Transoral Robotic Surgery (TORS): Procedure, Recovery, Risks and Results
Updated: 3 days ago
Written and medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: November 2026 · How we review
Quick Answer: What is transoral robotic surgery (TORS)?
Transoral robotic surgery (TORS) is an operation that removes tumors at the back of the throat through the mouth. A surgeon controls a camera and three robotic instruments from a console, so there is no need to split the jaw or make large cuts in the face or neck. Most people go home in 2 to 3 days. [1]
What the research says
TORS controls early throat cancer well. In 410 patients treated at 11 institutions, 2-year locoregional control was 91.8%, disease-specific survival 94.5% and overall survival 91%. (de Almeida et al., JAMA Otolaryngology–Head & Neck Surgery, 2015) [2]
TORS and radiotherapy are both reasonable options. In a randomized trial of 68 patients with early oropharyngeal cancer, 1-year swallowing scores were 86.9 after radiotherapy and 80.1 after TORS with neck dissection, a difference that was not clinically meaningful; side effect patterns differed between the two. (Nichols et al., The Lancet Oncology, 2019) [3]
Key takeaways
TORS reaches tumors at the back of the throat through the mouth using a robotic camera and instruments. [1]
It treats oropharyngeal, hypopharyngeal and laryngeal cancers, and some noncancerous problems such as obstructive sleep apnea. [1]
The robotic part usually takes 1.5 to 2 hours; with neck surgery, total time is about 4 to 5 hours. [1]
Most people stay in the hospital 2 to 3 days, compared with up to 15 days after jaw-splitting surgery. [1]
Pain and swallowing trouble usually ease in about 2 to 3 weeks. [1]
How does TORS work?
TORS works by passing a camera and robotic instruments through a single port in the mouth. The surgeon sits at a console, sees the back of the throat in 3D and steers three multi-jointed instruments that bend and flex in many directions. [1]
Before TORS, reaching these tumors often meant a mandibulotomy, which splits the lower jaw. That operation could take up to 12 hours and needed a long recovery. The FDA approved TORS in the United States in 2009, and its use has grown every year since. [1]
TORS avoids splitting the jaw, which shortens surgery and recovery.
What conditions does TORS treat?
TORS is mainly used for cancers at the back of the mouth and throat, and increasingly for some noncancerous conditions. [1]
Condition | Where it is |
Back of the tongue or the tonsils; HPV-related cases are rising | |
Lower part of the throat | |
Laryngeal cancer | Voice box (larynx) |
Benign tumors and cysts | Mouth and throat |
Airway blockage during sleep | |
Lingual tonsillitis | Inflamed tonsils at the base of the tongue |
Sources: [1]
Who is a candidate for TORS?
Whether TORS suits you depends on your overall health, your head and neck anatomy and how far a cancer has spread. Your provider recommends it only when it is safe and likely to work. You may not be a candidate if you have: [1]
Cancer that has spread too far to remove with surgery
Breathing problems that make surgery dangerous
A small mouth or other factors that make access difficult
Conditions that raise the risk of heavy bleeding
How do you prepare for TORS?
Preparing for TORS usually includes imaging scans to plan surgery and a swallowing evaluation with a speech-language pathologist (SLP), who also helps plan your recovery. [1]
What happens during TORS?
During TORS, you are fully asleep while the surgeon removes the tumor through your mouth from the robotic console. [1]
Nurses and assistants stay in the room to help and monitor you.
You receive anesthesia, so you feel no pain and are not aware of the surgery.
The robot port is lowered, and the camera and instruments are placed through the mouth.
The surgeon removes the tumor from the console, aiming to remove all of the disease.
If cancer may have spread to the neck, lymph nodes are removed (neck dissection) through the smallest possible incision.
Sources: [1]
Part of surgery | Typical time |
Robotic tumor removal | About 1.5 to 2 hours |
Total, including neck surgery and checks | About 4 to 5 hours |
Sources: [1]
What is recovery like after TORS?
Recovery after TORS is usually faster than after open surgery. Most people stay in the hospital 2 to 3 days and return to everyday activities within a few weeks. [1]
Added radiation or chemotherapy can change your recovery timeline.
In the hospital: your team watches for bleeding, keeps your airway clear and manages pain. [1]
Nutrition: a feeding tube may be used until you can eat by mouth. [1]
Swallowing: pain and swallowing trouble usually last about 2 to 3 weeks, and many people work with an SLP. [1]
At home: you get guidance on activity, easy-to-swallow foods and medicines for pain and constipation. [1]
What are the benefits and risks of TORS?
Compared with open surgery, TORS offers more precision, shorter surgery, an easier recovery and fewer complications. Complete removal of a tumor may also reduce or remove the need for radiation or chemotherapy. [1]
TORS | Open jaw-splitting surgery | |
Operating time | Often under 2 hours | Up to 12 hours |
Hospital stay | Usually 2 to 3 days | Up to 15 days |
Visible scars | Fewer | More |
Tracheostomy or major reconstruction | Less likely | More likely |
Sources: [1]
For early oropharyngeal cancer, one large study reported 3-year survival of 93% to 96% after TORS, similar to radiation therapy. [1] Complications are less common than with open surgery but can include: [1]
Abnormal bleeding, including hemorrhage
Aspiration, when food or liquid enters the lungs
Breathing problems, sometimes needing a tracheostomy
Temporary trouble swallowing
Risk is lower with a surgeon who has extensive TORS experience. [1]
When should you call your doctor after TORS?
Contact your provider right away if you have: [1]
Fever or other signs of infection
Signs of dehydration, such as dry mouth or dark urine
Bleeding from the surgical site
Difficulty breathing or swallowing
Nausea, vomiting or unusual swelling
Conclusion
TORS lets surgeons remove many throat tumors through the mouth, with shorter operations, faster recovery and fewer lasting speech and swallowing problems than open surgery. It is not right for every tumor, so candidacy is decided case by case.
If TORS has been suggested, ask your surgeon why you are a good candidate and how it compares with radiation or chemotherapy for your cancer.
Keep learning: Read our guide to throat cancer and the HPV connection or learn how the HPV vaccine lowers risk. For more background, see the National Cancer Institute's oropharyngeal cancer treatment page.
FAQ
What is transoral robotic surgery (TORS)?
TORS is minimally invasive surgery that removes tumors at the back of the throat through the mouth using robotic instruments and a 3D camera.
What conditions does TORS treat?
It treats oropharyngeal, hypopharyngeal and laryngeal cancers, plus benign tumors, sleep apnea and lingual tonsillitis.
Does TORS leave a scar?
TORS needs no external cuts to reach the tumor, though a small neck incision may be made if lymph nodes are removed.
How long does TORS take?
The robotic part takes about 1.5 to 2 hours, or about 4 to 5 hours with neck surgery.
How long is the hospital stay after TORS?
Most people stay 2 to 3 days, compared with up to 15 days after jaw-splitting surgery.
How long does recovery from TORS take?
Pain and swallowing trouble usually ease in 2 to 3 weeks, and most people resume daily activities within a few weeks.
Will I be able to swallow after TORS?
Swallowing is often difficult at first but usually improves within a few weeks, often with help from a speech-language pathologist.
What are the risks of TORS?
Risks include bleeding, aspiration, breathing problems that may need a tracheostomy and temporary swallowing difficulty.
Is TORS as effective as radiation for throat cancer?
For early-stage cancers, TORS has results comparable to radiation therapy, with 3-year survival of 93% to 96% in one large study.
Who is not a candidate for TORS?
People with cancer that has spread too far, serious breathing problems, a small mouth or a high bleeding risk may not qualify.
How do I prepare for TORS?
Preparation usually includes imaging scans to plan surgery and a swallowing evaluation with a speech-language pathologist. Stop eating and drinking after midnight before surgery unless told otherwise, and stop certain medicines, such as blood thinners, as your surgeon instructs [1].
Does TORS hurt, and what anesthesia is used?
You receive anesthesia, so you are fully asleep and feel no pain during surgery. Afterward, pain and trouble swallowing usually last about 2 to 3 weeks, and your team gives you medicines for pain [1].
When should I call my doctor after TORS?
Contact your provider right away if you have a fever or other signs of infection, signs of dehydration such as dry mouth or dark urine, bleeding from the surgical site, difficulty breathing or swallowing, or nausea, vomiting or unusual swelling [1].
Related Reading
Oropharyngeal Cancer: Symptoms, Causes, Diagnosis, Treatment, and Outlook — What You Need to Know covers the cancer most often treated with TORS.
Tonsil Cancer: Symptoms, Causes, Diagnosis, and Treatment explains a common type of throat cancer that TORS can remove.
Throat Cancer: Symptoms, the HPV Connection, and How Treatment Is Decided — A Complete Patient Guide explains how surgery, radiation and chemotherapy are chosen.
References
Cleveland Clinic. Transoral Robotic Surgery (TORS). Cleveland Clinic. Last updated April 22, 2024. https://my.clevelandclinic.org/health/procedures/transoral-robotic-surgery-tors
de Almeida JR, Li R, Magnuson JS, et al. Oncologic Outcomes After Transoral Robotic Surgery: A Multi-institutional Study. JAMA Otolaryngol Head Neck Surg. 2015;141(12):1043-1051. PMID 26402479. https://doi.org/10.1001/jamaoto.2015.1508
Nichols AC, Theurer J, Prisman E, et al. Radiotherapy versus transoral robotic surgery and neck dissection for oropharyngeal squamous cell carcinoma (ORATOR): an open-label, phase 2, randomised trial. Lancet Oncol. 2019;20(10):1349-1359. PMID 31416685. https://doi.org/10.1016/S1470-2045(19)30410-3
Medical disclaimer
This article is for general education only and does not replace advice from a qualified healthcare professional. Talk to your doctor about your own diagnosis and treatment, and seek emergency care right away for severe or sudden symptoms.
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