Pre-clinical training, technical adjustment and human case experience of transoral robotic surgery using Versius System

• Transoral Robotic Surgery is well-established using the DaVinci system. • Transoral robotic surgery with the Versius System is currently in its initial stage. • A mannequin model was effective for training and setup configuration. • The first human case demonstrated feasibility and excellent results. • In our preliminary experience, Versius proved to be a promising robotic system. This study describes the training experience with the Versius Robotic System (CMR Surgical) for Transoral Robotic Surgery (TORS), the setup of the robot and its applicability in a human case. A model mannequin with anatomical characteristics simulating the TORS working space was used for training purposes. Optimal docking, positioning of robotic arms and placement of instruments were defined using the mannequin. A human patient was selected based on the inclusion criteria, and a standardized protocol for robotic techniques was developed. The surgical procedure was conducted in accordance with ethical guidelines. The synthetic polymer mannequin mimicking human tissues and anatomy was used to define the robot set up for TORS. The patient was indicated for bilateral tonsillectomy due to recurrent episodes of tonsillitis. Bipolar Maryland and monopolar scissors were used. The procedure was uneventful. The patient remained hospitalized for 1 day and returned to work activities within 6-days, with no complications. The specialized mannequin proved to be effective in the simulation, training proposal and set up standardization. Furthermore, the Versius robot was found to be safe and achieved excellent results during surgery. Despite being very promising, the Versius system is still in its developmental phase and requires larger-scale samples for a more comprehensive evaluation. 4.