Transoral robotic surgery for obstructive sleep apnea syndrome: Principles and technique

Objective: The present study is a review of transoral robotic surgery (TORS) for the treatment of obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods: The review presents the experience of the robotic center that developed the technique with regards to patient selection, surgical method, and post-operative care. In addition, the review provides results of a systematic review and meta-analysis of the complications and clinical outcomes of TORS when applied in the management of OSAHS. Results: The rate of success, defined as 50% reduction of pre-operative AHI and an overall AHI <20 events/h, is achieved in up to 76.6% of patients with a range between 53.8% and 83.3%. The safety of this approach is reasonable as the main complication (bleeding) affected 4.2% of patients (range 4.2%-5.3%). However, transient dysphagia (7.2%; range 5%-14%) does compromise the quality of life and must be discussed with patients preoperatively. Conclusions: TORS for the treatment of OSAHS appears to be a promising and safe procedure for patients seeking an alternative to traditional therapy. Appropriate patient selection remains an important consideration for successful implementation of this novel surgical approach requiring further research.