Is the Da Vinci Xi system a real improvement for oncologic transoral robotic surgery? A systematic review of the literature

Fiacchini, Giacomo; Vianini, Matteo; Dallan, Iacopo; Bruschini, Luca

doi:10.1007/s11701-020-01132-0

Cited by 15 publications

(20 citation statements)

References 35 publications

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“…Finally, many surgeons feel that the more compact Xi endoscope, offering improved definition and clarity, is a major improvement compared to the Si system. 8 Concerning disadvantages of the Xi platform, the lack of the 5-mm EndoWrist ® Si instruments does not seem to restrict the maneuverability in the oropharynx, as the larger dimensions of the Xi's 8-mm instruments are compensated by the reduced size of endoscope and robotic arms and by the longer EndoWrist ® instruments. This is illustrated by a significantly shorter Xi console time for BOT resection compared to the Si (28.53 min, SD 4.46 vs. 34.00 min, SD 4.22, p = 0.024).…”

Section: Discussionmentioning

confidence: 99%

“…So far, few reports are published on the Xi performance for TORS. 8 Since Xi was granted a CE mark for TORS in 2016, our tertiary referral center (University Hospitals Leuven, Belgium) included all consecutive Xi-TORS patients in a prospective study to report on the feasibility, safety, technical specificities, and postoperative functional and oncological outcomes.…”

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confidence: 99%

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Transoral robotic surgery (TORS) using the da Vinci Xi: prospective analysis of feasibility, safety, and outcomes

et al. 2021

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Background: The da Vinci Xi system is not Food and Drug Administration approved for transoral robotic surgery (TORS), resulting in limited data.Methods: This prospective study evaluates the feasibility, safety, and outcomes of Xi-TORS in an oncological setting.Results: Sixty-one patients with head and neck cancer were consecutively included for Xi-TORS. Adequate exposure and macroscopically complete resection were achieved in 59 patients (success rate = 96.7%). Intraoperative difficulties and complications were encountered in 47.5% and 20.3% of patients, respectively. Postoperative hemorrhage occurred in 11.9%; no treatment-related deaths were encountered. Two-year overall survival and disease-specific survival were 90.5% and 95.6%, respectively. No long-term (>1 month) tracheotomies were necessary, and only two patients remained tube-feeding dependent. The functional baseline level was regained at 12 months for the MD Anderson Dysphagia Inventory and at 24 months for the Swallowing quality-of-life questionnaire.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Transoral robotic surgery (TORS) using the da Vinci Xi: prospective analysis of feasibility, safety, and outcomes

et al. 2021

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“…The use of the Da Vinci Xi system was made in four different studies and four consecutive years from 2017 until today (15)(16)(17)(18). Its application has remained marginal, in part due to the non-FDA approval for TORS procedures, and in part because of the technical peculiarities that limit its applications for certain TORS procedures (22).…”

Section: Discussionmentioning

confidence: 99%

“…It will be necessary in the future to design appropriate instruments for pediatric airway TORS surgeries, without converting the general or urological instruments available today. The Da Vinci Robotic System was built to treat general and urological pathologies, and, nowadays, its instrumentation is adapted to TORS procedures (22). For that reason, most of the time patient selection is tailored to what can be done with the available technology and not vice versa.…”

Section: Discussionmentioning

confidence: 99%

Experience in Transoral Robotic Surgery in Pediatric Subjects: A Systematic Literature Review

et al. 2021

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Pediatric transoral robotic surgery (TORS) has improved from 2007 to 2020, widening its indications and feasibility. This article aims to systematically analyze the procedures performed from the first use until the current year, observing their evolution over time. A systematic literature review was performed using PubMed, Scopus, Web of Science, and Cochrane databases between March 1, 2000, and April 1, 2020. We selected studies that were written only in English and were performed in live human subjects. About 16 studies were found with a total of 73 subjects treated, among them 41 were men and 32 were women with an average age of 6.8 ± 4.99 years. There have been four (5.47%) conversions. Both functional and benign-malignant diseases have been treated in the series. Eleven (15.06%) pre-operative tracheostomy and zero post-operative tracheostomy were performed. The bleeding data was only reported in 9 studies and was <50 ml. Only one (1.36%) intra-operative complication and 10 (12.32%) postoperative complications were reported. We consider the TORS procedures in pediatric subjects safe, feasible and with good surgical outcomes up to the laryngeal region.

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“…According to a recent systematic review, the most common TORS procedures in head and neck cancer cases were resections of oropharyngeal tumors. 1 TORS has also been well described in the surgical treatment of obstructive sleep apnea, especially for reduction of the base of tongue (BOT). 2 - 4 Given the limited operative space in the upper aerodigestive tract, TORS resection risks damage to surrounding structures not involved by the pathology (eg, the epiglottis and posterior pharyngeal wall).…”

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confidence: 99%

Utilization of Silicone Sheet as a Protective Guide During Transoral Robotic Tongue Base Surgery

Volner¹,

Mostales

Schoppy³

et al. 2021

OTO Open

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This article presents a simple technique where a silicone sheet is used during transoral robotic surgery (TORS) to protect the upper airway structures from thermal damage during a base of tongue procedure. We review 10 cases of TORS tongue base reduction with the use of this technique, with no complications and with reduction of thermal damage to the lingual epiglottis and surrounding pharyngeal wall. Furthermore, it served as a guide during tongue base dissection to provide visual and tactile feedback to the inferior limit of resection, as well as to protect the endotracheal tube. The silicone sheet is an ideal material for use as a thermal barrier due to its widespread availability, intrinsic thermal properties, and translucency. The technique of using the silicone sheet is easy to implement and may prove useful to many transoral robotic surgeons, especially for newly trained TORS users and trainees.

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Is the Da Vinci Xi system a real improvement for oncologic transoral robotic surgery? A systematic review of the literature

Cited by 15 publications

References 35 publications

Transoral robotic surgery (TORS) using the da Vinci Xi: prospective analysis of feasibility, safety, and outcomes

Transoral robotic surgery (TORS) using the da Vinci Xi: prospective analysis of feasibility, safety, and outcomes

Experience in Transoral Robotic Surgery in Pediatric Subjects: A Systematic Literature Review

Utilization of Silicone Sheet as a Protective Guide During Transoral Robotic Tongue Base Surgery

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