Robot‐assisted Parotidectomy: Improved Clinical and Patient‐Reported Outcomes
Ruochong Wang, Zhiyan Zhang, Zijun Dai, Anand Gupta, Jinghang Wei, Jialu He, Su Chen, Chunjie Li, Guiquan ZhuAbstract
Objective
To compare perioperative outcomes, postoperative safety, and patient‐reported outcomes among conventional, endoscopic, and robot‐assisted parotidectomy for primary benign parotid tumors.
Study Design
Retrospective comparative study.
Setting
Tertiary academic institution.
Methods
A total of 212 adults undergoing parotidectomy were enrolled from January 2022 to June 2025. All operations were performed by a single medical team; robot‐assisted and endoscopic procedures were performed by a single surgeon to reduce learning‐curve variation. Outcomes included perioperative metrics, short‐ and long‐term complications, local recurrence, scar visual analog scale, and Parotidectomy Outcome Inventory‐8 scores. Inverse probability of treatment weighting was used to reduce confounding; effect estimates are reported as weighted mean differences and odds ratios with 95% confidence intervals.
Results
Among 212 patients (78 conventional, 106 endoscopic, 28 robot‐assisted), statistical analyses showed that despite longer operative times (vs endoscopic: +41.63 minutes; vs conventional: +56.04 minutes), robot‐assisted parotidectomy resulted in lower blood loss (vs endoscopic: −14.03 mL; vs conventional: −10.30 mL). Compared to endoscopic surgery, it exhibited a lower risk of long‐term complications, including facial nerve palsy (−78% in odds). Compared to conventional surgery, both minimally invasive approaches achieved shorter incisions (robot‐assisted: −4.41 cm; endoscopic: −4.71 cm) and improved patient‐reported outcomes, while robot‐assisted surgery additionally reduced the risk of short‐term complications. No increased perioperative or postoperative risk was observed.
Conclusions
Robot‐assisted parotidectomy was associated with improved clinical and patient‐reported outcomes without evidence of increased risk. Its clinical value warrants further validation in prospective multicenter cohorts.