Transoral robotic total laryngectomy

Richard V. Smith, Bradley A. Schiff, Catherine Sarta, Stéphane Hans, Daniel Brasnu

Research output: Contribution to journalArticlepeer-review

46 Scopus citations


Objectives/Hypothesis: Minimally invasive surgery has become the standard of care in many organ systems. Head and neck surgery has incorporated transoral surgery, either laser microsurgery or robotic resection, in the management of pharyngeal and laryngeal cancers. To date, the laryngeal procedures have taken the form of partial laryngectomy, as transoral approaches have not allowed reconstruction following total laryngectomy. We present the first series of transoral total laryngectomies. Study Design: Multinational, multi-institutional prospective consecutive case series. Methods: Case series of completed and attempted transoral robotic surgery (TORS) total laryngectomy performed under an institutional review board protocol. The procedure was developed in the cadaver laboratory and applied to selected individuals requiring total laryngectomy for recurrent laryngeal cancer or post-therapeutic organ dysfunction. Results: TORS total laryngectomy was successfully performed in five patients and was unsuccessful in two others. Two of the patients had postoperative fistulae, and all seven are without evidence of recurrent cancer and are swallowing orally without gastrostomy supplementation. Conclusions: TORS total laryngectomy is feasible and can be taught to other surgeons. Potential benefits of this approach are present for patients undergoing salvage laryngectomy and include improved wound healing and functional results. This procedure further extends the applications of robotic head and neck surgery. Laryngoscope, 2013

Original languageEnglish (US)
Pages (from-to)678-682
Number of pages5
Issue number3
StatePublished - Mar 2013


  • Level of Evidence: 4
  • Total laryngectomy
  • endoscopic
  • surgery
  • transoral robotic surgery

ASJC Scopus subject areas

  • Otorhinolaryngology


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