuzeid WM, Bradford CR, Divi V (2013) Transoral robotic biopsy of the tongue base: a novel paradigm in the evaluation of unknown primary tumors of the head and neck. Head Neck 35(4):E126-130CrossRef

30.

Ofo E, Spiers H, Kim D, Duvvuri U (2018) Transoral robotic surgery and the unknown primary. ORL 80(3–4):148–155CrossRef

31.

Mendelsohn AH, Remacle M, Van Der Vorst S, Bachy V, Lawson G (2013) Outcomes following transoral robotic surgery: supraglottic laryngectomy. Laryngoscope 123(1):208–214CrossRef

32.

Ozer E, Alvarez B, Kakarala K, Durmus K, Teknos TN, Carrau RL (2013) Clinical outcomes of transoral robotic supraglottic laryngectomy. Head Neck 35(8):1158–1161CrossRef

33.

Dziegielewski PT, Kang SY, Ozer E (2015) Transoral robotic surgery (TORS) for laryngeal and hypopharyngeal cancers. J Surg Oncol 112(7):702–706CrossRef

34.

Dowthwaite S, Nichols AC, Yoo J, Smith RV, Dhaliwal S, Basmaji J et al (2013) Transoral robotic total laryngectomy: report of 3 cases. Head Neck 35(11):E338-342CrossRef

35.

Smith RV, Schiff BA, Sarta C, Hans S, Brasnu D (2013) Transoral robotic total laryngectomy. Laryngoscope 123(3):678–682CrossRef

36.

Lörincz BB, Busch C-J, Möckelmann N, Knecht R (2015) Feasibility and safety of transoral robotic surgery (TORS) for early hypopharyngeal cancer: a subset analysis of the Hamburg University TORS-trial. Eur Arch Otorhinolaryngol 272(10):2993–2998CrossRef

37.

Lee HY, You JY, Woo SU, Son GS, Lee JB, Bae JW et al (2015) Transoral periosteal thyroidectomy: cadaver to human. Surg Endosc 29(4):898–904CrossRef

38.

Anuwong A, Kim HY, Dionigi G (2017) Transoral endoscopic thyroidectomy using vestibular approach: updates and evidences. Gland Surg 6(3):277–284CrossRef

39.

Rich JT, Milov S, Lewis JS, Thorstad WL, Adkins DR, Haughey BH (2009) Transoral laser microsurgery (TLM) ± adjuvant therapy for advanced stage oropharyngeal cancer: outcomes and prognostic factors. Laryngoscope [cited 2019 Aug 8];119(9). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3877921/

40.

Luginbuhl A, Baker A, Curry J, Drejet S, Miller M, Cognetti D (2014) Preoperative cephalometric analysis to predict transoral robotic surgery exposure. J Robot Surg 8(4):313–317CrossRef

Title: Transoral Robotic Surgery
Publication date: 01-12-2021
Keywords: Tonsillectomy
Oropharyngeal Cancer
Published in: Indian Journal of Surgical Oncology / Issue 4/2021
Print ISSN: 0975-7651
Electronic ISSN: 0976-6952
DOI: https://doi.org/10.1007/s13193-021-01443-0

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Transoral Robotic Surgery

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 4/2021

Outcome Evaluation of Mandibular Pull-Through Approach for Glossectomies

Is Hyperthermic Intrathoracic Chemotherapy (HITHOC) Safe and Efficacious in Masaoka-Koga Stage-IVA Thymoma? A Pilot Study

Complications and Outcomes of Diaphragm Surgeries in Epithelial Ovarian Malignancies

Clinical Impact of Inferior Mesenteric Lymph Node Metastasis in Patients with Cancer of the Sigmoid Colon or Rectum

Laparoscopic Repair of Acute Post-Esophagectomy Diaphragmatic Herniation Following Minimal Access Esophagectomy

Free Flap Reconstruction and Its Management in Sickle Cell Trait: Lessons Learned from a Case