da Vinci Single‐Port Transoral Robotic Surgery in European Practice: Early Outcomes and Comparison With Transoral Laser Microsurgery

ABSTRACT Objectives To report early outcomes following implementation of a da Vinci Single‐Port transoral robotic surgery (SP‐TORS) programme in the United Kingdom. To provide contextual benchmarking, outcomes were compared with a historical institutional cohort treated using transoral laser microsurgery (TLM). Design Retrospective institutional series with comparison against a historical cohort using stabilised inverse‐probability‐of‐treatment weighting. Setting High‐volume UK Tertiary Head and Neck Centre. Participants All patients undergoing SP‐TORS between April 2024 and September 2025. Comparative analyses were limited to oncological resections and included 33 SP‐TORS and 61 TLM cases. Main Outcome Measures Feasibility, peri‐operative safety, postoperative haemorrhage, return to theatre, mortality, length of stay, time to oral diet, margin status and adjuvant therapy use. Results Sixty‐six patients underwent SP‐TORS. All procedures were completed transorally without unplanned conversion or peri‐operative mortality. Postoperative haemorrhage occurred in 4.5%, with one return to theatre. Length of stay did not differ between groups. Time to oral diet was longer following SP‐TORS (adjusted ratio 1.51, p = 0.005). ASCO‐defined involved margins were similar (OR 0.30, 95% CI 0.06–1.56; p = 0.15), whereas specimen ink‐positive margins were less frequent following SP‐TORS (OR 0.31, 95% CI 0.11–0.91; p = 0.03). A sensitivity analysis using propensity‐matched T1/T2 pairs demonstrated a consistent directional effect, though this did not reach significance in the smaller matched cohort. Adjuvant therapy use was comparable. Conclusion SP‐TORS implementation in a high‐volume UK centre was feasible and safe during early adoption, with low complication rates. Peri‐operative and early functional outcomes were broadly comparable with TLM. Although specimen ink‐positive margins were less frequent following SP‐TORS, interpretation should be cautious given the historical comparator and associated differences in departmental workflow. These findings support safe integration of SP‐TORS into transoral surgical practice and justify prospective evaluation.