Transoral robotic surgery offers advantages over more aggressive procedures for well-selected patients. TORS benefits are greater for patients whom surgical resection can reduce or eliminate the need for adjuvant therapy, open approaches, or primary chemoradiation.3 Transoral laser surgery uses the same transoral approach, but is limited by tangential cuts, risks of burning the airway, and limited hemostasis. Furthermore, laser technique turns difficult “en bloc” resection of tumors. In this case, TORS by its aforementioned resources, offers advantages over other surgical techniques.

TORS has also become a valuable tool in the investigation of patients with CUP. Palatine tonsillectomy and robotic lingual mucosectomy allows the identification of the primary carcinoma site in 72%–82% of patients, with a consequent reduction in toxicity of chemoradiation. Literature have shown that TORS can provide a complete tumor removal in 78% of patients.3

TORS is applied successfully for supraglottic surgeries, both in benign and malignant pathologies. Total robotic laryngectomies were previously described, however, the access to the glottis and sub glottis is limited without the single port technology (SP).

The best treatment strategy for sleep apnea is determined by a good patient selection. Continue positive airway pressure (CPAP), despite proved to be effective, has low long-term adherence (4). TORS was initially applied in 2010 as an alternative treatment for OSA, addressing the oro/hypopharyngeal obstruction.4 Tongue base reduction (BOT) and supraglottoplasty is the primary focus of TORS for OSA treatment. Resections can include the lingual tonsil and the tongue base, including an epiglottoplasty in selected cases.5 The main advantages of TORS, compared to non-robotic surgery, are the three-dimensional, and detailed visualization of this area, allowing a safe dissection and vascular control in each surgical step.4

O'Malley and Weinstein, in 2007, described TORS for skull base surgery. The first clinical application occurred in 2012 for the resection of a recurrent nasopharyngeal carcinoma with a nasal and oral approach combined. Since then, there have been several case reports that describe the use of robotics techniques for pathologies in the skull base. The robotic system has an advantage when compared with an endoscope, allowing both hands-free, independent optics motion, and three-dimensional visualization but still limited by narrow space, size of arms, and limited tools.