Recent advances in robot‐assisted head and neck surgery

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

doi:10.1002/rcs.1744

Cited by 35 publications

(39 citation statements)

References 68 publications

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“…TORS has progressed immensely since its FDA approval in 2009 [20,21]. Applications of TORS include resection of both benign and malignant lesions involving numerous anatomical sites such as the oropharynx, larynx, thyroid, and neck, with additional applications under investigation [20].…”

Section: Discussionmentioning

confidence: 99%

Transoral Robotic Surgery with Sialendoscopy for a Plunging Ranula

Carey

Hodnett²,

Rassekh³

et al. 2017

ORL

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Background/Aims: Plunging ranulas are oral mucoceles that often cannot be visualized directly and thus can be challenging to diagnose and differentiate from other neck lesions. Surgery is the preferred treatment option, but the optimal approach requires careful consideration. Methods: We report the case of a plunging ranula presenting as an isolated neck mass in a 33-year-old patient. This patient was treated with a novel transoral robotic surgery (TORS)-assisted approach aided by sialendoscopy. Results: TORS allowed for exceptional visualization and access to the plunging ranula and sublingual gland while avoiding critical neurovascular structures. The patient healed well without recurrence or complications. Conclusion: The TORS approach with sialendoscopy for plunging ranulas described in this case report shows promise and should be considered for certain clinical presentations. Additional studies evaluating the effectiveness of TORS for plunging ranulas may be indicated.

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Section: Discussionmentioning

confidence: 99%

Transoral Robotic Surgery with Sialendoscopy for a Plunging Ranula

Carey

Hodnett²,

Rassekh³

et al. 2017

ORL

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“…Despite the diversification in possible indications and a widespread scientific interest in computer-and robot-assisted surgical systems, a breakthrough into clinical daily routine still lies in the future. 1 This particularly pertains to head and neck surgical procedures and their distinct anatomical challenges. The range of commercially available systems is limited, and most centres use the daVinci® System (Intuitive Surgical, Sunnyvale, USA).…”

Section: Introductionmentioning

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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“…As robotic technologies mature, new head and neck applications being developed include approaches to thyroid, skull base, sleep, and nonoropharyngeal malignancy surgeries . As familiarity with the technology increases and patient benefits are further defined, it is likely that new robotic systems will enter clinical use, and new clinical applications for robotic surgery in otolaryngology will be extended …”

Section: Introductionmentioning

confidence: 99%

“…14 As familiarity with the technology increases and patient benefits are further defined, it is likely that new robotic systems will enter clinical use, and new clinical applications for robotic surgery in otolaryngology will be extended. 15 Despite advances in microlaryngeal phonosurgical techniques and robot-assisted surgery, robots currently have a very limited role in endolaryngeal surgery of the vocal folds. In theory, the benefits of robotic surgery should translate to phonosurgery as well, with potential benefits including improved optics, increased instrument degrees of freedom, and improved surgical dexterity with improved operative outcomes.…”

Section: Introductionmentioning

confidence: 99%

Robotic microlaryngeal phonosurgery: Testing of a “steady‐hand” microsurgery platform

et al. 2017

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Objectives/Hypothesis: To evaluate gains in microlaryngeal precision achieved by using a novel robotic "steady hand" microsurgery platform in performing simulated phonosurgical tasks.Study Design: Crossover comparative study of surgical performance and descriptive analysis of surgeon feedback. Methods: A novel robotic ear, nose, and throat microsurgery system (REMS) was tested in simulated phonosurgery. Participants navigated a 0.4-mm-wide microlaryngeal needle through spirals of varying widths, both with and without robotic assistance. Fail time (time the needle contacted spiral edges) was measured, and statistical comparison was performed. Participants were surveyed to provide subjective feedback on the REMS.Results: Nine participants performed the task at three spiral widths, yielding 27 paired testing conditions. In 24 of 27 conditions, robot-assisted performance was better than unassisted; five trials were errorless, all achieved with the robot. Paired analysis of all conditions revealed fail time of 0.769 6 0.568 seconds manually, improving to 0.284 6 0.584 seconds with the robot (P 5 .003). Analysis of individual spiral sizes showed statistically better performance with the REMS at spiral widths of 2 mm (0.156 6 0.226 seconds vs. 0.549 6 0.545 seconds, P 5 .019) and 1.5 mm (0.075 6 0.099 seconds vs. 0.890 6 0.518 seconds, P 5 .002). At 1.2 mm, all nine participants together showed similar performance with and without robotic assistance (0.621 6 0.923 seconds vs. 0.868 6 0.634 seconds, P 5 .52), though subgroup analysis of five surgeons most familiar with microlaryngoscopy showed statistically better performance with the robot (0.204 6 0.164 seconds vs. 0.664 6 0.354 seconds, P 5 .036).Conclusions: The REMS is a novel platform with potential applications in microlaryngeal phonosurgery. Further feasibility studies and preclinical testing should be pursued as a bridge to eventual clinical use.

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Recent advances in robot‐assisted head and neck surgery

Abstract: As head and neck surgeons become more familiar with robotic surgery some patients evidently benefit from new technologies. Increased competition between the systems will certainly drive technological improvement and decrease the financial burden. Copyright © 2016 John Wiley & Sons, Ltd.

Cited by 35 publications

References 68 publications

Transoral Robotic Surgery with Sialendoscopy for a Plunging Ranula

Transoral Robotic Surgery with Sialendoscopy for a Plunging Ranula

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

Robotic microlaryngeal phonosurgery: Testing of a “steady‐hand” microsurgery platform

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