Transoral robotic submandibular sialadenectomy: how and when

Capaccio, Pasquale; Montevecchi, Filippo; Meccariello, Giuseppe; Cammaroto, Giovanni; Magnuson, J. Scott; Pelucchi, Stefano; Bresciani, Lorenzo; Vicini, Claudio

doi:10.21037/gs.2020.02.04

Cited by 10 publications

(6 citation statements)

References 36 publications

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“…However, Prosser et al (2013) did not experience any mayor complications. We recently started our experience with transoral robotic submandibular sialadenectomy (TORSS) and, in line with other author's results, we did not observe any major complication; a persistent tingling of the tip of the tongue was described by the patient three months after the robotic procedure (Figure 3) (Capaccio et al, 2020).…”

Section: Intr Aor Al Surg Erysupporting

confidence: 80%

Submandibular gland excision: From external surgery to robotic intraoral and extraoral approaches

et al. 2020

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Submandibular gland excision is generally performed through a transcervical approach, a safe procedure that, however, carries few neurological, functional and aesthetic drawbacks. Intraoral approach to the submandibular gland has been described many years ago but it has been newly proposed in recent years thanks to endoscope‐assisted and robot‐assisted surgical procedures. The main purpose of intraoral approaches is to avoid cosmetic sequelae and to reduce the risk of marginal nerve injury although the recent introduction of retroauricular, postauricular, facelift and transhairline neck incisions has overcome the need for an alternative to traditional transcervical approach. Different surgical approaches (transoral versus transcervical) to the submandibular gland as well as different type of cutaneous incisions will be illustrated and discussed in the light of advancement of endoscope‐assisted and robot‐assisted procedures.

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Section: Intr Aor Al Surg Erysupporting

confidence: 80%

Submandibular gland excision: From external surgery to robotic intraoral and extraoral approaches

et al. 2020

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“…However, unfavorable cosmetic aspects (cervical scar) and reduced saliva production are side effects that always occur. In this context it should be mentioned that a cervical scar can be avoided when the SMG is removed by a transoral, e.g., robotic assisted approach [ 114 , 115 ]. Other complications (collateral damage to the lingual nerve and the mandibular branch of the facial nerve) are rare and should be discussed with the patient preoperatively.…”

Section: Discussionmentioning

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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“…During the TORS procedure, two robotic arms work inside the oral cavity, but the optical arm, suction device and one hand of the surgeon's assistant must be added to the count: the surgical field can become crowded at some point. Major complications, already very low in number with classical transoral technique, are almost nonexistent when using TORS, with only a possible persistent tingling of the tip of the tongue still present at 3 months after surgery [18]. VITOM-assisted surgery, on the other hand, has become more and more popular among different medical specialties such as reconstructive microsurgery, achieving interesting results.…”

Section: Discussionmentioning

confidence: 99%

Hybrid Exoscopic and Robotic Transoral Removal of a Bilateral Hilar Submandibular Stone: Technical Note and Review of the Literature

et al. 2023

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Submandibular gland sialolithiasis can be addressed by gland removal or by stone removal. Intraoral stone removal has now become the go-to technique to minimize aesthetic and functional sequelae (e.g., marginalis mandibulae injury, visible surgery scar) and, although traditional techniques were first experimented with (intraoral ducotomy), newer techniques drew the interest of the scientific community: sialoendoscopy, TORS-S (TransOral Robotic Surgery Assisted–Sialolithotomy) and VITOM-guided sialolithotomy. In this article, we compare the two newest transoral techniques for transoral sialolithotomy, TORS-S and 3D-4K VITOM-guided sialolithotomy, used to treat bilateral hilar submandibular gland sialolithiasis in the same patient, one technique for each side. Using these techniques, a faster recovery is achievable with almost no anatomical and/or functional sequelae, since they both allow better visualization and manipulation of soft tissues and noble structures (e.g., lingual nerve and Wharton’s duct) and make surgery easier and safer. Moreover, OR staff can better perceive surgical steps and be involved in the procedure, thus showing the high educational and training potential of these technologies.

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Transoral robotic submandibular sialadenectomy: how and when

Cited by 10 publications

References 36 publications

Submandibular gland excision: From external surgery to robotic intraoral and extraoral approaches

Submandibular gland excision: From external surgery to robotic intraoral and extraoral approaches

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

Hybrid Exoscopic and Robotic Transoral Removal of a Bilateral Hilar Submandibular Stone: Technical Note and Review of the Literature

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