Abstract
Transoral robot-assisted surgery (TORS) enables minimally invasive procedures in the areas of the mouth, palate, pharynx, larynx and tonsils. It offers numerous advantages such as enhanced precision, improved access and reduced surgical trauma compared to traditional, more invasive techniques; however, TORS also presents new anesthesiological challenges, particularly concerning airway management, anesthesia management and perioperative care. These aspects are the focus of this review. A key issue in TORS is airway management as many patients present with risk factors for a difficult airway, while at the same time it is essential to minimize obstruction of the surgical field and access. Several options are available for securing the airway during TORS. This article outlines and discusses the advantages and disadvantages of the various techniques. Special attention is paid to a novel ultra-thin endotracheal tube known as the Tritube©, which thanks to its slim design opens up new surgical and anesthesiological possibilities. The associated technique of flow-controlled ventilation (FCV) is discussed and compared to more established ventilation methods such as volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV). This article aims to provide an overview of anesthesia management in TORS, highlight potential risks and outline strategies to mitigate them.