• DOI:10.1177/0194599813503446
• Corpus ID: 3339804

Surgeon Experience and Complications with Transoral Robotic Surgery (TORS)

@article{Chia2013SurgeonEA,
  title={Surgeon Experience and Complications with Transoral Robotic Surgery (TORS)},
  author={Stanley Chia and Neil D. Gross and Jeremy D. Richmon},
  journal={Otolaryngology–Head and Neck Surgery},
  year={2013},
  volume={149},
  pages={885 - 892}
}

• S. Chia, N. Gross, J. Richmon
• Published 6 September 2013
• Medicine
• Otolaryngology–Head and Neck Surgery

Objective To investigate surgeon preferences for perioperative management of transoral robotic surgery (TORS) and explore the frequency of postoperative complications. Study Design Retrospective survey. Setting Multi-institutional. Subjects and Methods An electronic survey was sent to over 300 TORS-trained surgeons in the United States identified by Intuitive Surgical, Inc. Participation was voluntary and solicited by email invitations to participate 3 times over a 1-month period. Results A total of 2015 procedures were reported by 45 respondent TORS-trained surgeons: 67% academic, 33% nonacademic. A minority of TORS procedures (n = 214, 10.6%) were performed on previously irradiated patients. Neck dissections were performed concurrently (58%) or staged (42%). Fewer than 6% of TORS procedures required tracheotomy or reconstruction. Most surgeons (62%) initiated oral intake on postoperative day 0-1. Of the patients who required readmission, bleeding (n = 62, 3.1%) was the most common cause followed by dehydration (n = 26, 1.3%). Other complications of surgery included tooth injury (n = 29, 1.4%), percutaneous endoscopic gastrostomy (PEG) dependency >6 months (n = 21, 1.0%), temporary hypoglossal nerve injury (n = 18, 0.9%), and lingual nerve injury (n = 11, 0.6%). A total of 6 deaths (0.3%) were reported within 30 days of TORS. All reported deaths were due to postoperative hemorrhage. The complication rate decreased significantly with higher surgeon case volume (>50 cases). Conclusions TORS is associated with a low major complication rate, early initiation of oral intake, and a low rate of long-term PEG dependency. Postoperative hemorrhage was the most common cause of hospital readmission and postoperative mortality.