The recent article “20 Years of Transoral Robotic Surgery”, published in the AAO-HNS Bulletin, provides an excellent and timely overview of two decades of innovation that have profoundly transformed the field of Otolaryngology – Head and Neck Surgery. I would like to begin by thanking Gregory S. Weinstein, for kindly sharing this article with me and inviting reflection on the remarkable journey of TORS since its inception.
This anniversary offers an opportunity not only to review the historical milestones of TORS (Transoral Robotic Surgery,) but also to recognize the pioneering role of the Department of Otorhinolaryngology – Head and Neck Surgery at the University of Pennsylvania. It was within this academic and clinical environment that TORS was conceived, developed, and rigorously validated, ultimately reshaping surgical paradigms for oropharyngeal cancer and other head and neck tumors.
The leadership and vision of Gregory S. Weinstein and Bert W. O’Malley, were central to this transformation. Their work demonstrated that minimally invasive transoral approaches could achieve sound oncologic outcomes while significantly improving functional results, setting new standards for patient-centered care in head and neck oncology. Beyond their scientific contributions, their commitment to education and international collaboration has been instrumental in the global dissemination of TORS.
From an institutional perspective, we would like to express our sincere appreciation, on behalf of the Department of Otorhinolaryngology and the Hospital Universitario Rey Juan Carlos, for the continued support provided by the Philadelphia team to our own robotic surgery program, which was initiated in 2012. This collaboration was particularly impactful during my observership and training stay in Philadelphia in April 2013, which played a key role in consolidating our clinical and academic approach to transoral robotic surgery.
We are also grateful for the academic generosity reflected in the foreword to the book An Introduction to Robotics in Head and Neck Surgery (2015), edited by Raimundo Gutierrez Fonseca and myself. That contribution symbolized the spirit of mentorship and openness that has characterized the TORS community since its early days and continues to drive progress in the field. We have reproduced many times the original TORS training course scheme, and hope to also have contributed to the expansion of TORS in our country, and in some other parts of the world.
Twenty years after the first clinical application of TORS, the technique continues to evolve, supported by technological advances, expanding indications, and increasingly robust outcome data. This anniversary is not only a moment to celebrate past achievements, but also to reaffirm the importance of collaborative academic networks, structured training, and responsible innovation—the same principles that enabled TORS to emerge and flourish.
The story of TORS over the past two decades stands as a powerful example of how vision, teamwork, and international collaboration can translate technological innovation into meaningful improvements in patient care.
J Granell. Jan 9, 2026