{"entity":{"id":"tors","kind":"technology","name":"Transoral robotic surgery (TORS)","aka":[],"tldr":"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.","status":"established","asOf":"2026-09-07","wikipedia":"https://en.wikipedia.org/wiki/Transoral_robotic_surgery","links":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/Transoral_robotic_surgery"}],"tags":[],"related":[],"cancers":["head-and-neck","oropharyngeal-cancer","hpv-positive-oropharyngeal-cancer"],"sections":["surgery"],"technologies":["robotic-surgery"],"targets":[],"drugs":[],"companies":["intuitive-surgical"],"institutions":[],"pathways":[],"terms":[],"trials":["ecog-e3311","pathos"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"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.","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"],"since":2009},"route":"/technologies/tors/","neighbours":{"cancer":[{"id":"head-and-neck","kind":"cancer","name":"Head and neck squamous cell carcinoma","route":"/cancers/head-and-neck/"},{"id":"hpv-positive-oropharyngeal-cancer","kind":"cancer","name":"HPV-positive oropharyngeal cancer","route":"/cancers/hpv-positive-oropharyngeal-cancer/"},{"id":"hypopharyngeal-cancer","kind":"cancer","name":"Hypopharyngeal cancer","route":"/cancers/hypopharyngeal-cancer/"},{"id":"nasopharyngeal","kind":"cancer","name":"Nasopharyngeal carcinoma","route":"/cancers/nasopharyngeal/"},{"id":"oropharyngeal-cancer","kind":"cancer","name":"Oropharyngeal cancer (tonsil and base of tongue)","route":"/cancers/oropharyngeal-cancer/"},{"id":"recurrent-metastatic-nasopharyngeal-carcinoma","kind":"cancer","name":"Recurrent and metastatic nasopharyngeal carcinoma","route":"/cancers/recurrent-metastatic-nasopharyngeal-carcinoma/"}],"section":[{"id":"surgery","kind":"section","name":"Surgery & Interventional","route":"/fronts/surgery/"}],"technology":[{"id":"rejuv-recon-head-neck","kind":"technology","name":"Head and neck reconstruction: the free flap, and what it gives back","route":"/technologies/rejuv-recon-head-neck/"},{"id":"robotic-surgery","kind":"technology","name":"Robotic & minimally invasive surgery","route":"/technologies/robotic-surgery/"}],"company":[{"id":"intuitive-surgical","kind":"company","name":"Intuitive Surgical","route":"/companies/intuitive-surgical/"}],"trial":[{"id":"ecog-e3311","kind":"trial","name":"ECOG-ACRIN E3311","route":"/trials/ecog-e3311/"},{"id":"pathos","kind":"trial","name":"PATHOS","route":"/trials/pathos/"}],"roadmap":[{"id":"surgery-roadmap","kind":"roadmap","name":"Surgery roadmap: radical operations → less surgery → no surgery when a drug has done the work","route":"/roadmaps/surgery-roadmap/"}]}}