More than 10 years have passed since the da VinciⓇ Surgical System (Intuitive Surgical Inc.) was introduced to head and neck cancer treatment. It has spread all over the world very quickly and the indications for this procedure have been expanding. Trans-oral robotic surgery (TORS) was initially applied to oropharyngeal cancer (anterior wall and lateral wall), and is now widely used for naso-and hypo-pharyngeal cancer treatment. Although its indications remain open to discussion, TORS demonstrates good accessibility and operability for nasopharyngeal cancer. As for hypopharyngeal cancer, it is still difficult to obtain good exposure of the hypopharynx. However, new instruments have been shown to work in the hypopharynx, and the difficulty of exposing the hypopharynx will be addressed by making the instruments smaller. In Japan, a multi-institutional clinical study of TORS was completed last year, and the use of surgical robots has just been approved in the field of otolaryngology. Currently, in order to ensure the quality and safety of TORS, related societies are preparing rules and systems for conducting TORS.
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