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Transoral robotic surgery

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https://www.readbyqxmd.com/read/28064382/early-assessment-of-feasibility-and-technical-specificities-of-transoral-robotic-surgery-using-the-da-vinci-xi
#1
Philippe Gorphe, Jean Von Tan, Sophie El Bedoui, Dana M Hartl, Anne Auperin, Quentin Qassemyar, Antoine Moya-Plana, François Janot, Morbize Julieron, Stephane Temam
The latest generation Da Vinci(®) Xi™ Surgical System Robot released has not been evaluated to date in transoral surgery for head and neck cancers. We report here the 1-year results of a non-randomized phase II multicentric prospective trial aimed at assessing its feasibility and technical specificities. Our primary objective was to evaluate the feasibility of transoral robotic surgery using the da Vinci(®) Xi™ Surgical System Robot. The secondary objective was to assess peroperative outcomes. Twenty-seven patients, mean age 62...
January 7, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28050651/primary-transoral-robotic-surgery-with-concurrent-neck-dissection-for-early-stage-oropharyngeal-squamous-cell-carcinoma-implemented-at-a-danish-head-and-neck-cancer-center-a-phase-ii-trial-on-feasibility-and-tumour-margin-status
#2
Niclas Rubek, Hani Ibrahim Channir, Birgitte Wittenborg Charabi, Christel Bræmer Lajer, Katalin Kiss, Hans Ulrik Nielsen, Jens Bentzen, Jeppe Friborg, Christian von Buchwald
There is an increasing incidence of oropharyngeal squamous cell carcinoma (OPSCC) in the western world due to human papillomavirus (HPV). According to the Danish Head and Neck Cancer Group guidelines, the current recommended treatment of patients with OPSCC in Denmark is primary radiation therapy (RT) with or without concomitant chemotherapy. This is the first study in Scandinavia from a head and neck cancer centre that aims to demonstrate the feasibility of performing primary transoral robotic surgery (TORS) and concurrent neck dissection for patients with early stage OPSCC...
January 3, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28041765/-the-thin-alt-perforator-flap-for-oropharyngeal-robotic-assisted-reconstruction
#3
Q Qassemyar, P Aguilar, S Temam, F Kolb, P Gorphe
Since a few years, the transoral robotic surgery reduced the morbidity of oropharyngeal tumors excision. Large posterior tumors can now be removed without any scar visible on the face. In this context and to respect the thinness required for reconstructions at the junction of the upper aerodigestive tract, the free radial forearm flap still remains the solution of choice. However, if the transoral robotic surgery respects the anatomy and the aesthetics of patients at the visible and social area that represents the face, the forearm flap provides visible scars on the other region of social interaction that represents the upper limb...
December 29, 2016: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/28034402/transoral-robotic-surgery
#4
Shokjean Yee
Transoral robotic surgery (TORS) is a technique used to treat oral, throat, and skull base cancers using a minimally invasive robotic approach through the mouth and throat. The TORS procedure allows deeper access and dissection of suspicious lesions and neoplastic growths in the oral cavity and those that extend from the throat to the base of the skull. Robotic surgery allows the surgeon to operate in tight spaces without a large open incision. This article discusses symptoms and risk factors of oral, throat, and skull base cancers; types of procedures that can be performed using the TORS approach; specialized instrumentation; patient selection; surgical advantages and disadvantages; patient benefits; and the role of the surgical team in preparing to intraoperatively care for the TORS patient...
January 2017: AORN Journal
https://www.readbyqxmd.com/read/28025603/evidence-and-evidence-gaps-of-laryngeal-cancer-surgery
#5
REVIEW
Susanne Wiegand
Surgical treatment of laryngeal cancer has been established for decades. In addition to total laryngectomy, which was first performed in 1873, a large number or organ preservation surgical techniques, like open partial laryngectomy, transoral laser microsurgery, and transoral robotic surgery have been developed. Studies on laryngeal cancer surgery are mainly retrospective case series and cohort studies. The evolution of chemoradiation protocols and their analysis in prospective randomized trials have led to an increasing acceptance of non-surgical treatment procedures...
2016: GMS Current Topics in Otorhinolaryngology, Head and Neck Surgery
https://www.readbyqxmd.com/read/28009229/transoral-robotic-surgery-for-sellar-tumors-first-clinical-study
#6
Dorian Chauvet, Stéphane Hans, Antoine Missistrano, Celeste Rebours, Wissame El Bakkouri, Guillaume Lot
OBJECTIVE The aim of this study was to confirm the feasibility of an innovative transoral robotic surgery (TORS), using the da Vinci Surgical System, for patients with sellar tumors. This technique was designed to offer a new minimally invasive approach, without soft-palate splitting, that avoids the rhinological side effects of classic endonasal approaches. METHODS The authors performed a prospective study of TORS in patients with symptomatic sellar tumors. Specific anatomical features were required for inclusion in the study and were determined on the basis of preoperative open-mouth CT scans of the brain...
December 23, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28007583/towards-a-privacy-preserving-cohort-discovery-framework-for-clinical-research-networks
#7
Jiawei Yuan, Bradley Malin, François Modave, Yi Guo, William R Hogan, Elizabeth Shenkman, Jiang Bian
BACKGROUND: The last few years have witnessed an increasing number of clinical research networks (CRNs) focused on building large collections of data from electronic health records (EHRs), claims, and patient-reported outcomes (PROs). Many of these CRNs provide a service for the discovery of research cohorts with various health conditions, which is especially useful for rare diseases. Supporting patient privacy can enhance the scalability and efficiency of such processes; however, current practice mainly relies on policy, such as guidelines defined in the Health Insurance Portability and Accountability Act (HIPAA), which are insufficient for CRNs (e...
December 19, 2016: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28007349/the-temporalis-muscle-flap-for-reconstruction-of-soft-palate-and-lateral-oropharyngeal-wall-after-transoral-robotic-surgery
#8
Giuseppe Meccariello, Filippo Montevecchi, Alberto Deganello, Giovanni D'Agostino, Chiara Bellini, Ermelinda Zeccardo, Claudio Vicini
Trans Oral Robotic Surgery (TORS) is a prominent surgical approach for the resection of oropharyngeal tumors without division of the lip and mandible. Some defects following TORS are large and complex enough to benefit soft-tissue coverage. The pedicled temporalis muscle flap is a versatile and reliable flap and may be a valid option to reconstruct defects of the lateral pharyngeal wall and partial soft palate.
December 19, 2016: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/28004263/transoral-robotic-surgery-for-the-pediatric-head-and-neck-surgeries
#9
Evren Erkul, Umamaheswar Duvvuri, Deepak Mehta, Utku Aydil
Pediatric robotic surgery is a relatively new technology that has been shown to be safe and feasible for a number of pediatric procedures. Our literature analysis was performed using Pubmed database between January 2005 and December 2015, using key words: "robotic," "robotic surgery," "TORS," "pediatric," "children," "head and neck," and "da Vinci". We selected only publications in English. Eight published reports met the selection criteria. We totally found 41 patients, and the age range was between 2 months and 19 years...
December 21, 2016: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/27995544/transoral-robotic-resection-of-a-combined-laryngocele
#10
T J Gal, Brian Hixon, Paul Zhang
This case report describes the use of trans-oral robotic surgery (TORS) for the excision of a combined laryngocele. Mixed or combined laryngoceles extend from the supraglottic larynx through the thyrohyoid membrane into the neck. Surgical excision for these benign lesions often requires combined external (transcervical) and internal (transoral endoscopic) approaches which carry significant morbidity. We present the case of a 37-year-old male who was diagnosed with a large laryngopyocele and was subsequently managed with a transoral excision using the da Vinci Si surgical robot system...
December 19, 2016: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/27956103/transoral-robotic-surgery-tors-for-excision-of-a-retropharyngeal-intramuscular-lipoma
#11
Chase M Heaton, Saqib R Ahmed, William R Ryan
OBJECTIVE: To describe the feasibility, effectiveness, and improved morbidity profile of transoral robotic surgery (TORS) for the excision of a retropharyngeal intramuscular lipoma. METHODS: Case report of a robot-assisted transoral resection of a retropharyngeal intramuscular lipoma. RESULTS: A 62-year-old woman presented with tongue pain and globus with dysphagia for six months. Transoral exam revealed a pharyngeal submucosal mass, and MRI demonstrated a prevertebral lipomatous lesion with protrusion into the airway...
December 9, 2016: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/27943254/minimally-invasive-surgery-versus-radiotherapy-chemoradiotherapy-for-small-volume-primary-oropharyngeal-carcinoma
#12
REVIEW
James Howard, Liam Masterson, Raghav C Dwivedi, Faruque Riffat, Richard Benson, Sarah Jefferies, Piyush Jani, James R Tysome, Chris Nutting
BACKGROUND: More than 400,000 cases of oropharyngeal squamous cell carcinoma (OPSCC) are diagnosed each year worldwide and the incidence is rising, partly as a result of human papillomavirus. Human papillomavirus-associated OPSCC affects younger patients and often presents at a higher stage; however, it is associated with a better prognosis.Until recently, first-line management of OPSCC involved chemoradiotherapy, as research had demonstrated comparable survival outcomes when compared with open surgery, with significantly decreased morbidity...
December 11, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27930761/transoral-robotic-surgery-assisted-endoscopy-with-primary-site-detection-and-treatment-in-occult-mucosal-primaries
#13
Kyle M Hatten, Bert W O'Malley, Andres M Bur, Mihir R Patel, Christopher H Rassekh, Jason G Newman, Steven B Cannady, Ara A Chalian, Benjamin L Hodnett, Alexander Lin, John N Lukens, Roger B Cohen, Joshua M Bauml, Kathleen T Montone, Virginia A Livolsi, Gregory S Weinstein
Importance: Management of cervical lymph node metastasis without a known primary tumor is a diagnostic and treatment challenge for head and neck oncologists. Identification of the occult mucosal primary tumor minimizes the morbidity of treatment. Objective: To analyze the role of transoral robotic surgery (TORS) in facilitating the identification of a primary tumor site for patients presenting with squamous cell carcinoma of unknown primary (CUP). In addition, we assessed treatment deintensification by determining the number of patients who did not undergo definitive radiation therapy and chemotherapy...
December 8, 2016: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/27882552/trends-and-the-utilization-of-transoral-robotic-surgery-with-neck-dissection-in-new-york-state
#14
Catherine H Frenkel, Jie Yang, Mengru Zhang, Elliot Regenbogen, Dana A Telem, Ghassan J Samara
OBJECTIVES: The timing of neck dissection (ND) in relation to transoral robotic surgery (TORS) is controversial. This study identifies local practice patterns and economic and social access disparities during adoption of TORS. STUDY DESIGN: We analyzed utilization patterns of TORS and ND using the New York Statewide Planning and Research Cooperative System all-payer administrative database. Statewide head and neck cancer incidence from the Centers for Disease Control and Prevention (Bethesda, MD) was used to control for overall cancer incidence...
November 24, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27860242/transoral-robotic-surgery-base-of-tongue-mucosectomy-for-head-and-neck-cancer-of-unknown-primary
#15
Suren Krishnan, James Connell, Enyinnaya Ofo
BACKGROUND: Head and neck cancer of unknown primary (HNCUP) is a source of diagnostic uncertainty. Patients presenting with cytologically positive neck lumps without a clinically identifiable primary, require extensive investigation including imaging, tonsillectomy, panendoscopy and tissue biopsy. Treatment typically involves neck dissection, wide field radiotherapy and chemotherapy. Transoral robotic surgery (TORS) has emerged as an expanding surgical technique for resecting tumours of the oropharynx...
November 17, 2016: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27812692/radiotherapy-characteristics-and-outcomes-for-head-and-neck-carcinoma-of-unknown-primary-vs-t1-base-of-tongue-carcinoma
#16
Ali Hosni, Peter R Dixon, Anupam Rishi, Michael Au, Wei Xu, Yuyao Song, Douglas B Chepeha, David P Goldstein, Shao Hui Huang, John Kim, Brian O'Sullivan, John Waldron, Scott V Bratman, John R de Almeida
Importance: Transoral robotic surgery- or transoral laser microsurgery-assisted lingual tonsillectomy may improve the identification rate of hidden base-of-tongue (BOT) carcinoma presenting as head or neck carcinoma of unknown primary (CUP) site. Objective: To evaluate the potential impact of lingual tonsillectomy in CUP site by comparing differences in radiotherapy volumes, dosimetry, and clinical outcomes for CUP site and T1-category BOT carcinoma. Design, Setting, and Participants: Retrospective study of 115 patients treated at a tertiary cancer center between January 1, 2005, and December 31, 2013, that included patients with BOT carcinoma (category T1N1-3M0) and CUP site (category T0N1-3M0) with known p16 status...
December 1, 2016: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/27797004/novel-cause-of-black-thyroid-intraoperative-use-of-indocyanine-green
#17
Rebecca D Chernock, Ryan S Jackson
The antibiotic minocycline is virtually pathognomonic for brown-black discoloration of the thyroid gland referred to as 'black thyroid'. Black thyroid' is an incidental finding in patients taking the drug who undergo thyroid surgery for another indication and is not of known clinical significance. However, its recognition is important so as not to raise concern for a disease process. Here, we present the first case of 'black thyroid' attributable to the iodine-containing compound indocyanine green. Intraoperative indocyanine green was administered as part of a research protocol transoral robotic-assisted surgery for a base of tongue cancer in a 44-year-old man...
October 28, 2016: Endocrine Pathology
https://www.readbyqxmd.com/read/27796047/does-drug-induced-sleep-endoscopy-predict-surgical-success-in-transoral-robotic-multilevel-surgery-in-obstructive-sleep-apnea
#18
Taha S Meraj, Daniel G Muenz, Tiffany A Glazer, Rebecca S Harvey, Matthew E Spector, Paul T Hoff
OBJECTIVES/HYPOTHESIS: The aim of this study was to determine if drug-induced sleep endoscopy (DISE) was predictive of success for patients undergoing transoral robotic surgery (TORS) and multilevel procedures for sleep apnea. STUDY DESIGN: Retrospective case series of patients who underwent TORS surgery for sleep apnea METHODS: Before and after polysomnograms were analyzed to assess improvement, success, and cure. Improvement was defined as any decrease in apnea-hypopnea index (AHI), success as an AHI <20 with a decrease >50%, and cure as an AHI <5...
October 31, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27792258/flex-robotic-system-in-transoral-robotic-surgery-the-first-40-patients
#19
Stefan Mattheis, Pia Hasskamp, Laura Holtmann, Christina Schäfer, Urban Geisthoff, Nina Dominas, Stephan Lang
BACKGROUND: The Flex Robotic System is a new robotic device specifically developed for transoral robotic surgery (TORS). METHODS: We performed a prospective clinical study, assessing the safety and efficacy of the Medrobotics Flex Robotic System. A total of 40 patients required a surgical procedure for benign lesions (n = 30) or T1 and T2 carcinomas (n = 10). Access and visualization of different anatomic subsites were individually graded by the surgeon. Setup times, access and visualization times, surgical results, as well as adverse events were documented intraoperatively...
October 28, 2016: Head & Neck
https://www.readbyqxmd.com/read/27783427/a-european-multicenter-study-evaluating-the-flex-robotic-system-in-transoral-robotic-surgery
#20
Stephan Lang, Stefan Mattheis, Pia Hasskamp, Georges Lawson, Christian Güldner, Magis Mandapathil, Patrick Schuler, Thomas Hoffmann, Marc Scheithauer, Marc Remacle
OBJECTIVES/HYPOTHESIS: To evaluate the application of the Flex Robotic System in transoral robotic surgery (TORS). STUDY DESIGN: Multicenter, prospective, open-label, single-armed clinical study. METHODS: A prospective clinical follow-up multicenter study was performed from July 2014 to October 2015 assessing the safety and efficacy of the Medrobotics Flex Robotic System for access and visualization of the oropharynx, hypopharynx, and larynx as well as for resection of benign and malignant lesions...
October 26, 2016: Laryngoscope
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