The Flex robotic system compared to transoral laser microsurgery for the resection of supraglottic carcinomas: first results and preliminary oncologic outcomes

Eur Arch Otorhinolaryngol. 2020 Mar;277(3):917-924. doi: 10.1007/s00405-019-05767-0. Epub 2020 Jan 1.

Abstract

Purpose: Transoral robotic surgery (TORS) has the potential to improve some inherent disadvantages of transoral laser microsurgery (TLM). Here, we retrospectively assessed the application of the Medrobotics Flex system for the resection of supraglottic carcinomas compared to TLM.

Methods: 84 patients underwent surgery for supraglottic carcinomas with the Flex robotic system (n = 19, T-stage distribution in %: T1 42, T2 47, T3 11, T4 0) or TLM (n = 65, T-stage distribution in %: T1 40, T2 44, T3 14, T4 2). Clinical and oncologic parameters were compared.

Results: All surgeries were successfully completed with the Flex system and tracheostomy rate was 13%. For patients with adequate follow-up, 24-month disease-free survival was 71.4% (n = 5/7) after TORS compared to 64.9% (n = 24/37) after TLM. Local recurrence rates were 0% for TORS and 11% for TLM.

Conclusions: Initial results for supraglottic carcinoma resection using the Medrobotics Flex system are encouraging with excellent local tumor control.

Keywords: Flex robotic system; Laryngeal cancer; TLM; TORS.

MeSH terms

  • Carcinoma, Squamous Cell* / surgery
  • Humans
  • Laryngeal Neoplasms* / surgery
  • Laser Therapy*
  • Lasers
  • Microsurgery
  • Neoplasm Recurrence, Local / surgery
  • Retrospective Studies
  • Robotic Surgical Procedures*
  • Treatment Outcome