Initial implementation of robot-integrated specimen imaging in transoral robotic surgery

Abstract

The transoral approach to resecting oral and oropharyngeal tumors is associated with lower morbidity than open surgery, but is associated with a high positive margin rate. When margins are positive, it is critical that resection specimens be accurately oriented in anatomical context for gross and microscopic evaluation, and also that surgeons, pathologists, and other care team members share an accurate spatial awareness of margin locations. With clinical interest in digital pathology on the rise, this work outlines a proposed framework for generating 3D specimen models intraoperatively via robotintegrated stereovision, and using these models to visualize involved margins in both ex vivo (flattened) and in situ (conformed) configurations. Preliminary pilot study results suggest that stereo specimen imaging can be easily integrated into the transoral robotic surgery workflow, and that the expected accuracy of raw reconstructions is around 1.60mm. Ongoing data collection and technical development will support a full system evaluation.