Many thanks to Jason Fleming and the entire Liverpool Head & Neck Centre team for sharing this important work on the safety and efficacy of TORS using the Versius Surgical System.
This prospective Phase II clinical trial, conducted at the Liverpool Head & Neck Centre, included 60 TORS procedures for both malignant and benign indications. All procedures were completed without conversion, with no device-related complications. Median setup time was 10 minutes, median operative time 46 minutes, and 98.3% of cases had an estimated blood loss of <100 mL. In oncological resections, negative margins were achieved in 89.3% of cases, including 95.7% of T1–T2 resections.
But for me, the real importance of this paper goes beyond the numbers. We are entering an era of multi-platform robotic surgery. An increasing number of robotic systems are reaching clinical practice, while the volume of Robotic Head&Neck Surgery is still relatively limited (at least until robotic access to the neck becomes more widespread).
This creates a very practical reality: Head&Neck surgeons will increasingly have to work with the robotic platform available in their own hospital. This is particularly relevant because specialty-specific regulatory approval and formal accreditation for Head&Neck applications do not necessarily exist for every robotic platform (even it does not for da Vinci 5!!!).
Therefore, in many centres, the pathway to introducing a new robot into Head&Neck surgery will inevitably involve structured research programmes, appropriate training, institutional governance and, above all, progressively stronger clinical evidence.
We had already started exploring the use of Versius in Head&Neck surgery, reporting our preclinical experience previously. There was a previous report from London (Guy´s ans St Thomas) with 30 TORS procedures in humans. But the Liverpool study represents a major step forward: It is the first formal Phase II trial of Versius in TORS The study was conducted prospectively under a formal clinical trial framework, with MHRA and ethics approval and prospective registration. This is not the beginning of the Versius TORS story, it is the next and substantially stronger piece of evidence in that story. There is still work to do. Both were single-centre, single-arm studies. But the direction is clear. If your hospital has Versius, there is now meaningful prospective clinical evidence supporting its use for TORS.
The future of robotic Head&Neck surgery is unlikely to belong to a single platform. It will belong to evidence, training, adaptability, and surgeons who can make the technology available in their own institutions work safely for their patients.
J Granell. Aug 22, 2026
References
Preclinical studies
Faulkner J, Arora A, Swords C, Cook E, Rajangam A, Jeannon JP. Pre-clinical evaluation of a novel robotic system for transoral robotic surgery. Clin Otolaryngol. 2021 Jul;46(4):869-874. doi: 10.1111/coa.13740. Epub 2021 Feb 27.
Faulkner J, Naidoo R, Arora A, Jeannon JP, Hopkins C, Surda P. Combined robotic transorbital and transnasal approach to the nasopharynx and anterior skull base: Feasibility study. Clinical Otolaryngology 2020; 45:630-633. doi: 10.1111/coa.13550. Epub 2020 May 11.
Granell J, Ramirez-Rosa A, Fernandez-Rastrilla I, Granados-Sitges J, Caballero P, Granell L, Sanchez-Camon I, Mendez-Benegassi I, Gutierrez-Fonseca R. Feasibility of the set-up for the different approaches in robotic head and neck surgery with the Versius Surgical System. J Robot Surg. 2023 Dec;17(6):3035-3038. doi: 10.1007/s11701-023-01696-7.
Arora A, Faulkner J, Paleri V, Kapoor K, Al-Lami A, Olaleye O, Winter S, Oikonomou G, Ofo E, Ourselin S, Dasgupta P, Slack M, Jeannon JP. New robotic platform for transoral robotic surgery: an IDEAL stage 0 study. BMJ Surg Interv Health Technol. 2024 Mar 15;6(1):e000181. doi: 10.1136/bmjsit-2022-000181. PMID: 38500710; PMCID: PMC10946345
Clinical series
Faulkner J, Arora A, McCulloch P, Robertson S, Rovira A, Ourselin S, Jeannon JP. Prospective development study of the Versius Surgical System for use in transoral robotic surgery: an IDEAL stage 1/2a first in human and initial case series experience. Eur Arch Otorhinolaryngol. 2024 May;281(5):2667-2678. doi: 10.1007/s00405-024-08564-6.
Fleming JC, Davies K, Loh C, Wilkie M, Lawson X, Truckle S, Constable J, Gwinnutt J, Rodrigues J, Banks P, Mellor Z, Jones TM. Safety and Efficacy of the Versius Surgical System in Transoral Robotic Surgery: A Prospective Study. Otolaryngol Head Neck Surg. 2026 Aug 17. doi: 10.1002/ohn.70402.
Related posts (in this Web)
– Versius for TORS: from feasibility to clinical evidence Aug22, 2026
– Ultrasonic Dissector for the Versius. Feb 17, 2025
– Stabilizing Versius instruments in TORS Sep 15, 2024
– BABA with the Versius Surgical System Mar 12, 2024