Da Vinci 5 in Transoral Robotic Surgery: First Impression

Introduction: The latest update on the surgical robot most used for Transoral Robotic Surgery (TORS), the Da Vinci, comes in the form of the Da Vinci 5. Currently, there is no literature about its use in TORS. This study aims to determine if the Da Vinci 5 is at least non-inferior and as safe as previous Da Vinci models. Methods: The retrospective chart review was performed in patients who had oropharyngeal lesions and underwent an intraoral approach robotic surgery. All surgeries of the oropharynx performed utilizing the Da Vinci 5 surgical system at a single institution were included in this study. All patients were followed for at least 30 days following surgery. The metrics studied were patient demographics, surgical outcomes, complications, and readmissions. Results: A total of 14 head and neck surgery cases were performed utilizing the Da Vinci 5 surgical system. Thirteen of the cases were performed for malignancy and included 7 cases of HPV-related SCC of tonsil, 2 cases of HPV-related metastatic SCC to cervical nodes with unknown primary tumor, 1 base of tongue mucoepidermoid carcinoma, 1 HPV-related SCC of base of tongue, 1 P16 negative SCC at base of tongue, and 1 SCC of suprahyoid epiglottis. One case was performed for lingual tonsillitis. All malignancy cases resulted in negative surgical margins. All patients were able to eat the next day, as established by our post-operative protocol. All patients were discharged in less than 3 days. No complications related to surgery were observed. No patients required readmission after surgery. Conclusions: Our early experience has demonstrated that surgery of the oropharynx can be safely performed with the Da Vinci 5 surgical system. Patient outcomes and complication rates remain similar to those observed in our experience with the Da Vinci Xi and SP systems. Our results demonstrate that the Da Vinci 5 is at least non-inferior to previous models with regards to surgery of the oropharynx. Future studies comprehensively investigating the cost-effectiveness and long-term clinical impact will allow us to determine the added benefits and provide a holistic understanding of the new advance may bring.