Transoral Robotic Reconstructive Surgery Reconstruction of a Tongue Base Defect with a Radial Forearm Flap

Garfein, Evan S.; Greaney, Patrick J.; Easterlin, Bradley; Schiff, Bradley A.; Smith, Richard V.

doi:10.1097/prs.0b013e318213a0e4

Cited by 26 publications

(14 citation statements)

References 5 publications

(2 reference statements)

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“…For patients who require free flap reconstruction of the ablative defect, feasibility studies and initial case series detailing free tissue transfers via minimally invasive surgical approaches and robotic-assisted microanastomotic techniques have also demonstrated reliable perioperative outcomes [17, 20–25]. …”

Section: Resultsmentioning

confidence: 99%

The Role of Transoral Robotic Surgery in the Management of Oropharyngeal Cancer: A Review of the Literature

et al. 2012

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Background. Transoral robotic surgery (TORS) is an emerging treatment option for the treatment of head and neck malignancies, particularly for oropharyngeal squamous cell carcinoma (OPSCC). Preliminary studies have demonstrated excellent oncologic and functional outcomes that have led to a resurgence of interest in the primary surgical management of OPSCC. The aim of the present study was to review the evidence base supporting the use of TORS in OPSCC. Methods. Studies evaluating the application of TORS in the treatment of head and neck squamous cell carcinoma (HNSCC), and more specifically OPSCC, were identified for review. Further searches were made of reference lists for complete evaluation of minimally invasive surgery (MIS) in treating OPSCC. Results. Seventeen results relating to the application of TORS in treatment of OPSCC were identified. Further results relating to the role of transoral laser microsurgery (TLM) in OPSCC were included for review. Feasibility, oncologic, and functional data is summarized and discussed. Discussion. Management strategies for patients with OPSCC continue to evolve. Minimally invasive surgical techniques including TORS and TLM offer impressive functional and oncologic outcomes particularly for patients with early T-classification and low-volume regional metastatic disease. Potential exists for treatment deintensification, particularly in patients who are HPV positive.

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Section: Resultsmentioning

confidence: 99%

The Role of Transoral Robotic Surgery in the Management of Oropharyngeal Cancer: A Review of the Literature

et al. 2012

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“…The utilization of the robot in performing free flaps has been validated [28,[33][34][35]. Among the first surgeons to ever dare explore the potential of performing such high risk surgery were Katz et al at the Johns Hopkins University School of Medicine (Baltimore, MD) in 2005 who successfully performed an experimental free flap on a porcine model using the da Vinci® robot [28].…”

Section: Free Flapsmentioning

confidence: 99%

“…Following swallowing evaluation after the first week, the patient was started on oral diet on postoperative day 8 [34].…”

Section: Oropharyngeal Surgerymentioning

confidence: 99%

Robotics in plastic surgery, a review

et al. 2012

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Robotic surgery is an emerging technology that is conquering the surgery field by storm. It has found solid applications in general surgery, gynecological surgery, vascular surgery, and especially in urology and cardiothoracic surgery. Its application is however restricted in the various fields of plastic surgery. There is no doubt that robots have a potential to become an important toll in reconstructive plastic surgery, but the extent of their use in aesthetic surgery is constrained. A review of the literature showed that several centers are currently using surgical robots for reconstructive and microsurgery. Robotic surgery is feasible and technically advantageous, though very costly. There is a paucity of data however concerning the long-term benefits of robotics versus conventional techniques, and none regarding aesthetic surgery applications. We strongly believe that, without ignoring the tremendous potential benefits of robotic technology in many fields of plastic surgery, no machine, no matter how sophisticated it is, will ever succeed at replacing the artistic sense, feeling, and touch necessary to achieve beauty with harmonious proportions.

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“…Transoral robotic reconstruction of oropharyngeal defects has gained momentum and is now performed routinely in at least five academic centers in the United States. [5][6][7][8][9] Robotic microsurgery is a burgeoning field that has great potential for growth as robotic technology and instrumentation improves. [10][11][12] Muscle flaps are one of the few reconstructive procedures in which plastic surgeons bypass the skin entirely to gain access to deeper tissue planes.…”

mentioning

confidence: 99%

Robotic Harvest of the Latissimus Dorsi Muscle: Laboratory and Clinical Experience

Selber

Baumann

Holsinger

2012

J reconstr Microsurg

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Minimally invasive harvest of the latissimus dorsi (LD) muscle is a desirable goal because of both the wide utility of this muscle and the length of incision required to harvest it. In this study, robotic harvest of the LD muscle was evaluated in a cadaver model and clinical series. Ten LD flaps were robotically harvested in eight cadavers. Positioning, port placement, procedural steps, instrumentation, and technical obstacles were all critically analyzed and reported. After modifying the technique based on experience gained in the cadaver study, eight LD muscles were robotically harvested and transferred in eight patients. Access included a short axillary incision and two additional port sites along the anterior border of the muscle. Insufflation was used to maintain the optical cavity. Indications included pedicled flaps for implant-based breast reconstruction and free flaps for scalp reconstruction. All flaps were successfully transferred without converting to open technique. In the clinical series, average time for setup and port placement was 23 minutes, and average robotic time was 1 hour and 51 minutes. There were no major complications. Robotic harvest of the LD is feasible and effective and permits full muscle harvest without a visible incision.

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Transoral Robotic Reconstructive Surgery Reconstruction of a Tongue Base Defect with a Radial Forearm Flap

Cited by 26 publications

References 5 publications

The Role of Transoral Robotic Surgery in the Management of Oropharyngeal Cancer: A Review of the Literature

The Role of Transoral Robotic Surgery in the Management of Oropharyngeal Cancer: A Review of the Literature

Robotics in plastic surgery, a review

Robotic Harvest of the Latissimus Dorsi Muscle: Laboratory and Clinical Experience

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