Introduction: Transoral robotic surgery has been dominated by a single family of robotic platforms. The Versius Surgical System from CMR Surgical is a UK based novel robotic platform that offers an alternative to the currently available robotic systems. This study evaluates this novel system for use in TORS and reports a world first in human experience.
Methods: This is a first in human and small cohort feasibility study in which patients received TORS with the Versius robotic system. All procedures were performed at a single, UK, tertiary head and neck centre in accordance with IDEAL-D Stage 1/2a study principles. The primary outcome was successful completion of procedures. Secondary outcomes include setup and operative times, intra and post-operative complications, patient reported outcomes and surgeon reported outcome measures.
Results: 10 patients underwent TORS with the Versius robot. The first 5 patients had benign pathology before proceeding to patients with malignant disease. All procedures were successfully completed. Surgical access was not limited to each anatomical site and no significant operative issues occurred. Mean setup time was 24 minutes, mean surgical time was 48 minutes per procedure. No significant complications occurred. Patient reported outcomes were consistent with the general TORS cohort and surgeon reported outcomes were that TORS can feasibly be performed with the Versius robotic platform. The operative surgeons reported that the available instruments differed from what is available with other systems and some instrument optimisation would be desirable.
Conclusions: This IDEAL stage1/2a first in human study demonstrates that transoral robotic surgery for oropharyngeal pathology is feasible using the Versius Surgical System. The system performed favourably in all domaines and Versius may offer a viable alternative to other robotic platforms. The development of TORS specific instrumentation is desired by the the surgical team to enhance the performance of the system. A larger multicentre evaluation of Verius in accordance to IDEAL is recommended to further evaluate the use of Versius in TORS.
