Transoral robotic surgery for residual and recurrent oropharyngeal cancers: Exploratory study of surgical innovation using the IDEAL framework for early‐phase surgical studies

Paleri, Vinidh; Fox, Hannah; Coward, Stephanie; Ragbir, Maniram; McQueen, Andrew; Ahmed, Omar A.; Meikle, David; Saleh, Daniel; O’Hara, James; Robinson, Max

doi:10.1002/hed.25032

Cited by 33 publications

(38 citation statements)

References 28 publications

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“…In selected cases, TORS has shown good oncological outcomes for this patient group. The published literature along with the unpublished series from the author's case load [40] is presented in Table 3. Significant expertise with TORS is needed prior to embarking on these procedures.…”

Section: Recurrent Cancermentioning

confidence: 99%

Transoral Robotic Surgery for Oropharyngeal Cancer

Paleri¹,

Fox²,

Winter³

2018

ORL

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Transoral robotic surgery has shown significant promise in the management of oropharyngeal cancer since its description in 2007. The oncological efficacy of this procedure has been proven in several single-centre studies, multicentre collaborative publications and systematic reviews. The rapid take-up of transoral robotic surgery shows greater acceptance by professionals and is associated with a relatively short learning curve. This overview discusses the rationale and principles underlying the use of transoral robotic surgery in primary and recurrent oropharyngeal cancer and the emerging role for this technique in diagnosing the unknown primary site, and summarizes ongoing research in this field.

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Section: Recurrent Cancermentioning

confidence: 99%

Transoral Robotic Surgery for Oropharyngeal Cancer

Paleri¹,

Fox²,

Winter³

2018

ORL

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“…The authors report successful oncological resections and excellent recovery of speech and swallow. Paleri et al [9] describe their approach to RAR in a group of 26 patients undergoing TORS for residual and recurrent oropharyngeal cancers. The average times to de-cannulation and re-instatement of oral diet were 5.8 and 13 days, respectively.…”

Section: Robot-assisted Flap Insetmentioning

confidence: 99%

“…In the long term, a reduction in primary CRT and de-escalation of postoperative CRT through TORS pathways may reduce the incidence of osteoradionecrosis, which carries a large economic burden and has a significant impact on quality of life [15][16][17]. It should be pointed out that there is a steep learning curve for the surgeon performing TORS, and managing complex and salvage cases should not be undertaken early on in this process [9].…”

Section: Introductionmentioning

confidence: 99%

“…The authors recommend that class I and II defects should be either left to heal by secondary intention or local flaps, whilst class III or IV defects require regional or free flap reconstruction. In terms of a reconstructive strategy following TORS resections, reconstruction should be planned if coverage of major vessels is needed or if a substantial throughand-through defect into the neck occurs [9]. Numerous local flaps have been described for post-TORS defects depending upon the site of resection.…”

Section: Introductionmentioning

confidence: 99%

“…As experience improves, so larger and more complex resections, including salvage surgery, are becoming possible with TORS [9,11,12]. The natural evolution of this process has meant that reconstructive surgeons are beginning to investigate the role of robot-assisted reconstruction (RAR) and transoral robotic reconstructive surgery (TORRS) [13].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Robot-Assisted Reconstruction in Head and Neck Surgical Oncology: The Evolving Role of the Reconstructive Microsurgeon

Chalmers

Schlabe

Yeung

et al. 2018

ORL

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Transoral robotic surgery (TORS) is gaining more widespread use among head and neck surgical procedures. As experience grows with this technique, so do the indications of when and in which patients it can be used. Already established in the treatment of small oral cavity tumours, it is expanding into larger multi-site resections and resections, such as through-and-through-into-the-neck defects, that will require reconstruction. With robot-assisted surgery advancing, so robot-assisted reconstruction (RAR) is evolving. In this paper, we discuss the evolving role of reconstruction in post-TORS defects as well as the role of RAR in today’s practice.

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Outcome selection, measurement and reporting for new surgical procedures and devices: a systematic review of IDEAL/IDEAL-D studies to inform development of a core outcome set

et al. 2020

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Background: Outcome selection, measurement and reporting for the evaluation of new surgical procedures and devices is inconsistent and lacks standardization. A core outcome set may promote the safe and transparent evaluation of surgical innovations. This systematic review examined outcome selection, measurement and reporting in studies conducted within the IDEAL (Idea, Development, Exploration, Assessment and Long-term monitoring) framework to examine current practice and inform the development of a core outcome set for early-phase studies of surgical procedures/devices. Methods: Web of Science and Scopus citation searches were performed to identify author-reported IDEAL/IDEAL-D studies for any surgical procedure/device. Outcomes were extracted verbatim, including contextual information regarding outcome selection and measurement. Outcomes were categorized to inform a conceptual framework of outcome domains relevant to evaluating innovation. Results: Some 48 studies were identified. Outcome selection, measurement and reporting varied widely across studies in different IDEAL stages. From 1737 outcomes extracted, 22 domains specific to evaluating innovation were conceptualized under seven broad categories: procedure completion success/failure; modifications; unanticipated events; surgeons' experiences; patients' experiences; resource use specific to the innovative procedure/device; and other innovation-specific outcomes. Most innovation-specific outcomes were measured and reported in only a small number of studies. Conclusion: This review highlighted the need for guidance and standardization in outcome selection and reporting in the evaluation of new surgical procedures/devices. Novel outcome domains specific to innovation have been identified to establish a core outcome set for future evaluations of surgical innovations.

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Transoral robotic surgery for residual and recurrent oropharyngeal cancers: Exploratory study of surgical innovation using the IDEAL framework for early‐phase surgical studies

Cited by 33 publications

References 28 publications

Transoral Robotic Surgery for Oropharyngeal Cancer

Transoral Robotic Surgery for Oropharyngeal Cancer

Robot-Assisted Reconstruction in Head and Neck Surgical Oncology: The Evolving Role of the Reconstructive Microsurgeon

Outcome selection, measurement and reporting for new surgical procedures and devices: a systematic review of IDEAL/IDEAL-D studies to inform development of a core outcome set

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