Understanding contraindications for transoral robotic surgery (TORS) for oropharyngeal cancer

Revisiting vascular contraindications for transoral robotic surgery for oropharyngeal cancer

“…Nevertheless, the advantages of transoral robotic surgery for enhancing the surgical field visualization in oropharyngeal tumors and for improving the postoperative outcomes as compared to open approaches have been confirmed by numerous authors since the first descriptions by Weinstein and O'Malley 1, 2, 3, 4, 18, 19, 20. To date, a retropharyngeal ICA has, however, been considered to be a contraindication for TORS due to the risk of a catastrophic vascular injury 10, 21. We have developed and recently published the cervical‐transoral robotic oropharyngectomy approach with free flap reconstruction as a refined procedure for complex situations such as salvage oropharyngectomy 11.…”

A european multicenter study evaluating the flex robotic system in transoral robotic surgery

“…With respect to TLM, the da Vinci System offers the advantage of a better overview and wristed instruments. However, even experienced surgeons face limitations when using established techniques such as TLM or the da Vinci System in TORS . In 2013, Moore and Hinni stated: “Transoral laser surgery for base of tongue tumors is challenging.…”

Fortschritte in der transoralen roboterassistierten Chirurgie

“…Es handelt sich hierbei im Wesentlichen um vaskuläre, funktionelle und onkologische Kontraindikationen [30]. Insbesondere die anatomische Nähe des Tumors zur Arteria carotis, der zu erwartende Verlust von mehr als der Hälfte des funktionellen Gewebes im Bereich des Zungengrunds oder der Supraglottis und die fehlende Einstellbarkeit des Tumors sind die Hauptkontraindikationen für TORS.…”