Current Trends in Robotic Surgery for Otolaryngology

Byrd, J. Kenneth; Duvvuri, Umamaheswar

doi:10.1007/s40136-013-0025-6

Cited by 28 publications

(31 citation statements)

References 42 publications

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“…45 However, the role of the da Vinci robot has increased dramatically because of additional developments and refinements, and it has been used for a wide range of procedures in the head and neck. [51][52][53] There are intraoperative issues that are specific to TORS. Previous studies have reported a setup time of 15 to 19 minutes, with an operative time of 39 to 84 minutes, depending on the exact procedure and experience level of the team.…”

Section: Transoral Robotic Surgerymentioning

confidence: 99%

Transoral Robotic Surgery in Oropharyngeal Carcinoma

Helman¹,

Schwedhelm²,

Kadakia³

et al. 2015

Archives of Pathology &Amp; Laboratory Medicine

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Context The incidence of oropharyngeal squamous cell carcinoma has increased during the past decade and is related primarily to the human papillomavirus. This change in etiology, from tobacco and alcohol to human papillomavirus, has resulted in improved survival for the disease. In the United States, open resection had largely been replaced by concurrent chemotherapy and/or radiotherapy by the early 2000s. The advent of transoral surgery has led to an increase in surgery as the primary treatment for both early- and advanced-stage oropharyngeal squamous cell carcinoma because it has potential advantages over open surgery and nonsurgical modalities. Objective To provide an overview of transoral robotic surgery for oropharyngeal squamous cell carcinoma and contrast it with other surgical and nonsurgical modalities. Data Sources Articles from 2000 to 2014 were accessioned on PubMed and reviewed for utility by the primary authors. Conclusions Transoral surgery has become more commonly used as a minimally invasive approach to treat oropharyngeal tumors. Other strategies, including radiation, chemotherapy with radiation, and open surgery, are still important treatment approaches. The treatment options for an individual patient rely on multiple factors, including the tumor location and size, features of the tumor, and patient comorbidities. The continued study of these techniques is important to match the patient with the most appropriate treatment.

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Section: Transoral Robotic Surgerymentioning

confidence: 99%

Transoral Robotic Surgery in Oropharyngeal Carcinoma

Helman¹,

Schwedhelm²,

Kadakia³

et al. 2015

Archives of Pathology &Amp; Laboratory Medicine

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“…This system, developed for use in thoracoscopy and laparoscopy, utilizes rigid 3D high‐definition angled and linear endoscopes in combination with robotic arms, and offers many unique aspects, including endowrist movement and tremor filtering . The da Vinci system is not without challenges though, most notable the system's large footprint and rigid, linear scopes, which limits its access to regions in the head and neck that cannot be exposed via “line‐of‐sight.” Flexible endoscopes to visualize around the curves of the tongue base and pharynx have previously been used for biopsies and surveillance but until recently could not be used for surgical resection secondary to the lack of tension/counter tensions required for resection.…”

Section: Introductionmentioning

confidence: 99%

Transoral surgery using the Flex Robotic System: Initial experience in the United States

et al. 2018

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Background This multicenter, retrospective review documents the initial experience using the Flex system for transoral surgery in 2 United States academic centers. Methods All patients who underwent transoral robotic surgery using the Medrobotics Flex Robotic System (Raynham, MA) between September 2015 and May 2017 were reviewed. Rates of successful surgery and complications were evaluated. Results Thirty‐six men and 32 women were enrolled in the study. The average age was 55.6 years (range 17‐82 years). The Flex system was used successfully in surgery of the tongue base, the palatine tonsils, the supraglottis, the glottis, the hypopharynx, the oral tongue, and the soft palate. Only 6 cases (7.6%) required readmission after discharge. There were no intraoperative or immediate postoperative complications, with no cases of intraoperative hemorrhage. Conclusion To the best of our knowledge, this is the first study in the United States evaluating the use of the Flex system to safely resect lesions in the oral cavity, larynx, and pharynx.

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“…TLM has well documented acceptable oncologic outcomes, and interim functional and disease-control data have indicated that TORS can additionally be a safe, useful, and cost-effective component in the approach to a variety of conditions in the head and neck [5,10,17,[23][24][25][26]. There are ongoing efforts to further document the value of both TLM and TORS and expand the clinical application of these techniques.…”

Section: Introductionmentioning

confidence: 99%

Transoral endoscopic head and neck surgery (eHNS) for minor salivary gland tumors of the oropharynx

et al. 2017

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Background: Transoral endoscopic head and neck surgery (eHNS), including transoral laser microsurgery (TLM) and transoral robotic surgery (TORS), provides access to subsites in the head and neck that have traditionally been difficult to approach. Minor salivary gland tumors, while relatively uncommon, are frequently malignant and can occur at sites in the oropharynx accessible by transoral eHNS. Presented here is the largest review to date of patients with minor salivary gland tumors of the oropharynx managed with transoral eHNS as primary or salvage therapy. Methods: A retrospective chart review was performed, including data from 20 patients with minor salivary gland tumors of the oropharynx managed with transoral eHNS at 2 tertiary, academic medical centers. Details of tumor pathology, margin analysis, adjuvant therapy, and an assessment of oncologic outcome were included. Results: The base of tongue was the most common tumor site (75%). Adenoid cystic carcinoma (ACC) accounted for most cases (35%), and negative margins were obtained in most (95%) through an endoscopic-only approach. Overall, 50% of patients received post-operative radiation therapy. Postoperative complications were limited, with one patient (5%) returning to the OR for control of post-operative oropharyngeal bleeding. On average follow-up of 36 months, 90% of patients were alive with no evidence of recurrence.

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Current Trends in Robotic Surgery for Otolaryngology

Cited by 28 publications

References 42 publications

Transoral Robotic Surgery in Oropharyngeal Carcinoma

Transoral Robotic Surgery in Oropharyngeal Carcinoma

Transoral surgery using the Flex Robotic System: Initial experience in the United States

Transoral endoscopic head and neck surgery (eHNS) for minor salivary gland tumors of the oropharynx

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