First use of a new retractor in transoral robotic surgery (TORS)

Abstract

Transoral robotic surgery (TORS) has gained importance in head and neck surgery due to the possibility to visualize regions within the pharynx and larynx which are difficult to access. The success of transoral surgery depends on the exposure of the region of interest in order to allow visualization using a camera system. The Medrobotics Flex(®) Robotic System is a new flexible endoscopic system designed to overcome difficulties experienced in transoral surgery using other robotic systems with rigid endoscopes and instruments. In this article, we describe the first use of the Medrobotics Flex(®) Retractor in humans, a retractor designed for advanced transoral procedures. We report our experience in 11 patients requiring surgery of the oropharynx, hypopharynx, and supraglottic larynx. In all cases, we successfully exposed all targeted surgical regions. We experienced easy handling of the retractor alongside comparable positioning times and no observed mucosal damage.

Improving exposure for transoral oropharyngeal surgery with the floor of mouth window: A cadaveric feasibility study

“…Others have sought to solve the access problem by innovating on the gag itself. Transoral surgeons have used the McIvor, Boyle-Davis, Dingman, FK, and LARS retractors, including unnamed variants, plus the myriad of tongue blades that accompany all this hardware [14–17]. Some opt for laryngoscopes, and these too come in many shapes and sizes.…”

Flex Robotic System in transoral robotic surgery: The first 40 patients

“…In 11 patients, a diagnostic endoscopy followed by a biopsy was carried out (Table ), and in 29 patients, the total resection of a lesion or tumor was the goal of the surgical procedure (Table ). In the first 15 patients, the Feyh–Kastenbauer retractor (Gyrus ACMI, Southborough, MA) was used for exposure of the pharynx and larynx, whereas in the following 25 cases, a newly designed retractor (Flex Retractor System; Medrobotics) was applied. In procedures in the anterior anatomic neck regions, such as the base of the tongue, vallecula, or epiglottis, we preferred a transnasal intubation, placing the intubation tube at the posterior pharyngeal wall in order to achieve a broad exposure (Fig.…”

Hybrid procedure for total laryngectomy with a flexible robot‐assisted surgical system

“…As previously described, the scope is mounted on a cart and stand beside the surgical table to approach the oral cavity from the caudal direction . For optimal opening of the oral cavity a newly designed retractor (Flex® Retractor, Medrobotics, MA) was introduced as previously described by Hasskamp et al, featuring curved blades and additional adjustment capabilities (Figure S1a) .…”