Understanding contraindications for transoral robotic surgery (TORS) for oropharyngeal cancer

Excerpt

Transoral robotic surgery (TORS) was invented at the University of Pennsylvania in 2004 and arose from a specifically designed translational research program which included airway mannequin, cadaver, and animal model experimentation. The success of these preclinical efforts led to the first prospective human clinical research trial of TORS in 2005 [1, 2]. In 2009 the outcomes report from a multi-institutional retrospective trial, led by Weinstein and O’Malley [3] at the University of Pennsylvania, was utilized by the United States Food and Drug Administration (FDA) to approve the use of the da Vinci Surgical System (Intuitive Surgical Inc, Sunnyvale, CA, USA) for TORS in patients. TORS procedures have been described to manage pathologies at numerous anatomic sites from the glottis and hypopharynx to the nasopharynx and skull base [4‐6]. The most commonly reported use of TORS for malignant disease, however, has been for oropharyngeal cancer, particularly tongue base or tonsillar cancer [3, 7, 8]. This paper presents the contraindications for TORS oropharyngeal cancer resection as developed and performed at the University of Pennsylvania. …