A best evidence topic was written according to a structured protocol. The question addressed was
whether TransOral Robotic Surgery (TORS) is a safe and effective multilevel treatment for Obstructive
Sleep Apnoea (OSA) in obese patients following failure of conventional treatment(s). A total of 39 papers
were identi
fi
ed using the reported searches of which 5 represented the best evidence to answer the
clinical question. The authors, date, journal, study type, population, main outcome measures and results
are tabulated. Existing treatments for OSA - primarily CPAP - though highly effective are poorly tolerated
resulting in an adherence often lower than 50%. As such, surgery is regaining momentum, especially in
those patients failing non-surgical treatment (CPAP or oral appliances). TORS represents the latest
addition to the armamentarium of Otorhinolaryngologists - Head and Neck Surgeons for the manage-
ment of OSA. The superior visualisation and ergonomics render TORS ideal for the multilevel treatment
of OSA. However, not all patients are suitable candidates for TORS and its suitability is questionable in
obese patients. In view of the global obesity pandemic, this is an important question that requires
addressing promptly. Despite the drop in success rates with increasing BMI, the success rate of TORS in
non-morbidly obese patients (BMI
¼
30-35kgm
-2
) exceeds 50%. A 50% success rate may at
fi
rst seem low,
but it is important to realize that this is a patient cohort suffering from a life-threatening disease and no
option left other than a tracheostomy. As such, TORS represents an important treatment in non-morbidly
obese OSA patients following failure of conventional treatment(s)