The dawn of robotic surgery in otolaryngology-head and neck surgery

Nakayama, Meijin; Holsinger, F. Christopher; Chevalier, Dominique; Orosco, Ryan K.

doi:10.1093/jjco/hyz020

Cited by 28 publications

(18 citation statements)

References 60 publications

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“…In the past few decades, endoscopic surgery in the head and neck region has been rapidly expanding in the form of minimally invasive surgeries; transoral robotic surgery (TORS), 25 transoral video laryngoscopic surgery (TOVS), 26 and endoscopic laryngo‐pharyngeal surgery (ELPS). 6 Associated devices include multiarm retractors or curved laryngoscopes, which provide the operator excellent visualization of the field.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic near‐infrared photoimmunotherapy in an orthotopic head and neck cancer model

et al. 2021

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Near‐infrared photoimmunotherapy (NIR‐PIT) is a cell selective cancer therapy that uses an antibody‐photoabsorber (IRDye700DX, IR700) conjugate (APC) and NIR light. NIR‐PIT targeting epidermal growth factor receptor (EGFR) in head and neck cancer (HNC) was conditionally approved in Japan in 2020. APC‐bound tumors can be detected using endoscopic fluorescence imaging, whereas NIR light can be delivered using endoscopic fiber optics. The aims of this study were: (1) to assess the feasibility of endoscopic NIR‐PIT in an orthotopic HNC model using a CD44‐expressing MOC2‐luc cell line; and (2) to evaluate quantitative fluorescence endoscopic imaging prior to and during NIR‐PIT. The results were compared in 3 experimental groups: (1) untreated controls, (2) APC injection without light exposure (APC‐IV), and (3) APC injection followed by NIR light exposure (NIR‐PIT). APC injected groups showed significantly higher fluorescence signals for IR700 compared with the control group prior to therapeutic NIR light exposure, and the fluorescence signal significantly decreased in the NIR‐PIT group after light exposure. After treatment, the NIR‐PIT group showed significantly attenuated bioluminescence compared with the control and the APC‐IV groups. Histology demonstrated diffuse necrotic death of the cancer cells in the NIR‐PIT group alone. In conclusion, endoscopically delivered light combined with quantitative fluorescence imaging can be used to “see and treat” HNC. This method could also be applied to other types of cancer approachable with endoscopy.

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Section: Discussionmentioning

confidence: 99%

Endoscopic near‐infrared photoimmunotherapy in an orthotopic head and neck cancer model

et al. 2021

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“…The application of robotic technology in the head and neck field (26,27,29,30) has favored the spread of this procedure not only for oropharyngeal (29,30) and, more recently, laryngeal (31) and neck disorders (32), but also for anterior oral floor diseases (28,33). A transoral robotassisted management of large submandibular gland stones was recently described in a small and heterogeneous series of patients (21,28,34,35), while only two case reports on TORSS have been published for different salivary disorders (20,22).…”

Section: Discussionmentioning

confidence: 99%

Transoral robotic submandibular sialadenectomy: how and when

Capaccio¹,

Montevecchi

Meccariello

et al. 2020

Gland Surg

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Traditional removal of the submandibular gland is done through a transcervical approach; new proposals have come into the scientific limelight such as endoscopy-assisted transcervical sialadenectomy or (robot-assisted) submandibular sialadenectomy through a postauricular facelift transcervical approach.Transoral submandibular sialadenectomy has been described in the past, but with the advent of transoral robotic surgery, the proposal of removing the submandibular gland from the oral floor is gaining strength.A transoral robotic submandibular sialadenectomy by the Si Da Vinci Surgical Robot was performed in a 68-years-old female patient under general anaesthesia. The transoral robotic procedure was successful with no major postoperative complications. A mild tingling of the tip of the tongue was described by the patient 3 months after. The surgical time took 110 minutes. No residual gland was observed at ultrasonography. The transoral robotic submandibular sialadenectomy seems to be, with selective indication based on clinical and radiological assessment, a viable and safe alternative to traditional management in patients who refuse a cervical scar and the risk of paralysis of the facial nerve.

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“…TORS is very expensive; the cost of a robotic platform is about e3 million, and even maintenance costs are very high (e100,000/year), therefore it is accessible to only a few centers (10,28,29). Exposure of the surgical field can be a problem.…”

Section: Discussionmentioning

confidence: 99%

3D Exoscopic Surgery (3Des) for Transoral Oropharyngectomy

et al. 2020

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Over the past three decades, the incidence of oropharyngeal squamous cell carcinoma has increased, primarily related to the spread of human papillomavirus. Treatment has always been preferentially unimodal (surgery or radiotherapy) for early stage disease and multimodal (surgery with adjuvant therapy or concomitant chemoradiotherapy) for advanced stages. Recently, the surgical approach has gained renewed interest due to the morbidity of non-surgical treatments and also to technical innovations. We have coined the term 3Des (3D exoscope surgery) to describe the use of the 3D Vitom Exoscope System for transoral surgery of oropharyngeal cancers. During the period from June 2017 to May 2018, 10 patients with oropharyngeal cancer were treated by oropharyngeal surgery with the 3Des approach at FPO IRCCS Institute of Candiolo. The aim of the present prospective study was to evaluate the utility of 3Des for the treatment of early-stage oropharyngeal cancer. 3Des could represent a viable alternative to the operating microscope and robotic surgery thanks to its excellent ability to provide 3D visual information, depth of field, magnification, image contrast, color imaging, and low running costs. It promises great utility in the learning process, with the possibility of recording in high definition.

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The dawn of robotic surgery in otolaryngology-head and neck surgery

Cited by 28 publications

References 60 publications

Endoscopic near‐infrared photoimmunotherapy in an orthotopic head and neck cancer model

Endoscopic near‐infrared photoimmunotherapy in an orthotopic head and neck cancer model

Transoral robotic submandibular sialadenectomy: how and when

3D Exoscopic Surgery (3Des) for Transoral Oropharyngectomy

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