Current Advances in Robotics for Head and Neck Surgery—A Systematic Review

Abstract

Background. In the past few years, surgical robots have recently entered the medical field, particularly in urology, gynecology, and general surgery. However, the clinical effectiveness and safety of robot-assisted surgery (RAS) in the field of head and neck surgery has not been clearly established. In this review, we evaluate to what extent RAS can potentially be applied in head and neck surgery, in which fields it is already daily routine and what advantages can be seen in comparison to conventional surgery. Data sources. For this purpose, we conducted a systematic review of trials published between 2000 and 2021, as well as currently ongoing trials registered in clinicaltrials.gov. The results were structured according to anatomical regions, for the topics “Costs,” “current clinical trials,” and “robotic research” we added separate sections for the sake of clarity. Results. Our findings show a lack of large-scale systematic randomized trials on the use of robots in head and neck surgery. Most studies include small case series or lack a control arm which enables a comparison with established standard procedures. Conclusion. The question of financial reimbursement is still not answered and the systems on the market still require some specific improvements for the use in head and neck surgery.

Cumulative sum analysis of the learning curve for robotic retroauricular thyroidectomy

“…We aimed to evaluate the learning curve for robotic retroauricular thyroidectomy using CUSUM analysis and share our experiences. Currently, robotic surgery is recognized as the standard in visceral surgery in gynecology and urology (17). The advantages of robotics in head and neck surgery include the avoidance of scarring on the face and neck, and the possibility of performing precise surgery in a narrow anatomic region where major vessels and cranial nerves are complexly clustered.…”

Robotic and robot-assisted skull base neurosurgery: systematic review of current applications and future directions

“…The proportion of surgical procedures using robot-as-sisted systems is growing rapidly, with a variety of semicustomizable robotic systems currently available on the market. 10,34 There have been promising attempts at incorporating robotic instrumentation into skull base neurosurgery, although the overall impact and scope of robotics in the daily practice of skull base neurosurgery is minimal. We performed this review to identify current strategies and attempts for accessing skull base anatomy using robotics and to identify potential systems or approaches that may have feasibility over the coming years.…”

“…6,7 There is significant literature pertaining to the use of robot-assisted surgery for accessing the skull base for otolaryngological applications, including relatively large clinical case series and systematic reviews. [8][9][10] Given the growing use of the EEA to reach the skull base and the continually reduced size of robot-assisted systems such as the da Vinci Surgical System (Intuitive Surgical Inc.), robotic applications in skull base neurosurgery are growing in importance but remain relatively understudied.…”

Evaluation of a curved surgical prototype in a human larynx

“…Based on our evaluation, the additional costs for a surgical procedure assisted by a DaVinci system are approximately 6000 EUR (7100 USD). These costs are made up of maintenance charges, acquisition costs, as well as instrument acquisition and reprocessing [ 15 ]. Likewise, the cost of a procedure with the s-MAC system consists of investment and operating costs: The C-MAC D-BLADE videolaryngoscope and suitable monitor, which are already available in most hospitals, can be seen as initial investments.…”