TORS with the Flex® Robotic System

Robot-assisted surgery has become a popular alternative to many open traditional surgical procedures. While modern robotic surgical techniques have been described since the late 1980s, telesurgery (i.e., surgery done at a distance from the patient) was first successfully performed in 2001, when physicians situated in New York removed the gallbladder of a 62-year-old patient in Strasbourg, France [1]. Since then, technology has improved and remote robotic surgery has become quite prevalent and sophisticated. Used primarily in urology and gynecology at its inception, transoral robotic surgery (TORS) was eventually developed for use in head and neck procedures. The da Vinci system® (Intuitive Surgical Inc., Sunnyvale, CA, USA) is one such advanced robot, studied extensively at the University of Pennsylvania for its application in TORS in order to perfect and standardize its use [1, 2]. The da Vinci was the only tool available to perform TORS on the head and neck, yet has its own limitations. The newest iteration of robotic surgical equipment is the Flex® Robotic System (Medrobotics, Raynham, MA, USA), which improves upon some of the shortcomings of its predecessors. This chapter will focus on the present state of TORS of the head and neck and the future possibilities which improved technology can provide.