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

Schuler, Patrick J.; Hoffmann, Thomas; Veit, J.; Rotter, Nicole; Friedrich, Daniel; Greve, Jens; Scheithauer, Marc O.

doi:10.1002/rcs.1749

Cited by 22 publications

(22 citation statements)

References 22 publications

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“…To date, the Medrobotics Flex System (Medrobotics, Raynham, USA) is the only commercially available system to overcome the demand of a straight line of sight. The flexible construction is reported to be beneficial for laryngeal surgery on cadaver models, although success in clinical application has been restricted to selected cases and supraglottic entities …”

Section: Discussionmentioning

confidence: 99%

Teleoperated tubular continuum robots for transoral surgery – feasibility in a porcine larynx model

Friedrich

Modes

Hoffmann

et al. 2018

Robotics Computer Surgery

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Section: Discussionmentioning

confidence: 99%

Teleoperated tubular continuum robots for transoral surgery – feasibility in a porcine larynx model

Friedrich

Modes

Hoffmann

et al. 2018

Robotics Computer Surgery

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“…16 Most of the TORS total laryngopharyngeal surgeries have involved combined transcervical and TORS approaches. [16][17][18] An early report described transoral robotic supracricoid partial laryngectomy with cartilaginous framework preservation, 19 a cartilage-preserving approach was described, and cricohyoidoepiglottopexy (CHEP) was not performed. Recently, a technique for TORS SCPL-CHEP was described using the da Vinci Si system.…”

Section: Discussionmentioning

confidence: 99%

Hybrid supracricoid partial laryngectomy with cricohyoidoepiglottopexy via transoral robotic surgery

2018

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Objectives/Hypothesis To describe a hybrid supracricoid partial laryngectomy with cricohyoidoepiglottopexy (hybrid SCPL‐CHEP) combining limited transcervical and transoral robotic approaches. Study Design Preclinical cadaveric study. Methods Using six human cadavers in a series of three preclinical laboratories (July 2016–February 2018), we developed a novel hybrid technique for SCPL‐CHEP. A flexible single‐port robotic surgical system was utilized for the transoral aspects of the procedure. Results Detailed procedural steps are defined: 1) transoral: mucosal incisions under direct visualization of the laryngopharynx (tumor resection); 2) transcervical: incision and mobilization of the larynx and pexis; and 3) transoral: mucosal closure. Hybrid SCPL‐CHEP was technically feasible and allowed for complete transoral mucosal reconstruction. We discuss potential clinical significance of adding this TORS approach to conventional open SCPL‐CHEP. Conclusions This hybrid technique for SCPL‐CHEP provides two main advantages over the standard technique: direct visualization during tumor resection prior to laryngotomy and full closure of the laryngopharynx defect. These technical refinements might facilitate postoperative recovery and in turn make this larynx preservation procedure more accessible to patients and surgeons. A clinical trial evaluating the efficacy of hybrid SCPL‐CHEP appears warranted to validate these observations. Level of Evidence NA Laryngoscope, 129:2065–2070, 2019

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“…Type A features an armless overtube with jointed tools, which has a similar configuration to the standard dual channel endoscope but differs in that the surgical tool includes a bending section of a surgical tip. Examples of type A are DDES, STRAS, ViaCath, and FLEX . They commonly have a translational and rolling segment followed by a deflecting segment at the tip.…”

Section: Methodsmentioning

confidence: 99%

“…Robotic technologies have overcome the limitations of these manual platforms facilitating intuitive and efficient multitasking control on the surgeon's side as well as the precise and intelligent movement of the robot on the patient's side. STRAS, MASTER, ViaCath, FLEX, i2Snake, and CYCLOPS systems have shown the possibility of advanced endoscopic surgery with their highly dexterous robotic arm. However, they also seem to have common difficulties in designing flexible manipulators with sufficient miniaturization and payload capability to perform various intraluminal surgical operations.…”

Section: Introductionmentioning

confidence: 99%

K‐FLEX: A flexible robotic platform for scar‐free endoscopic surgery

Hwang

Kwon

2020

Robotics Computer Surgery

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Background Despite its high lesion accessibility and versatility, endoscopic platforms have suffered from designing flexible manipulators with high payload capability sufficient to perform advanced endoscopic procedures. Methods A flexible robotic platform, K‐FLEX, has been developed with a design of 17 mm in overall diameter. To overcome the shape distortion and deflection in payload handling, a strong continuum manipulator has been designed to have maximum resistance to the distortion. The kinematic analysis and mapping strategy have been established for the master‐slave teleoperation. Results The proposed manipulator has shown 7.5 mm in trajectory variation to lift the weight of 300 g. Finally, the feasibility of the integrated K‐FLEX system has been verified through three kinds of simulated surgical tasks. Conclusions The initial prototype of the proposed robot showed the possibility of advanced endoscopic surgery with improved payload capability.

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

Abstract: Transoral robot assisted surgery has the potential to reduce morbidity, hospital time and fistula rates in a selected group of patients. Initial clinical studies and further development of supplemental tools are in progress. Copyright © 2016 John Wiley & Sons, Ltd.

Cited by 22 publications

References 22 publications

Teleoperated tubular continuum robots for transoral surgery – feasibility in a porcine larynx model

Teleoperated tubular continuum robots for transoral surgery – feasibility in a porcine larynx model

Hybrid supracricoid partial laryngectomy with cricohyoidoepiglottopexy via transoral robotic surgery

K‐FLEX: A flexible robotic platform for scar‐free endoscopic surgery

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