# Transoral robotic surgery (TORS)

Source: https://onco.cc/technologies/tors/  
OnCo record `tors` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Transoral robotic surgery removes early (T1 to T2) throat tumours through the mouth with a robot and 3D endoscope, avoiding splitting the jaw or a tracheostomy. In HPV-positive oropharyngeal cancer the pathology then guides how much radiation to add, but randomised trials found it no better than radiation for swallowing, and surgeon volume matters.

## Summary

FDA-cleared 2009 for T1-T2 oropharyngeal tumours. Enables primary surgical management of HPV-positive oropharyngeal cancer with pathology-guided adjuvant de-escalation (ECOG 3311). ORATOR trials found comparable oncologic outcomes to radiation with different toxicity profiles (swallowing favoured radiation in ORATOR; ORATOR2 halted after surgical deaths). Selection and surgeon volume matter.

## Fields

- Kind: Technology
- Status: established
- Last checked: 2026-09-07
- Principle: Da Vinci or Flex robot instruments and a 3D endoscope pass through a mouth retractor to resect the tumour with margins; neck dissection is done separately.
- Since: 2009
- Strengths: Avoids mandibulotomy and tracheostomy; Pathology-based selection of adjuvant therapy
- Limitations: Bleeding risk, swallowing morbidity; Not superior to radiation in randomised comparison for function

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Transoral_robotic_surgery
- Wikipedia: https://en.wikipedia.org/wiki/Transoral_robotic_surgery

## Connected records

- cancers: [Head and neck squamous cell carcinoma](https://onco.cc/cancers/head-and-neck/), [HPV-positive oropharyngeal cancer](https://onco.cc/cancers/hpv-positive-oropharyngeal-cancer/), [Hypopharyngeal cancer](https://onco.cc/cancers/hypopharyngeal-cancer/), [Nasopharyngeal carcinoma](https://onco.cc/cancers/nasopharyngeal/), [Oropharyngeal cancer (tonsil and base of tongue)](https://onco.cc/cancers/oropharyngeal-cancer/), [Recurrent and metastatic nasopharyngeal carcinoma](https://onco.cc/cancers/recurrent-metastatic-nasopharyngeal-carcinoma/)
- fronts: [Surgery & Interventional](https://onco.cc/fronts/surgery/)
- technologies: [Head and neck reconstruction: the free flap, and what it gives back](https://onco.cc/technologies/rejuv-recon-head-neck/), [Robotic & minimally invasive surgery](https://onco.cc/technologies/robotic-surgery/)
- companies: [Intuitive Surgical](https://onco.cc/companies/intuitive-surgical/)
- trials: [ECOG-ACRIN E3311](https://onco.cc/trials/ecog-e3311/), [PATHOS](https://onco.cc/trials/pathos/)
- roadmaps: [Surgery roadmap: radical operations → less surgery → no surgery when a drug has done the work](https://onco.cc/roadmaps/surgery-roadmap/)

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JSON: https://onco.cc/api/v1/entities/tors.json