Execution of Ipsilateral Radical Tonsillectomy and Tongue Base Mucosal Wedge Biopsy with Trans Oral Robotic Surgery (TORS) in the Setting of Carcinoma Unknown Primary (CUP): Insights into Surgical Techniques and Instrumentation

Transoral robotic surgery (TORS) has transformed the management of oropharyngeal tumors with its precise and minimally invasive techniques. However, its role in identifying primary sites in carcinoma of unknown primary with secondary neck nodal metastasis remains understudied. Here, we present a case series of 18 patients who underwent ipsilateral radical tonsillectomy and tongue base mucosal wedge biopsy using transoral robotic surgery (TORS) at a tertiary care institute. This study offers a concise overview of the surgical steps and instrumentation employed in the procedure, focusing on patient positioning, robotic arm placement, optical dilation, tissue dissection, hemostasis, and closure. By elucidating the technical nuances of the surgical procedure, this study aims to promote the adoption of minimally invasive approaches in head and neck surgery, thereby advancing patient care.