title: Transoral robotic surgery: radical tonsillectomy.
abstract: OBJECTIVE
  To describe and show the feasibility of a new surgical technique for transoral robotic surgery (TORS) radical tonsillectomy.
  
  
  METHODS
  A prospective, phase 1 clinical trial.
  
  
  METHODS
  Academic, tertiary referral center.
  
  
  METHODS
  A total of 27 participants were prospectively selected using a volunteer sample. All eligible patients agreed to participate in the study.
  
  
  METHODS
  Patients underwent TORS radical tonsillectomy for previously untreated invasive squamous cell carcinoma of the tonsillar region without free-flap reconstruction, staged neck dissection, and adjuvant therapy.
  
  
  METHODS
  Outcome measures included final pathologic margin status, need for short- and long-term tracheotomy tube placement, and need for gastrostomy tube feedings among patients with a minimum 6-month follow-up. The incidence of significant postoperative complications was recorded.
  
  
  RESULTS
  No mortality occurred. Final margins found to be negative for cancer were achieved in 25 of 27 patients (93%). Surgical complications included 1 case each of postoperative mucosal bleeding, delirium tremens, unplanned tracheotomy for temporary exacerbation of sleep apnea, and hypernasality and 2 cases of moderate trismus. Twenty-six of 27 patients (96%) were swallowing without the use of a gastrostomy.
  
  
  CONCLUSIONS
  Radical tonsillectomy using TORS is a new technique that offers excellent access for resection of carcinomas of the tonsil with acceptable acute morbidity. Future reports will focus on long-term oncologic and functional outcomes.
authors: Department of Otorhinolaryngology, Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, PA 19104, USA. gregory.weinstein@uphs.upenn.edu
authors: Gregory S
authors: GS
authors: Weinstein
authors: Bert W
authors: BW
authors: O'Malley
authors: Wendy
authors: W
authors: Snyder
authors: Eric
authors: E
authors: Sherman
authors: Harry
authors: H
authors: Quon
mesh_terms: D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D019723:Endoscopes; D004724:Endoscopy / Q000379:methods*; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009055:Mouth; D011446:Prospective Studies; D012371:Robotics / Q000295:instrumentation*; D014067:Tonsillar Neoplasms / Q000473:pathology / Q000601:surgery*; D014068:Tonsillectomy / Q000295:instrumentation*; D016896:Treatment Outcome