Our Experience—Design and Delivery of a Safe Trans Oral Robotic Programme in the National Health Service (NHS)

Trans oral robotic surgery (TORS) is a minimally invasive technique for head and neck cancers. It is shown favourable recovery and long-term functionality outcomes compared to traditional treatments. Our department at the Royal Surrey County Hospital implemented a service transformation project for a TORS programme in December 2019. The “plan, do, study and act” (PDSA) quality improvement model was used. This incorporated logistical, training, clinical and financial aspects. Twenty-five patients were selected for oropharyngectomy, tonsillectomy or tongue base resections over a period of 1 year. Patients were matched with similar patients undergoing the same non-robotic procedures. TORS showed an improvement in time required to return to normal diet and time needing regular analgesia. Peri-operative complications were similar in both groups. An improving learning curve was observed over time for console times.