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Transoral robotic surgery

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https://www.readbyqxmd.com/read/29327784/transoral-robotic-surgery-for-oropharyngeal-carcinoma-surgical-margins-and-oncologic-outcomes
#1
Eric J Moore, Kathryn M Van Abel, Daniel L Price, Christine M Lohse, Kerry D Olsen, Ryan S Jackson, Eliot J Martin
BACKGROUND: This study presents oncologic outcomes after transoral robotic surgery (TORS) ± adjuvant therapy for oropharyngeal squamous cell carcinoma (SCC). METHODS: Three hundred fourteen patients undergoing TORS ± adjuvant therapy for oropharyngeal SCC from May 1, 2007, to May 31, 2015, are analyzed. RESULTS: Median follow-up was 3.3 years (interquartile range [IQR] 1.8-5.3 years; range 1 day to 9.3 years). Estimated locoregional recurrence-free survival, distant metastasis-free survival (DMFS), overall survival (OS), and cancer-specific survival (CSS) rates (95% confidence interval [CI] number still at risk) at 5 years after surgery were 92% (88-95; 92), 90% (86-94; 92), 86% (82-92; 98), and 94% (91-97; 98), respectively...
January 12, 2018: Head & Neck
https://www.readbyqxmd.com/read/29327731/transoral-robotic-surgery-in-eagle-s-syndrome-our-experience-on-four-patients
#2
D H Kim, Y H Lee, D Cha, S H Kim
Eagle's syndrome is characterised by focal pain in the tonsillar fossa on wide mouth opening or head rotation and various accompanying symptoms. While the syndrome is difficult to diagnose, shortening the styloid process via a transoral or transcervical surgical approach has been shown to be the most effective treatment. The aim of this article was to document our experience with a transoral robotic approach to treat Eagle's syndrome and to present the outcomes of four patients. We reviewed the cases of four patients with Eagle's syndrome who underwent transoral robotic surgery (TORS)...
December 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/29302476/robotic-and-endoscopic-transoral-thyroidectomy-feasibility-and-description-of-the-technique-in-the-cadaveric-model
#3
Bora Kahramangil, Khuzema Mohsin, Hassan Alzahrani, Daniah Bu Ali, Syed Tausif, Sang-Wook Kang, Emad Kandil, Eren Berber
Background: Numerous new approaches have been described over the years to improve the cosmetic outcomes of thyroid surgery. Transoral approach is a new technique that aims to achieve superior cosmetic outcomes by concealing the incision in the oral cavity. Methods: Transoral thyroidectomy through vestibular approach was performed in two institutions on cadaveric models. Procedure was performed endoscopically in one institution, while the robotic technique was utilized at the other...
December 2017: Gland Surgery
https://www.readbyqxmd.com/read/29298526/comparison-of-radiofrequency-and-transoral-robotic-surgery-in-obstructive-sleep-apnea-syndrome-treatment
#4
Engin Aynacı, Murat Karaman, Burak Kerşin, Mahmut Ozan Fındık
INTRODUCTION: Radiofrequency tissue ablation (RFTA) and transoral robotic surgery (TORS) are the methods used in OSAS surgery. We also aimed to compare the advantages and disadvantages of RF and TORS as treatment methods applied in OSAS patients in terms of many parameters, especially apnea hypopnea index (AHI). MATERIALS AND METHODS: Patients were classified by performing a detailed examination and evaluation before surgery. 20 patients treated with anterior palatoplasty and uvulectomy -/+ tonsillectomy + RFTA (17 males, 3 females) and 20 patients treated with anterior palatoplasty and uvulectomy -/+  tonsillectomy + TORS (16 males, 4 females) were included in the study...
January 3, 2018: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/29244238/transoral-robotic-surgery-for-oropharyngeal-squamous-cell-carcinoma-in-the-era-of-human-papillomavirus
#5
Omar Mahmoud, Kim Sung, Francisco J Civantos, Giovanna R Thomas, Michael A Samuels
BACKGROUND: The emergence of transoral robotic surgery (TORS) ignited the debate between surgical and nonsurgical strategies on oropharyngeal squamous cell carcinoma (SCC) management; a question further complicated by human papillomavirus (HPV). We evaluated the survival by treatment strategy independently in HPV-related and HPV-nonrelated oropharyngeal SCC. METHODS: The National Cancer Database was queried for patients with oropharyngeal SCC with known HPV status who underwent primary TORS or primary radiotherapy...
December 15, 2017: Head & Neck
https://www.readbyqxmd.com/read/29244229/transoral-robotic-surgery-for-residual-and-recurrent-oropharyngeal-cancers-exploratory-study-of-surgical-innovation-using-the-ideal-framework-for-early-phase-surgical-studies
#6
Vinidh Paleri, Hannah Fox, Sarah Coward, Maniram Ragbir, Andrew McQueen, Omar Ahmed, David Meikle, Daniel Saleh, James O'Hara, Max Robinson
BACKGROUND: The purpose of this study was to identify the role of transoral robotic surgery (TORS) in the management of residual and recurrent oropharyngeal cancer. METHODS: IDEAL (Idea, Development, Exploration, Assessment, Long-term Follow-up) 2a framework. RESULTS: Of 26 patients assessed for TORS, 21 underwent the procedure, 5 underwent open resection (4 due to unsuitable anatomy/tumor extent and 1 on the basis of patient choice). Three patients underwent intraoperative ultrasound-assisted robotic resection, and 3 received robotic-assisted free flap inset...
December 15, 2017: Head & Neck
https://www.readbyqxmd.com/read/29236272/medical-malpractice-and-transoral-robotic-surgery-evaluation-and-some-preemptive-thoughts
#7
Daniel D Lydiatt, Ryan Sewell
Medical malpractice is costly and disruptive, and it is important to prevent. We conducted a study with the objective to look at medical malpractice in robotic surgery overall, to evaluate reasons for litigation, and to comment on possible strategies to avoid litigation with transoral robotic surgery. We used the Westlaw computerized database to identify all state and federal verdict summaries in medical malpractice cases. We found 17 cases alleging malpractice that involved the use of robotic surgery. In all, the plaintiffs in 6 cases (35%) contended that an open rather than a robotic approach should have been used, 5 (29%) alleged negligent credentialing, 4 (24%) alleged training deficiencies, 2 (12%) alleged manufacturing problems, and 1 (6%) charged that robotic surgery should have been performed instead of open surgery (1 case involved two of these allegations)...
December 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/29224814/transoral-robotic-surgery-based-therapy-in-patients-with-stage-iii-iv-oropharyngeal-squamous-cell-carcinoma
#8
Young Min Park, Hye Ryun Kim, Byoung Chul Cho, Ki Chang Keum, Nam Hoon Cho, Se-Heon Kim
OBJECTIVE: TORS-based therapy including chemotherapy or RTx was administered to patients with stage III-IV OPSCC. We analyzed the oncological and functional outcomes of stage III-IV OPSCC patients who underwent TORS-based therapy. MATERIALS AND METHODS: Between May 2008 and May 2016, 80 patients participated in this clinical trial. RESULTS: A negative margin was identified in 66 patients (82.5%) and a positive margin in 14 (17.5%). TNM stages were III in 13 patients (16...
December 2017: Oral Oncology
https://www.readbyqxmd.com/read/29224809/unplanned-readmission-following-transoral-robotic-surgery
#9
Michael C Topf, Amanda Vo, Patrick Tassone, Christopher Shumrick, Adam Luginbuhl, David M Cognetti, Joseph M Curry
OBJECTIVES: To determine the rate of unplanned readmission after transoral robotic surgery (TORS), and to determine which patient or surgical factors increase the likelihood of readmission. MATERIALS AND METHODS: Retrospective chart review of all patients who underwent TORS for squamous cell carcinoma at our institution from March 2010 through July 2016. Primary outcome was unplanned readmission to the hospital within 30 days of discharge. Univariable and multivariable logistic regression were performed to identify risk factors for unplanned readmission...
December 2017: Oral Oncology
https://www.readbyqxmd.com/read/29206695/drug-induced-sleep-endoscopy-from-obscure-technique-to-diagnostic-tool-for-assessment-of-obstructive-sleep-apnea-for-surgical-interventions
#10
Joshua H Atkins, Jeff E Mandel
PURPOSE OF REVIEW: Provide a practical update on drug-induced sleep endoscopy (DISE) for anesthesia providers, which can also serve as a reference for those preparing to establish a DISE program. RECENT FINDINGS: New developments in surgical approaches to OSA and the growing global incidence of the condition have stimulated increased interest and demand for drug-induced sleep endoscopy. New techniques include transoral robotic surgery and hypoglossal nerve stimulation...
December 4, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29204587/transoral-robotic-surgery-vs-endoscopic-partial-midline-glossectomy-for-obstructive-sleep-apnea
#11
David Folk, Mark D'Agostino
Objective: To compare sleep-related outcomes in obstructive sleep apnea hypopnea syndrome (OSAHS) patients following base of tongue resection via robotic surgery and endoscopic midline glossectomy. Methods: This was a retrospective study. A total of 114 robotic and 37 endoscopic midline glossectomy surgeries were performed between July 2010 and April 2015 as part of single or multilevel surgery. Patients were excluded for indications other than sleep apnea or if complete sleep studies were not obtained...
June 2017: World Journal of Otorhinolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29204586/transoral-robotic-surgery-for-obstructive-sleep-apnea-syndrome-principles-and-technique
#12
Claudio Vicini, Filippo Montevecchi, Riccardo Gobbi, Andrea De Vito, Giuseppe Meccariello
Objective: The present study is a review of transoral robotic surgery (TORS) for the treatment of obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods: The review presents the experience of the robotic center that developed the technique with regards to patient selection, surgical method, and post-operative care. In addition, the review provides results of a systematic review and meta-analysis of the complications and clinical outcomes of TORS when applied in the management of OSAHS...
June 2017: World Journal of Otorhinolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29194991/hemorrhage-following-transoral-robotic-surgery-tors
#13
Ashley Hay, Jocelyn Migliacci, Daniella Karassawa Zanoni, Jay O Boyle, Bhuvanesh Singh, Richard J Wong, Snehal G Patel, Ian Ganly
BACKGROUND: To report our experience of postoperative hemorrhage in patients following transoral robotic surgery (TORS). METHODS: Data was collected on patients having TORS. Postoperative hemorrhage within 30 days was graded using the Mayo clinic grading system. RESULTS: TORS operations were performed on 122 patients. There were 23 bleeding events classified as minor to severe following 19 operations (16%). Hemorrhage requiring a return to the operating room occurred after 7 operations (6%)...
December 1, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/29183011/transoral-robotic-surgery-with-sialendoscopy-for-a-plunging-ranula
#14
Ryan M Carey, Benjamin L Hodnett, Christopher H Rassekh, Gregory S Weinstein
BACKGROUND/AIMS: Plunging ranulas are oral mucoceles that often cannot be visualized directly and thus can be challenging to diagnose and differentiate from other neck lesions. Surgery is the preferred treatment option, but the optimal approach requires careful consideration. METHODS: We report the case of a plunging ranula presenting as an isolated neck mass in a 33-year-old patient. This patient was treated with a novel transoral robotic surgery (TORS)-assisted approach aided by sialendoscopy...
November 29, 2017: ORL; Journal for Oto-rhino-laryngology and its related Specialties
https://www.readbyqxmd.com/read/29182490/positive-margins-by-oropharyngeal-subsite-in-transoral-robotic-surgery-for-t1-t2-squamous-cell-carcinoma
#15
Michael J Persky, William G Albergotti, Tanya J Rath, Mark W Kubik, Shira Abberbock, Mathew Geltzeiler, Seungwon Kim, Umamaheswar Duvvuri, Robert L Ferris
Objective To compare positive margin rates between the 2 most common subsites of oropharyngeal transoral robotic surgery (TORS), the base of tongue (BOT) and the tonsil, as well as identify preoperative imaging characteristics that predispose toward positive margins. Study Design Case series with chart review. Setting Tertiary care referral center. Subjects and Methods We compared the final and intraoperative positive margin rate between TORS resections for tonsil and BOT oropharyngeal squamous cell carcinoma (OPSCC), as well as the effect of margins on treatment...
November 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29160154/staging-neck-dissection-and-transoral-robotic-surgery-treatment-algorithm-in-palatine-tonsil-cancer
#16
Joseph Spellman, Ryan Sload, Paul Kim, Peter Martin, Gabriel Calzada
Objective This study introduces a treatment algorithm based on staging neck dissection to identify patients with palatine tonsil squamous cell carcinoma who can be effectively treated with single-modality transoral robotic surgery while maintaining quality of life. Study Design Retrospective case series. Setting Kaiser Permanente Southern California Medical Group from 2012 to 2017. Subjects and Methods Patients with early-stage (T1/2) palatine tonsil squamous cell carcinoma with clinically and radiographically N0 necks underwent staging neck dissection...
November 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29152739/first-bite-syndrome-following-transcervical-arterial-ligation-after-transoral-robotic-surgery
#17
Michael C Topf, Ethan Moritz, John Gleysteen, Joseph M Curry, David M Cognetti, Adam J Luginbuhl
OBJECTIVE: To assess the incidence of first bite syndrome (FBS) in transoral robotic surgical (TORS) patients undergoing transcervical arterial ligation. METHODS: Retrospective case series of all patients diagnosed with FBS following prophylactic transcervical arterial ligation of branches of the external carotid system between March 2010 and December 2016 at a single academic center. RESULTS: Six patients with FBS after TORS with transcervical arterial ligation were evaluated, representing 7% of all patients who underwent neck dissection with concomitant transcervical arterial ligation (6 of 83)...
November 20, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29130568/flexible-next-generation-robotic-surgical-system-for-transoral-endoscopic-hypopharyngectomy-a-comparative-preclinical-study
#18
Ichiro Tateya, Yoon Woo Koh, Raymond K Tsang, Steven S Hong, Ryuji Uozumi, Yo Kishimoto, Taro Sugimoto, F Christopher Holsinger
BACKGROUND: The purpose of this cadaveric study was to determine the efficacy of a flexible, next-generation robotic surgical system for transoral robotic hypopharyngectomy. METHODS: A comparative evaluation study of the flexible versus rigid robotic surgical systems for the hypopharynx was conducted using 3 cadavers. Endpoints for assessment were visualization of the hypopharynx, access to the hypopharynx, and difficulty of dissection. Hypopharyngectomy was performed on 3 other cadavers using the da Vinci Sp surgical system...
November 11, 2017: Head & Neck
https://www.readbyqxmd.com/read/29128262/intraoperative-imaging-during-minimally-invasive-transoral-robotic-surgery-using-near-infrared-light
#19
Nicholas Scott-Wittenborn, Ryan S Jackson
PURPOSE: The purpose of this study was to determine if the use of the FIREFLY imaging system could be an asset in transoral robotic surgery (TORS) for oropharyngeal squamous cell carcinoma (OPSCC). The system uses indocyanine green dye (ICG), which fluoresces when illuminated by near-infrared light from the Da Vinci robot. The system may improve visualization of tumor margins, highlight important vascular structures, and help identify the location of tumors and unknown primary head and neck cancers...
September 6, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/29121199/the-next-19-years-of-the-american-head-and-neck-society
#20
Jeffrey N Myers
Jeffrey N. Myers, MD, PhD, president of the American Head and Neck Society (AHNS) for 2016 to 2017, offered his perspectives on the AHNS's history, present-day activities, and future plans at this year's annual meeting of the society. The society was created from the 1998 merger of 2 societies, the Society for Head and Neck Surgeons (SHNS), founded in 1954, and the American Society for Head and Neck Surgery (ASHNS), founded in 1959, to become the largest organization in North America for the advancement of research and education in head and neck oncology...
November 9, 2017: JAMA Otolaryngology—Head & Neck Surgery
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