摘要： Background: Monopolar electrocautery (EC) is the surgical cutting and haemostatic tool most commonly used for transoral robotic surgery (TORS). The aim of this study was to retrospectively compare EC e?cacy in the treatment of patients a?ected by T1 or T2 oropharyngeal and supraglottic squamous cell carcinomas with the more recently introduced laser ?bres. Methods: We considered all TORS patients admitted to our department from January 2010 to June 2019. The outcomes of patients treated with Thulium: yttrium aluminium garnet (YAG) laser (TY-TORS), CO2 laser (CO2-TORS) and EC (EC-TORS) were analysed in order to assess surgical performances, functional outcomes and postoperative complications. Results: Twenty patients satis?ed the enrolling criteria, of which nine underwent laser-TORS, and the remaining 11 underwent EC-TORS. In all candidates, TORS procedures were completed without the need for microscopic/open conversion. Close or positive margins were signi?cantly more frequent in EC-TORS (p = 0.028). A considerable di?erence was found in overall functional parameters: times of nasogastric tube and tracheostomy removal and time of hospital discharge were signi?cantly shorter in laser-TORS (p = 0.04, p = 0.05, p = 0.04, respectively). Conclusions: Laser-TORS showed better results in comparison with EC-TORS in term of tumour resection margins and patient functional outcomes. Our ?ndings can be justi?ed with the greater tissue thermal damage caused by EC-TORS, despite prospective randomized trials and increased patient numbers being needed to con?rm these preliminary conclusions.