Transoral surgery using the Flex Robotic System: Initial experience in the United States

Persky, Michael J.; Issa, Mohamad; Bonfili, Jennifer R.; Goyal, Neerav; Goldenberg, David; Duvvuri, Umamaheswar

doi:10.1002/hed.25375

Cited by 19 publications

(18 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The daVinci® surgical robot (Intuitive Surgical® Inc, Sunnyvale, CA, USA), allowing for a magnified and three-dimensional view through a dual endoscope, tremor filter, scaling of robotic arm movements and range of movement, is hereby the most commonly used robotic system (RS). But novel platforms, such as the Flex® Robotic System (Medrobotics® Cooperation, Raynham, MA, USA) particularly addressing obstacles in the head and neck, are also becoming more popular for performing TORS [ 7 , 8 ]. Multiple large prospective studies have indicated safety and demonstrated favorable prognostic and functional outcome of TORS in treatment of patients with head and neck squamous cell carcinoma (HNSCC) [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Acceptance and adoption of transoral robotic surgery in Germany

Mandapathil

Meyer

2021

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

Purpose Since its introduction over a decade ago, the use of robotic surgery (RS) in head and neck surgery has widely spread around the globe, with very differential adoption of this novel surgical technique in different parts of the world. In this study, we analyze the acceptance and adoption of robotic surgery in the head and neck in Germany. Materials and methods A cross-sectional analysis using a questionnaire evaluating the acceptance and adoption of RS was performed. Questionnaires were distributed to all chairmen /-women of Otorhinolaryngology, Head and Neck Surgery Departments in Germany. Results A total of 107 respondents completed the questionnaire (65.2%). At university hospitals, 71.4% of the respondents indicated that a robotic system was available, and 21.4% responded that robotic surgery was performed at their institution; 22.7% and 0.04%, respectively, at non-university hospitals. The overall adoption rate was 0.8%. The most common cases performed were TORS resection in the oropharynx. Main reasons for not adopting this technique were costs, lack of interest and available co-operations. Conclusion This study provides evidence of the extent of adoption of TORS in Germany; main perceived barriers to adoption are costs with lack of cost-covering reimbursement and insufficient co-operations with other disciplines as well as hospital administration resulting in a very low adoption rate of this technique over the past decade. Results from this study may assist in decision-making processes on adopting this technique in the future.

show abstract

Section: Introductionmentioning

confidence: 99%

Acceptance and adoption of transoral robotic surgery in Germany

Mandapathil

Meyer

2021

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

show abstract

“…After abstract screening for eligibility, 61 articles were considered eligible. Among these, we included 14 articles in qualitative synthesis after a full-text assessment [ 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ]. The other 47 papers were excluded for the following reasons: studies on cadavers ( n = 15) or mannequins ( n = 1), commentaries on the Flex Robotic System without patients ( n = 7), and studies on other robotic systems ( n = 24).…”

Section: Resultsmentioning

confidence: 99%

“…Among the papers that matched the inclusion criteria, five publications were case reports [ 12 , 13 , 17 , 23 , 24 ], two were case series [ 11 , 16 ], three were retrospective studies [ 18 , 20 , 21 ], and four were prospective studies [ 14 , 15 , 19 , 22 ] ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

The Flex Robotic System in Head and Neck Surgery: A Review

Riva

Cravero

Briguglio

et al. 2022

Cancers

View full text Add to dashboard Cite

The Flex Robotic System is a device intended for robot-assisted visualization and surgical site access to the head and neck. The aim of this review is to summarize the current knowledge about the Flex Robotic System in head and neck transoral robotic surgery (TORS). The primary search was performed using the term “Flex Robot” across several databases (PubMed, Embase, Cochrane, Scopus). Patients were treated for both benign and malignant diseases. The oropharynx was the most frequent site of disease, followed by the supraglottic larynx, hypopharynx, glottic larynx, oral cavity, and salivary glands. Most of the studies did not reveal major intra- or post-operative complications. Bleeding incidence was low (1.4–15.7%). Visualization of the lesion was 95–100%, while surgical success was 91–100%. In conclusion, lesions of the oropharynx, hypopharynx, or larynx can be successfully resected, thus making the Flex Robotic System a safe and effective tool, reducing the morbidity associated with traditional open surgery.

show abstract

“…An additional retrospective, multi-center study in the United States similarly evaluated outcomes in patients undergoing surgery using the FLEX system between 2015 and 2017. 55 Thirty-one out of 68 patients had a resection, as opposed to biopsy. The authors demonstrated superior results in terms of hemostasis in comparison to previous TORS studies.…”

Section: Energy Delivery Via the Flex Robotic Systemmentioning

confidence: 99%

<p>Novel Energy Devices in Head and Neck Robotic Surgery – A Narrative Review</p>

Ross¹,

Tolley²,

Awad³

2020

RSRR

View full text Add to dashboard Cite

The advent of trans-oral robotic surgery (TORS) has facilitated removal of tumors previously deemed unresectable, by providing access to the deep structures of the head and neck. Despite this, the wider dissemination of TORS has been restricted due to issues with line of access, as the da Vinci robot was never designed with head and neck surgery in mind. Flexible instruments and novel energy delivery devices offer great potential in overcoming some of the existing challenges surrounding TORS. This review aimed to summarize the existing literature surrounding energy delivery in TORS and highlight areas of future innovation. MEDLINE was searched for studies relating to energy delivery in TORS in November 2019. The existing literature surrounding monopolar and bipolar electrocautery, LASER (CO 2 , Tm:YAG and blue LASER), Ligasure and Harmonic was reviewed. Additionally, the latest iteration of the da Vinci; the SP, and the FLEX robot were evaluated as novel methods of energy delivery in TORS. Overall, these novel energy devices and robotic systems are predicted to further improve energy delivery to the head and neck. The use of flexible LASER in particular is well substantiated in the literature. This has the potential to achieve treatment de-escalation, based on the excellent outcomes demonstrated for disease-free margins and post-operative morbidity.

show abstract

Transoral surgery using the Flex Robotic System: Initial experience in the United States

Cited by 19 publications

References 15 publications

Acceptance and adoption of transoral robotic surgery in Germany

Acceptance and adoption of transoral robotic surgery in Germany

The Flex Robotic System in Head and Neck Surgery: A Review

<p>Novel Energy Devices in Head and Neck Robotic Surgery – A Narrative Review</p>

Contact Info

Product

Resources

About