Feasibility of Transoral Robotic Surgery with a Modular Multi-Arm Platform in Early Oropharyngeal Squamous Cell Carcinoma

Transoral robotic surgery (TORS); Oropharyngeal squamous cell carcinoma; Modular robotic system; Glossotonsillar sulcus; Lingual artery ligation.

Surender Kumar Dabas1
Department of Surgical Oncology, Manipal
Hospital, Dwarka, New Delhi, India.
E-mail: Surender.dabas@manipalhospitals.com

Reetesh Ranjan2*
Department of Surgical Oncology, Manipal
Hospital, Dwarka, New Delhi, India.
E-mail: ireetesh.ranjan@gmail.com

Bikash Gurung3
Department of Surgical Oncology, Manipal
Hospital, Dwarka, New Delhi, India.
E-mail: drbikas.gurung@gmail.com

Sukirti Tiwari4
Department of Surgical Oncology, Manipal
Hospital, Dwarka, New Delhi, India.
E-mail: Sukirti.t@gmail.com

Kiran Kumar Shetty5
Department of Product Performance
Engineering and Post Market Clinical Follow
Up, Meril Life Sciences, Vapi, Gujarat, India.
E-mail: Kirankumar.shetty@merillife.com

Received: 19-06-2026
Revised: 22-07-2026
Accepted: 25-07-2026

European Journal of Prosthodontics and Restorative Dentistry (2026) 34 (7s), 230–235

Feasibility of Transoral Robotic Surgery with a Modular Multi-Arm Platform in Early Oropharyngeal Squamous Cell Carcinoma

Background: Transoral robotic surgery (TORS) is an established minimally invasive approach for early-stage oropharyngeal squamous cell carcinoma (OPSCC), providing oncologic control while preserving function. Experience with newer modular multi-arm robotic platforms in TORS remains limited. The objective of this report was to describe the operative technique and evaluate the technical feasibility and early oncologic outcomes of TORS performed using a modular robotic platform. Methods: A 38-year-old male with cT2N1M0 HPVindependent OPSCC of the right glossotonsillar sulcus underwent TORS using the MIZZO™ Endo 4000 system followed by modified neck dissection (levels II–V). Operative setup included 15–20° cervical extension, FK retractor exposure, 30° lateral cart angulation, and sequential endoscope-first docking to achieve stable triangulation. Circumferential mucosal incision and controlled submucosal dissection were performed under three-dimensional visualization with prophylactic ligation of the right lingual artery. Results: Complete tumor excision with negative surgical margins (R0) was achieved. Final histopathology confirmed moderately differentiated squamous cell carcinoma with 29 lymph nodes negative for metastasis (pT2N0). Docking time was 15 minutes, console time 80 minutes, and total operative time approximately 200 minutes, with estimated blood loss <50 mL. No intraoperative complications, robotic malfunction, conversion, postoperative hemorrhage, airway compromise, or need for tracheostomy or enteral feeding occurred. The patient was discharged uneventfully. Conclusion: TORS using a modular multi-arm robotic platform was technically feasible and achieved favourable early oncologic and perioperative outcomes. Larger prospective studies are required to validate reproducibility and long-term results.

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