Transoral Robotic Surgery (TORS) in Laryngeal and Hypopharyngeal Cancer
- 1 June 2009
- journal article
- research article
- Published by Mary Ann Liebert Inc in Journal of Laparoendoscopic & Advanced Surgical Techniques
- Vol. 19 (3), 361-368
- https://doi.org/10.1089/lap.2008.0320
Abstract
Objectives: The current trend in managing laryngeal and hypopharyngeal cancer is to perform organ preservation therapy, which improves quality of life and decreases treatment-related morbidity. Transoral robotic surgery (TORS) can overcome the limit of “line of sight” often met in classic transoral procedure. We utilized a robotic surgical system to evaluate the feasibility and oncologic safety of transoral partial pharyngectomy and laryngectomy. Materials and Methods: TORS was performed by using a “da Vinci surgical robot” (Intuitive Surgical, Inc., Sunnyvale, CA). An FK retractor (Gyrus Medical Inc., Maple Grove, MN) was used to expose the cancerous lesion transorally, and an endoscopic arm was introduced through the oral cavity with two instrument arms placed 30 degrees apart from the endoscopic arm. We performed TORS on 1 patient with pyriform sinus carcinoma and 4 patients with glottic carcinoma as a prospective human trial. Results: Average surgical time measured was 39 minutes, including an average of 25 minutes used for locating the robotic surgical system in place and exposing the lesion. TORS can provide a magnified three-dimensional view and overcome the limitation resulting from the “line of sight” that hinders the classic transoral procedure. All surgical resection margins were free of carcinoma. There were no perioperative complications, and also, no mortality due to the surgical procedure. Conclusions: This study demonstrates that the application of TORS for partial pharyngectomy and partial laryngectomy is technically feasible and safe.Keywords
This publication has 19 references indexed in Scilit:
- Organ Preserving Transoral Laser Microsurgery for Cancer of the HypopharynxThe Laryngoscope, 2008
- Transoral Robotic Surgery: Supraglottic Laryngectomy in a Canine ModelThe Laryngoscope, 2005
- Robot-Assisted Pharyngeal and Laryngeal Microsurgery: Results of Robotic Cadaver DissectionsThe Laryngoscope, 2005
- Robotic Microlaryngeal Surgery: A Technical Feasibility Study Using the daVinci Surgical Robot and an Airway MannequinThe Laryngoscope, 2005
- Robotic surgery in urology: fact or fantasy?BJU International, 2004
- CO2 laser surgery: A larynx preservation alternative for selected hypopharyngeal carcinomasHead & Neck, 2004
- The technique of apical dissection of the prostate and urethrovesical anastomosis in robotic radical prostatectomyBJU International, 2004
- Predictive values for aspiration after endoscopic laser resections of malignant tumors of the hypopharynx and larynxHead & Neck, 2003
- Robotically assisted coronary artery bypass surgery with the ZEUS telemanipulator systemSeminars in Thoracic and Cardiovascular Surgery, 2003
- Laser Cordectomy or Radiotherapy: Cure Rates, Communication, and CostOtolaryngology -- Head and Neck Surgery, 1993