Transoral Robotic Surgery: Supraglottic Partial Laryngectomy

Abstract

Objectives:We assessed the feasibility of performing transoral supraglottic partial laryngectomy with robotic instrumen tation. Methods:Transoral robotic surgery (TORS) was performed on 3 human patients with supraglottic carcinoma in a pro spective human trial. The study was approved by our institutional review board and involved the da Vinci Surgical Robot (Intuitive Surgical, Inc, Sunnyvale, California).Results: All procedures were completed robotically. The median overall operation time to perform the robotic procedure was 120 minutes (range, 1:32:48 to 2:58:18), including 18 minutes (range, 00:6:07 to 00:30:39) for exposure and robotic positioning. There were no intraoperative or postoperative complications or surgical mortality. Conclusions:The preliminary results of our series suggest that application of the da Vinci robotic surgical system for TORS to supraglottic partial laryngectomy is technically feasible and relatively safe. Furthermore, TORS provides ex cellent surgical exposure that allows complete tumor resection. Most importantly, TORS provides an alternative to open approaches and "conventional" transoral supraglottic partial laryngectomy.

Minimally Invasive Procedures for Laryngeal Carcinoma: Transoral Endoscopic Laser and Transoral Robotic Surgery

“…It is difficult to work with long instruments. In 2007, Weinstein et al (26) published regarding supraglottic laryngectomy using the TRS technique. The three-dimensional microscopic view and bimanual use of robotic arms allow a delicate surgery in a restricted field.…”

Management of the Airway in Transoral Robotic Surgery for Head and Neck Cancer

“…Clinical experience has made it particularly useful for the surgical treatment of head and neck cancer [2] . Virtually it allows the transoral resection of any lesion of the oropharynx [3,4] , hypopharynx or larynx [5] , provided that it is limited to soft tissue. Indications are still being defined today [6] .…”

The incidence of human papillomavirus in patients with the head and neck squamous cell carcinoma treated by transoral robotic surgery

“…Weinstein ve ark. [8] transoral yolla radikal tonsillektomi, supraglottik larenjektomi ve dil kökü rezeksiyonu ameliyatlarını tanımlamışlardır. [7][8][9] Daha sonra TORC ile kordektomi, nazofarenkse, orofarenkse yaklaşımlar bildirilmiştir.…”

“…[8] transoral yolla radikal tonsillektomi, supraglottik larenjektomi ve dil kökü rezeksiyonu ameliyatlarını tanımlamışlardır. [7][8][9] Daha sonra TORC ile kordektomi, nazofarenkse, orofarenkse yaklaşımlar bildirilmiştir. [8,9] Amerikan Gıda ve İlaç Dairesi (USFDA) 2010 yılında yetişkinlerde oral kavite, orofarenks, farenks ve larenksin benign ve malign lezyonlarında TORC'un kullanımını onaylamıştır.…”

“…[7][8][9] Daha sonra TORC ile kordektomi, nazofarenkse, orofarenkse yaklaşımlar bildirilmiştir. [8,9] Amerikan Gıda ve İlaç Dairesi (USFDA) 2010 yılında yetişkinlerde oral kavite, orofarenks, farenks ve larenksin benign ve malign lezyonlarında TORC'un kullanımını onaylamıştır. [10] Transoral robotik cerrahi ile; glottik/supraglottik tümörler (T 1 , T 2 ) seçilmiş orofarengeal tümörler; (T 1 , T 2 , T 3 , T 4 ) ameliyat edilebilir.…”