Robot-assisted Free Flap Reconstruction of Oropharyngeal Cancer—A Preliminary Report

Lai, Chih-Sheng; Chen, I-Chen; Liu, Shih–An; Lu, Chen-Te; Yen, Jung-Hsing; Song, Ding-Yu

doi:10.1097/sap.0000000000000464

Cited by 16 publications

(10 citation statements)

References 21 publications

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“…This time proven approach provides safe and effective surgical access, but is associated with delayed recovery of oral function and obvious facial scarring [34, 53]. TORS offers the advantage of superb visualization as demonstrated by the reduced positive margin rate and precise instrumentation to perform large oropharyngeal resections in a less invasive and cosmetically superior fashion.…”

Section: Discussionmentioning

confidence: 99%

Transoral robotic surgery with radial forearm free flap reconstruction: case control analysis

Biron

O’Connell

Barber

et al. 2017

J of Otolaryngol - Head & Neck Surg

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BackgroundThe resection of large oropharyngeal tumors traditionally involves a lip-splitting mandibulotomy for adequate margin visualization and free flap reconstruction of the surgical defect. Transoral robotic surgery (TORS) has emerged as a technique that can resect large and complex oropharyngeal tumors, avoiding a lip-splitting approach. The aim of this study is to compare the lip-splitting mandibulotomy approach versus TORS for the management of advanced stage oropharyngeal carcinomas.MethodsProspectively collected data from 18 patients with advanced stage oropharyngeal squamous cell carcinoma (OPSCC) who received TORS with radial forearm free flap reconstruction (RFFF) was compared to a matched cohort of 39 patients who received a lip-splitting mandibulotomy and RFFF. Patients were matched for stage, p16 positivity, smoking, age and gender. Length of hospital stay (LOHS), tracheostomy decanulation time, operative time, surgical margin status, and post-operative complications were compared between groups.ResultsPatients who received TORS with RFFF had a significantly lower mean LOHS, compared to patients who were treated by lip-splitting mandibulotomy and RFFF (14.4 vs 19.7 days, p = 0.03). No significant differences were seen between groups in terms of operative time, tracheostomy decannulation time, margin positivity and post-operative complications.ConclusionTORS with radial forearm free flap reconstruction is a safe, effective and cost-saving alternative to the lip-splitting mandibulotomy approach for the treatment of advanced stage OPSCC.

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Section: Discussionmentioning

confidence: 99%

Transoral robotic surgery with radial forearm free flap reconstruction: case control analysis

Biron

O’Connell

Barber

et al. 2017

J of Otolaryngol - Head & Neck Surg

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“…Robotic‐assisted technology has been developed to facilitate minimal invasive surgeries. The da Vinci surgical system has already been widely applied in various surgical procedures . The technology has many advantages in comparison to standard minimally invasive approaches: high resolution, 3D optics, intuitive motion, and greatly enhanced precision.…”

Section: Discussionmentioning

confidence: 99%

“…The da Vinci surgical system has already been widely applied in various surgical procedures. [11][12][13][14][15][16][17] The technology has many advantages in comparison to standard minimally invasive approaches: high resolution, 3D optics, intuitive motion, and greatly enhanced precision. Yet aside from robotic harvest of the latissimus dorsi muscle, the use of robotic technology has been limited in plastic breast surgery.…”

Section: Surgical Techniquementioning

confidence: 99%

Robotic da Vinci Xi-assisted nipple-sparing mastectomy: First clinical report

et al. 2017

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Nipple-sparing mastectomy (NSM) is increasingly popular for the treatment of selected breast cancers and prophylactic mastectomy. Surgical scarring and esthetic outcomes are important patient-related cosmetic considerations. Today, the concept of minimally invasive surgery has become popular, especially using robotic surgery. The authors report the first case of NSM using the latest version of the da Vinci Xi surgical system (Xi). The final incision used to remove the entire mammary gland was located behind the axillary line. In this position, hidden by the arm of the patient, the incision was not visible and was compatible with immediate breast reconstruction.

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“…Post-oncological resection, robotic surgery is widely described, in particular for those tumours whose excision involves oropharyngeal tissue deficiency. Different techniques have been put forward, and some use a pedicled flap, such as the facial artery musculomucosal (FAMM) flap [41]; while others take into consideration free flaps, like those of the anterolateral thigh or radial forearm [42][43][44]. The obvious advantage of the robot is in suturing the fasciocutaneous paddle, as it allows greater manipulation and suturing in covered areas.…”

Section: Reconstructive Surgerymentioning

confidence: 99%

Alternative Applications of Trans-Oral Robotic Surgery (TORS): A Systematic Review

Cammaroto

Stringa

Zhang

et al. 2020

JCM

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Background: The role of robotic surgery in the field of oncology has been widely described, in particular for the tumours of the oropharynx and larynx, but its efficacy for benign pathology is inconsistent. Methods: An exhaustive review of the English literature on trans-oral robotic surgery (TORS) for benign conditions was performed using PubMed electronic database. Results: The research was performed in March 2019 and yielded more than eight hundred articles, with 103 meeting the inclusion criteria and considered in the present study. Conclusions: The application of TORS for the treatment of obstructive sleep apnoea syndrome seems to be particularly well documented. Additionally, there exists a special interest in its use where high precision in limited anatomic space is required. There are still different structural and economic limitations for the application of TORS, however, the progressive technologic innovations and the increasing adoption of robotic surgery seem to encourage the uptake of this technique.

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Robot-assisted Free Flap Reconstruction of Oropharyngeal Cancer—A Preliminary Report

Abstract: The application of a robotic surgical system seems to be a safe option in the free flap reconstruction of oropharyngeal defects without lip or mandible splitting.

Cited by 16 publications

References 21 publications

Transoral robotic surgery with radial forearm free flap reconstruction: case control analysis

Transoral robotic surgery with radial forearm free flap reconstruction: case control analysis

Robotic da Vinci Xi-assisted nipple-sparing mastectomy: First clinical report

Alternative Applications of Trans-Oral Robotic Surgery (TORS): A Systematic Review

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