Laser‐Assisted Transoral Robotic Supraglottic Laryngectomy

ABSTRACT Objective To describe the operative setup, safety principles, and stepwise technique for laser‐assisted transoral robotic supraglottic laryngectomy using a flexible CO 2 laser system. Methods This operative video demonstrates laser‐assisted transoral robotic supraglottic laryngectomy performed with the da Vinci SP platform. Key technical steps include laser‐safe airway management, transoral exposure with a Feyh–Kastenbauer retractor, robotic docking, flexible CO 2 laser fiber placement through a distal drop‐in guide, aiming‐beam confirmation, noncontact laser dissection, coordinated bedside suction and bipolar hemostasis, and en bloc specimen delivery. Results The technique allows controlled transoral access to the supraglottic larynx with three‐dimensional visualization, precise noncontact laser incision, and preservation of uninvolved glottic and subglottic structures. A deliberate sequence of inferior, lateral, and superior release facilitates exposure of the pre‐epiglottic space, specimen mobilization, and margin‐oriented en bloc resection. Conclusion Laser‐assisted transoral robotic supraglottic laryngectomy combines the precision of CO 2 laser surgery with the visualization and dexterity of single‐port robotic surgery. With appropriate patient selection, strict laser safety, and a standardized team‐based workflow, this technique can support precise en bloc resection, reliable margin assessment, and preservation of uninvolved laryngeal structures.