Transoral robotic surgery: A personal journey of innovation and transformation

Transoral robotic surgery (TORS) represents one of the most significant advances in the surgical management of head and neck tumors over the past half century. As a pioneer of TORS, I co-led and witnessed firsthand the translation of robotic technology from far-reaching concept to transformative clinical practice. This manuscript provides a first-person account of the development, validation, and dissemination of TORS. It describes the original rationale, motivations, preclinical studies, initial clinical applications, and major resistance encountered in this journey of disruptive innovation. In addition, the process for overcoming the resistance to change, acquiring the first Food and Drug Administration (FDA) approval, initiating training programs, and expanding into the depth of an oncologic treatment paradigm will be discussed. Beyond the technical milestones of introducing innovation, this narrative emphasizes the leadership, perseverance, and collaboration required to bring a disruptive innovation from vision to standard of care.