Robot-assisted sialolithotomy with sialoendoscopy: a review of safety, efficacy and cost

Tampio, Alex J F; Marzouk, Mark

doi:10.1007/s11701-020-01097-0

Cited by 8 publications

(30 citation statements)

References 13 publications

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“…Very good results were reported after the application of TDS [ 30 , 31 , 32 , 33 , 34 , 35 , 36 ] and sialendoscopy-assisted TDS [ 37 , 38 , 39 , 40 , 41 ]. Several groups reported transoral robot-assisted extraction of deeply located and large submandibular sialoliths [ 42 , 43 , 44 ], also in combination with sialendoscopic assistance [ 45 , 46 ]. A combined endoscopic–transcutaneous approach was also described for submandibular stones [ 39 ].…”

Section: Introductionmentioning

confidence: 99%

Treatment of Sialolithiasis: What Has Changed? An Update of the Treatment Algorithms and a Review of the Literature

Koch

Mantsopoulos

Müller

et al. 2021

JCM

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Treatment for sialolithiasis has undergone significant changes since the 1990s. Following the development of new minimally invasive and gland-preserving treatment modalities, a 40–50% rate of gland resection was reduced to less than 5%. Extracorporeal shock-wave lithotripsy (ESWL), refinement and extension of methods of transoral duct surgery (TDS), and in particular diagnostic and interventional sialendoscopy (intSE) are substantial parts of the new treatment regimen. It has also become evident that combining the different treatment modalities further increases the effectiveness of therapy, as has been especially evident with the combined endoscopic–transcutaneous approach. In the wake of these remarkable developments, a treatment algorithm was published in 2009 including all the known relevant therapeutic tools. However, new developments have also taken place during the last 10 years. Intraductal shock-wave lithotripsy (ISWL) has led to remarkable improvements thanks to the introduction of new devices, instruments, materials, and techniques, after earlier applications had not been sufficiently effective. Techniques involving combined approaches have been refined and modified. TDS methods have been modified through the introduction of sialendoscopy-assisted TDS in submandibular stones and a retropapillary approach for distal parotid sialolithiasis. Recent trends have revealed a potential for significant changes in therapeutic strategies for both major salivary glands. For the submandibular gland, ISWL has replaced ESWL and TDS to some extent. For parotid stones, ISWL and modifications of TDS have led to reduced use of ESWL and the combined transcutaneous–sialendoscopic approach. To illustrate these changes, we are here providing an updated treatment algorithm, including tried and tested techniques as well as promising new treatment modalities. Prognostic factors (e.g., the size or location of the stones), which are well recognized as having a strong impact on the prognosis, are taken into account and supplemented by additional factors associated with the new applications (e.g., the visibility or accessibility of the stones relative to the anatomy of the duct system).

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Section: Introductionmentioning

confidence: 99%

Treatment of Sialolithiasis: What Has Changed? An Update of the Treatment Algorithms and a Review of the Literature

Koch

Mantsopoulos

Müller

et al. 2021

JCM

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“…Our mean operative time of 134 minutes is comparable to reported literature on TORS-assisted combined approaches (62-120 minutes). 14-16 This is slightly longer than the average 90 to 113 minutes cited for conventional combined sialendoscopic approaches. 18-20 Additionally, increased surgical experience decreases operative times; ours decreased from 153 minutes in the first half of the cases to 117 minutes in the second half, again comparable to conventional time ranges.…”

Section: Discussionmentioning

confidence: 89%

“…Though easier to localize, megaliths create a tougher operative environment by distorting the anatomy of the duct and surrounding structures, and they contribute to increased gland inflammation. Our cohort also had more patients with multiple stones (11 vs 7), 15,16 more patients with multiple stones >4 mm (9 vs 2), 15 and more stones per patient (mean [range], 3.9 [2-9] vs 2.4 [2-3]). 16 Patients with multiple stones often had more difficulty with localization or had an additional initial sialendoscopy.…”

Section: Discussionmentioning

confidence: 96%

“…Our cohort also had more patients with multiple stones (11 vs 7), 15,16 more patients with multiple stones >4 mm (9 vs 2), 15 and more stones per patient (mean [range], 3.9 [2-9] vs 2.4 [2-3]). 16 Patients with multiple stones often had more difficulty with localization or had an additional initial sialendoscopy. Both factors may have contributed to temporary nerve injury by prolonging the operative time and, subsequently, the time that the lingual nerve is held in traction.…”

Section: Discussionmentioning

confidence: 96%

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Nuances and Management of Hilar Submandibular Sialoliths With Combined Transoral Robotic Surgery–Assisted Sialolithotomy and Sialendoscopy

Wen

Douglas

Elrakhawy

et al. 2020

Otolaryngol.--head neck surg.

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Objective To describe the management, technical nuances, and success rates of transoral robotic surgery (TORS)–assisted sialolithotomy. Study Design Retrospective database review. Setting Quaternary academic medical center. Methods Between the months of January 2015 and May 2019, patients with hilar submandibular gland stones underwent 2 main variations of TORS-assisted sialolithotomy and sialendoscopy: (1) TORS followed by sialendoscopy for patients with palpable predominantly single stones and (2) either sialendoscopy followed by TORS and sialendoscopy or sialendoscopy followed by TORS only for patients with nonpalpable or multiple stones. Clinical charts were reviewed to collect data, including stone size (imaging review, intraoperative measurement), palpability, duration of operation, TORS variation, operative challenges, symptom improvement, gland preservation rate, and complications. Results Thirty-seven patients were identified. Patients were 26 to 80 years old (mean, 57.2 years), and 40.5% were female. Twenty-four patients (64.9%) underwent TORS followed by sialendoscopy; 10 (27.0%), sialendoscopy followed by TORS and sialendoscopy; and 3 (8.1%), sialendoscopy followed by TORS only. The mean stone size was 12.4 mm (range, 4-28 mm). Eleven patients had multiple stones with a mean 4 stones per patient (range, 2-9). Procedural success was 91.9% (34/37) at a mean follow-up of 34.2 weeks (range, 1.4-262.1), and the gland preservation rate was 97.3% (36/37). No patients reported symptoms of lingual nerve injury at 3-month follow-up. Conclusion TORS combined with sialendoscopy for hilar submandibular gland sialolithiasis allows for improved visualization of critical anatomy, tissue manipulation, and operative flexibility. In our experience, the operative success rate is high, and duration of surgery compares favorably with conventional combined hilar approaches.

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“…[68,69] Robotic systems have been used for submandibular sialolith removal since 2011. [70] Tampio et al [71] described the advantages of robot-assisted sialolithotomy with sialoendoscopy as a high success rate of sialolith removal, lower risk of permanent lingual nerve damage, and temporary tongue paresthesia.…”

Section: Thyroid Parathyroid and Neckmentioning

confidence: 99%

Robotic Surgery in Otolaryngology-Head and Neck Surgery: Yesterday, Today and Tomorrow

Bayram¹,

Eskıızmır²,

Cingi³

et al. 2020

ENT Updates

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In the present review, we aim to give an overview of the development and utilization of robotic surgery in otolaryngology-head and neck surgery from its introduction, current status, and future applications. Robotic surgery has been applied either pre-clinically or is already in clinical use for several indications in otolaryngology and head and neck surgery. Due to its rapid progress and technological development, it appears it will be a more active tool in the future for the diagnosis and treatment of a number of diseases in otolaryngology-head and neck surgery practice.

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Robot-assisted sialolithotomy with sialoendoscopy: a review of safety, efficacy and cost

Cited by 8 publications

References 13 publications

Treatment of Sialolithiasis: What Has Changed? An Update of the Treatment Algorithms and a Review of the Literature

Treatment of Sialolithiasis: What Has Changed? An Update of the Treatment Algorithms and a Review of the Literature

Nuances and Management of Hilar Submandibular Sialoliths With Combined Transoral Robotic Surgery–Assisted Sialolithotomy and Sialendoscopy

Robotic Surgery in Otolaryngology-Head and Neck Surgery: Yesterday, Today and Tomorrow

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