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Peer-reviewedCC BY 4.0Journal of Surgical Oncology

Transoral Robotic Surgery in Head and Neck Oncology: A Scoping Review of Evidence, Technological Advancements, and Future Trajectories

  • Anna Luíza Damaceno Araújo1,2
  • Karthik N. Rao3
  • Juan P. Rodrigo4
  • Vincent Vander Poorten5,6
  • Orlando Guntinas‐Lichius7
  • Alfio Ferlito8
  • Luiz Paulo Kowalski1,9
9 affiliations
  1. 1Head and Neck Surgery Department and LIM 28 University of São Paulo Medical School São Paulo Brazil
  2. 2Hospital Israelita Albert Einstein São Paulo Brazil
  3. 3Department of Head and Neck Oncology Sri Shankara Cancer Foundation Bangalore India
  4. 4Department of Otolaryngology, Hospital Universitario Central de Asturias, ISPA, IUOPA, CIBERONC University of Oviedo Oviedo Spain
  5. 5Department of Oncology, Section Head and Neck Oncology KU Leuven Leuven Belgium
  6. 6Otorhinolaryngology—Head and Neck Surgery, Leuven Cancer Institute University Hospitals Leuven Leuven Belgium
  7. 7Department of Otorhinolaryngology Jena University Hospital Jena Germany
  8. 8International Head and Neck Scientific Group Padua Italy
  9. 9Department of Head and Neck Surgery and Otorhinolaryngology A.C. Camargo Cancer Center São Paulo State of São Paulo Brazil
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Abstract

Robotic surgery has transformed head and neck cancer (HNC) treatment. This scoping review synthesizes evidence on transoral robotic surgery (TORS), focusing on applications, limitations, and future directions. Following PRISMA‐ScR guidelines, this review used the PCC framework (Population: HNC patients; Concept: technological advancements; Context: any clinical setting). A systematic search of five databases and gray literature was conducted. Two independent reviewers screened records and extracted data from clinical trials and reviews. From 5411 records, 21 studies were included. Evidence confirms TORS provides excellent local disease control and functional benefits (e.g., shorter hospitalization, improved swallowing) over open surgery, albeit with a distinct complication profile (e.g., hemorrhage). A significant finding is the scarcity of high‐quality randomized trials comparing TORS to radiotherapy or open surgery. Technologically, evolution from multiport to single‐port and flexible systems has improved access, though limitations like absent haptic feedback persist. Emerging trends focus on AI integration for precision and developing smaller instruments. Robotic surgery is a viable, evolving approach for HNC with demonstrable functional advantages. Its future depends on overcoming technological limits, establishing cost‐effectiveness, and validating efficacy through robust comparative studies. AI integration is a promising frontier for enhancing surgical precision and personalization.

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Cite

BibTeXRIS
BibTeX
@article{araujo2026transoral,
  title = {{Transoral Robotic Surgery in Head and Neck Oncology: A Scoping Review of Evidence, Technological Advancements, and Future Trajectories}},
  author = {Anna Luíza Damaceno Araújo and Karthik N. Rao and Juan P. Rodrigo and Vincent Vander Poorten and Orlando Guntinas‐Lichius and Alfio Ferlito and Luiz Paulo Kowalski},
  journal = {Journal of Surgical Oncology},
  year = {2026},
  month = aug,
  doi = {10.1002/jso.70353},
  url = {https://doi.org/10.1002/jso.70353},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Transoral Robotic Surgery in Head and Neck Oncology: A Scoping Review of Evidence, Technological Advancements, and Future Trajectories
AU  - Anna Luíza Damaceno Araújo
AU  - Karthik N. Rao
AU  - Juan P. Rodrigo
AU  - Vincent Vander Poorten
AU  - Orlando Guntinas‐Lichius
AU  - Alfio Ferlito
AU  - Luiz Paulo Kowalski
PY  - 2026
DA  - 2026/08/16
JO  - Journal of Surgical Oncology
DO  - 10.1002/jso.70353
UR  - https://doi.org/10.1002/jso.70353
AB  - Robotic surgery has transformed head and neck cancer (HNC) treatment. This scoping review synthesizes evidence on transoral robotic surgery (TORS), focusing on applications, limitations, and future directions. Following PRISMA‐ScR guidelines, this review used the PCC framework (Population: HNC patients; Concept: technological advancements; Context: any clinical setting). A systematic search of five databases and gray literature was conducted. Two independent reviewers screened records and extracted data from clinical trials and reviews. From 5411 records, 21 studies were included. Evidence confirms TORS provides excellent local disease control and functional benefits (e.g., shorter hospitalization, improved swallowing) over open surgery, albeit with a distinct complication profile (e.g., hemorrhage). A significant finding is the scarcity of high‐quality randomized trials comparing TORS to radiotherapy or open surgery. Technologically, evolution from multiport to single‐port and flexible systems has improved access, though limitations like absent haptic feedback persist. Emerging trends focus on AI integration for precision and developing smaller instruments. Robotic surgery is a viable, evolving approach for HNC with demonstrable functional advantages. Its future depends on overcoming technological limits, establishing cost‐effectiveness, and validating efficacy through robust comparative studies. AI integration is a promising frontier for enhancing surgical precision and personalization.
SN  - 0022-4790
SN  - 1096-9098
ER  -