Hybrid procedure for total laryngectomy with a flexible robot-assisted surgical system

Int J Med Robot. 2017 Jun;13(2). doi: 10.1002/rcs.1749. Epub 2016 May 16.

Abstract

Introduction: Total laryngectomy is a standard procedure in head-and-neck surgery for the treatment of cancer patients. Recent clinical experiences have indicated a clinical benefit for patients undergoing transoral robot-assisted total laryngectomy (TORS-TL) with commercially available systems. Here, a new hybrid procedure for total laryngectomy is presented.

Methods: TORS-TL was performed in human cadavers (n = 3) using a transoral-transcervical hybrid procedure. The transoral approach was performed with a robotic flexible robot-assisted surgical system (Flex®) and compatible flexible instruments. Transoral access and visualization of anatomical landmarks were studied in detail.

Results: Total laryngectomy is feasible with a combined transoral-transcervical approach using the flexible robot-assisted surgical system. Transoral visualization of all anatomical structures is sufficient. The flexible design of the robot is advantageous for transoral surgery of the laryngeal structures.

Conclusion: Transoral robot assisted surgery has the potential to reduce morbidity, hospital time and fistula rates in a selected group of patients. Initial clinical studies and further development of supplemental tools are in progress. Copyright © 2016 John Wiley & Sons, Ltd.

Keywords: TORS; camera; flex; robot-assisted; total laryngectomy.

MeSH terms

  • Aged
  • Cadaver
  • Combined Modality Therapy / methods
  • Female
  • Humans
  • Laryngectomy / methods*
  • Larynx / pathology*
  • Larynx / surgery*
  • Male
  • Natural Orifice Endoscopic Surgery / methods*
  • Robotic Surgical Procedures / methods*
  • Treatment Outcome
  • User-Computer Interface