Background: Transoral robotic surgery (TORS), introduced by Weinstein et al. in 2005, has been adopted as a minimally invasive procedure also in head and neck surgery. The robot allows surgical interventions in anatomically complex spaces that can only be reached thanks to the use of well- articulated handpieces. The 3D vision gives the feeling of being inside the patient. It is a very different condition from endoscopic LASER surgery.Methods: 162 patients have been enrolled and treated for H&N cancer by TORS at Head & Neck Surgery Dpt of INT, Naples Italy. The staging assessment, including neck ultrasound and total body PET/CT scan, was performed in each patient according to the TNM classification.
Results: From October 2013 to December 2023, 162 consecutive TORS were performed. The three main subsites were: supraglottic larynx, parapharyngeal space and oropharynx. Neck dissection was performed in 23 cases. Tracheotomy was performed in 10 cases for respiratory failures. At the end of surgery, a feeding tube was inserted in 55 patients. The average length of hospital stay was 10 days. Major complications included post-surgery bleeding in 3 patients; and respiratory failures in 2 patients, treated with tracheotomy and monitored in the Intensive Care Unit (ICU) for 3 days.
Conclusions: Robotic surgery is to be considered a valid alternative to traditional open treatment with the advantages of an endoscopic procedure together with excellent oncological and functional results. Furthermore, TORS is more appropriate for personalized combination with radio and chemotherapy as well as novel therapeutic deintensification of HPV-related OPSCC 

Dr F. Ionna has completed his Medical Degree at the age of 25 years from Naples Federico II University and his surgery specialty and sub-specialty post-graduate studies at Federico II University School of Medicine with final ENT as well as maxillofacial surgeon board certifications. He is the director of the Head and Neck Surgery Division and the related Department, at the Natl Comprehensive Cancer Center in Naples, Italy. He has published more than 100 papers in PubMed indexed journals and past-president of the Italian ENT association (AOICO).