da Vinci Single-Port Transoral Robotic Surgery in European Practice: Early Outcomes and Comparison With Transoral Laser Microsurgery.

Objectives

To report early outcomes following implementation of a da Vinci Single-Port transoral robotic surgery (SP-TORS) programme in the United Kingdom. To provide contextual benchmarking, outcomes were compared with a historical institutional cohort treated using transoral laser microsurgery (TLM).

Design

Retrospective institutional series with comparison against a historical cohort using stabilised inverse-probability-of-treatment weighting.

Setting

High-volume UK Tertiary Head and Neck Centre.

Participants

All patients undergoing SP-TORS between April 2024 and September 2025. Comparative analyses were limited to oncological resections and included 33 SP-TORS and 61 TLM cases. MAIN OUTCOME MEASURES Feasibility, peri-operative safety, postoperative haemorrhage, return to theatre, mortality, length of stay, time to oral diet, margin status and adjuvant therapy use.

Results

Sixty-six patients underwent SP-TORS. All procedures were completed transorally without unplanned conversion or peri-operative mortality. Postoperative haemorrhage occurred in 4.5%, with one return to theatre. Length of stay did not differ between groups. Time to oral diet was longer following SP-TORS (adjusted ratio 1.51, p= 0.005). ASCO-defined involved margins were similar (OR 0.30, 95% CI 0.06-1.56; p = 0.15), whereas specimen ink-positive margins were less frequent following SP-TORS (OR 0.31, 95% CI 0.11-0.91; p = 0.03). A sensitivity analysis using propensity-matched T1/T2 pairs demonstrated a consistent directional effect, though this did not reach significance in the smaller matched cohort. Adjuvant therapy use was comparable.

Conclusion

SP-TORS implementation in a high-volume UK centre was feasible and safe during early adoption, with low complication rates. Peri-operative and early functional outcomes were broadly comparable with TLM. Although specimen ink-positive margins were less frequent following SP-TORS, interpretation should be cautious given the historical comparator and associated differences in departmental workflow. These findings support safe integration of SP-TORS into transoral surgical practice and justify prospective evaluation.