• Emma Keane, Isobel O'Riordan, Thomas Crotty, Justin M Hintze, Edlir Shytaj, Fergal O'Duffy, Tadgh P O'Dwyer, and Tom Moran.
• St Vincent's University Hospital, Merrion Road, Dublin, Ireland. emmakeane@rcsi.ie.
• Ir J Med Sci. 2022 Feb 1; 191 (1): 361-365.

BackgroundTransoral robotic surgery (TORS) has shown promising results in the treatment of myriad head and neck pathologies but is now most commonly used in the investigation and management of oropharyngeal squamous cell carcinoma.AimsThe aim of this study was to report our cases of the newly introduced TORS, particularly its role in identifying primary of unknown origin and the potential implications for patients. A literature review and our early experience should begin to debunk some of the criticisms of TORS including setup times and cost.MethodsProspective data was collected from all patients undergoing transoral robotic surgery including demographics, indication, histology results in primary of unknown origin and complications.ResultsWe have performed 36 TORS procedures in total ranging from intermediate to major complex. Our complication rate is low, and this has improved with the passage of time. Haemorrhage rates remain at 5.6% (n = 2), and the average length of stay is 1 day. Successful identification of a primary tumour in cancer of unknown primary was 80% (n = 8).ConclusionsWe anticipate the integration of TORS into routine practice in the investigation and management of a number of ENT pathologies following robust clinical trials.© 2021. Royal Academy of Medicine in Ireland.

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