A novel technique in transoral robotic surgery: A case report of rotating and switching technique.

Background: Transoral robotic surgery (TORS) for tongue base lesions located above the operative field is predominantly an upward procedure, which makes surgery difficult.
Methods: To illustrate our technique for this procedure, we report the case of an 82-year-old male with a p16-negative oropharyngeal carcinoma of the tongue base who underwent TORS. The field of view was turned upside down, and the operation switched the typical left- and right-arm functions. The daVinci Xi was docked, the 0° endoscope was rotated 180°, and the first arm was switched to the right hand and the third arm to the left hand.
Results: Although the lesion extended from the tongue base to the soft palate and mobile tongue, the planned resection line was followed.
Conclusions: This technique improves operability by allowing downward manipulation and preventing the left and right arms from crossing. Further validation of the technique's effectiveness and safety is needed.
(© 2023 John Wiley & Sons Ltd.)