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Transoral Robotic Surgery (TORS)

Minimally invasive robotic-assisted surgical approach using the da Vinci Surgical System through the mouth to access and resect oropharyngeal, supraglottic, and hypopharyngeal tumors with improved visualization and precision compared to open surgery.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

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This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our KBB (Kulak Burun Boğaz) department. Book Appointment →

What is Transoral Robotic Surgery (TORS)?

Transoral Robotic Surgery (TORS) is a minimally invasive surgical technique using the da Vinci Surgical System with three-dimensional high-definition visualization and wristed instruments inserted through the oral cavity to access and resect tumors in the oropharynx, supraglottis, hypopharynx, and base of tongue. FDA-approved in 2009, TORS revolutionized head and neck cancer surgery by avoiding traditional open approaches requiring mandibulotomy or pharyngotomy.

Indications include early to intermediate-stage (T1-T2) oropharyngeal squamous cell carcinoma (especially HPV-positive), supraglottic carcinoma, parapharyngeal space tumors, base of tongue tumors, and obstructive sleep apnea base of tongue reduction. Contraindications include trismus limiting exposure, fixed deep tumors, large vessels traversing the resection field, and tumors requiring free flap reconstruction with mandibular access.

Outcomes show oncologic equivalence to open surgery and chemoradiation with superior functional preservation. HPV-positive oropharyngeal cancer treated with TORS plus risk-adapted adjuvant therapy achieves 90%+ 5-year survival with improved swallowing, speech, and quality of life. Multidisciplinary tumor board evaluation determines optimal patient selection considering tumor extent, anatomy, and patient preference.

Symptoms

Persistent sore throat or unilateral throat pain
Globus sensation or feeling of lump in throat
Dysphagia (difficulty swallowing) particularly with solid foods
Otalgia (referred ear pain) without ear pathology
Neck mass (cervical lymphadenopathy) often presenting feature in HPV+ disease
Voice changes or hoarseness for supraglottic tumors
Hemoptysis or oral bleeding from advanced lesions

Risk Factors

HPV (human papillomavirus type 16) infection — primary driver of oropharyngeal cancer
Tobacco use (cigarette, smokeless tobacco) — synergistic with alcohol
Heavy alcohol consumption
Male sex (HPV+ oropharyngeal cancer 4:1 male predominance)
Multiple sexual partners increasing HPV exposure risk
Immunosuppression (HIV, transplant patients)
Previous head and neck radiation therapy

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Sore throat persisting >2-3 weeks despite antibiotics
  • Painless neck mass particularly in adults age 40-60
  • Unilateral throat pain with referred otalgia
  • Persistent dysphagia or odynophagia
  • Hoarseness lasting more than 2 weeks
  • Visible oropharyngeal mass on examination
  • Newly diagnosed oropharyngeal or supraglottic cancer for treatment evaluation

Treatment Methods

01
Comprehensive workup including flexible fiberoptic laryngoscopy, MRI of head/neck, PET-CT for staging, and HPV status (p16 immunohistochemistry)
02
Multidisciplinary tumor board discussion for optimal treatment selection
03
Preoperative dental evaluation, swallowing assessment, and nutritional optimization
04
TORS resection with 1 cm margins using da Vinci robotic system through specialized retractor
05
Selective neck dissection (typically levels II-IV) ipsilateral or bilateral based on tumor location
06
Risk-adapted adjuvant therapy: observation for low-risk T1N0/N1, radiation for intermediate risk, chemoradiation for extranodal extension or positive margins
07
Long-term surveillance with imaging, endoscopy, swallowing therapy, and survivorship care

Which Department to Visit?

You can visit our KBB (Kulak Burun Boğaz) department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About KBB (Kulak Burun Boğaz) Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.