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Transoral robotic surgery

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https://www.readbyqxmd.com/read/29765822/minimally-invasive-surgery-for-resection-of-parapharyngeal-space-tumors
#1
Irit Duek, Gill E Sviri, Salem Billan, Ziv Gil
Background  Surgical removal of parapharyngeal space tumors (PPST) poses challenges due to the complex anatomy of the region. PPSTs are routinely resected by a transcervical approach using blind finger dissection. Large PPSTs or those located high at the skull base, often require transmandibular or infratemporal fossa approaches, associated with considerable morbidity. Objective  Here, we describe an approach for PPST removal that comprises transcervical endoscopic, with or without transoral robotic technique...
June 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29754260/robotic-lateral-oropharyngectomy-following-diagnostic-tonsillectomy-is-oncologically-safe-in-patients-with-high-risk-human-papillomavirus-related-squamous-cell-cancer
#2
Somiah Siddiq, David Cartlidge, Sarah Stephen, Hans P Sathasivam, Hannah Fox, James O'Hara, David Meikle, Muhammad Shahid Iqbal, Charles G Kelly, Max Robinson, Vinidh Paleri
PURPOSE: Diagnostic tonsillectomy is rarely an oncologic operation owing to close or positive margins. The standard of care is for further treatment to the primary site, typically with adjuvant radiotherapy. METHODS: 14 patients with close or positive margins following a diagnostic tonsillectomy underwent transoral robotic surgery (TORS) and lateral oropharyngectomy; five patients with the longest follow-up had their excision specimens examined with a step serial sectioning technique (SSS)...
May 12, 2018: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29741427/time-course-of-subacute-pain-after-transoral-robotic-surgery-tors-for-oropharyngeal-squamous-cell-carcinoma-versus-traditional-bilateral-tonsillectomy-in-adults-a-case-control-study
#3
Susanne Irene Scott, Anne Kathrine Østergaard Madsen, Niclas Rubek, Hani Ibrahim Channir, Henrik Kehlet, Christian von Buchwald
OBJECTIVE: To examine pain after Transoral Robotic Surgery (TORS) for oropharyngeal squamous cell carcinoma (OPSCC) versus traditional bilateral tonsillectomy in adults. METHODS: Pain evolvement was assessed in a prospective case-control design of 16 consecutive patients treated with TORS for early stage OPSCC versus 12 patients, who underwent bilateral tonsillectomy on suspicion of malignant disease. The TORS group received an optimized analgesia regime of preoperative oral celecoxib and gabapentin, intra- and postoperative high-dose intravenous dexamethasone, and regular postoperative oral contalgin, gabapentin, celecoxib, paracetamol and rescue morphine...
May 9, 2018: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/29732318/diagnostic-value-of-lingual-tonsillectomy-in-unknown-primary-head-and-neck-carcinoma-identification-after-a-negative-clinical-workup-and-positron-emission-tomography-computed-tomography
#4
Chad K Sudoko, Marc A Polacco, Benoit J Gosselin, Joseph A Paydarfar
Objective: Diagnostic rates of unknown primary head and neck carcinoma (UPHNC) using lingual tonsillectomy (LT) are highly variable. This study sought to determine the diagnostic value of LT in UPHNC identification using strict inclusion criteria and definitions to produce a more accurate estimate of diagnosis rate. Methods: In this retrospective chart review, records of patients who underwent LT for UPHNC were reviewed. Inclusion criteria included absence of suspicious findings on physical exam and positron emission tomography-computed tomography as well as negative biopsies after panendoscopy and palatine tonsillectomy...
2018: Frontiers in Oncology
https://www.readbyqxmd.com/read/29721545/revisiting-vascular-contraindications-for-transoral-robotic-surgery-for-oropharyngeal-cancer
#5
Philippe Gorphe, Anne Auperin, Jean-François Honart, Jean Ton Van, Sophie El Bedoui, François Bidault, Stéphane Temam, Frédéric Kolb, Quentin Qassemyar
Objective: We analyzed the outcomes for patients with a retropharyngeal internal carotid artery (ICA) who underwent a transoral robotic surgery (TORS) procedure involving a cervical-transoral robotic oropharyngectomy course with free flap reconstruction. Methods: Patients were included in the prospective multicentric trial NCT02517125. These patients were scheduled to undergo surgery for an oropharyngeal localization. By pre-operative CT scan and MRI it was determined that they had a retropharyngeal internal carotid artery...
April 2018: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/29721446/a-contemporary-review-of-evidence-for-transoral-robotic-surgery-in-laryngeal-cancer
#6
REVIEW
Philippe Gorphe
Numerous studies have shown that transoral robotic surgery (TORS) for oropharyngeal cancers is safe and that it yields satisfactory functional and oncological outcomes. For many teams worldwide, it is therefore a standard surgical approach with eligible patients. In the same time, TORS is increasingly being used and described in the context of laryngeal cancer surgery. It is proposed as an alternative to open approaches, which may yield inconsistent functional results and significant rates of postoperative complications...
2018: Frontiers in Oncology
https://www.readbyqxmd.com/read/29719420/transoral-robotic-surgery-for-oropharyngeal-cancer-patient-selection-and-special-considerations
#7
REVIEW
R Michael Baskin, Brian J Boyce, Robert Amdur, William M Mendenhall, Kathryn Hitchcock, Natalie Silver, Peter T Dziegielewski
The increasing incidence of oropharyngeal squamous cell carcinoma (OPSCC) emphasizes the importance of optimizing treatment for the disease. Historical protocol has utilized definitive radiation and invasive open procedures; these techniques expose the patient to significant risks and morbidity. Transoral robotic surgery (TORS) has emerged as a therapeutic modality with promise. Here, the literature regarding proper patient selection and other considerations for this procedure was reviewed. Multiple patient and tumor-related factors were found to be relevant for successful use of this treatment strategy...
2018: Cancer Management and Research
https://www.readbyqxmd.com/read/29697873/transoral-robotic-resection-of-benign-tumors-of-the-upper-aerodigestive-tract-experience-of-the-french-group-of-gettec
#8
Emilien Chabrillac, Sylvain Morinière, Franck Jegoux, David Blanchard, Olivier Choussy, Stéphane Hans, Sébastien Vergez
BACKGROUND: The purpose of this study was to assess the current use of transoral robotic surgery (TORS) in benign tumors of the upper aerodigestive tract through a case series and a literature review. METHODS: This multicentric retrospective study was conducted in 6 French centers between November 2009 and July 2017. RESULTS: Twenty-one patients had a TORS resection of a tumor at varied locations with differing histopathologic characteristics...
April 26, 2018: Head & Neck
https://www.readbyqxmd.com/read/29650421/financial-outcomes-of-transoral-robotic-surgery-a-narrative-review
#9
REVIEW
Sammy Othman, Brian J McKinnon
OBJECTIVE: To determine the current cost impact and financial outcomes of transoral robotic surgery in Otolaryngology. DATA SOURCES: A narrative review of the literature with a defined search strategy using Pubmed, MEDLINE, CINAHL, and Web of Science. REVIEW METHODS: Using keywords ENT or otolaryngology, cost or economic, transoral robotic surgery or TORs, searches were performed in Pubmed, MEDLINE, CINAHL, and Web of Science and reviewed by the authors for inclusion and analysis...
April 3, 2018: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/29602216/transoral-resection-of-extensive-pediatric-supraglottic-neurofibroma
#10
Mark A Arnold, Anthony J Mortelliti, Mark F Marzouk
This case report describes the novel use of transoral robotic surgery (TORS) with delayed transoral laser microsurgery (TLM) for residual disease in the resection of a pediatric neurofibroma with supraglottic and parapharyngeal space extension. Postoperatively, the patient had excellent functional outcomes. This case demonstrates that pediatric TORS is feasible, safe, and complementary to TLM. Neurofibroma is just one of the diverse pathologic processes of the pediatric airway that can be managed via transoral surgery, and applications of TORS with TLM will continue to broaden as our experience develops...
March 30, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29549505/nasopharynx-access-by-minimally-invasive-transoral-robotic-surgery-anatomical-study
#11
Amine Harichane, Dorian Chauvet, Stéphane Hans
This study was made to assess the possibilities and limits of minimally invasive transoral approach to the nasopharynx using the Da Vinci surgical robot. It was conducted on eleven corpses, without need for palatine split; using surgical robots Da Vinci models S HD and Si HD. We have defined "anatomical key landmarks" on all sides of the nasopharynx, to confirm our hypothesis. All of the nasopharynx could be visualized and transorally reached by the robot with a validation of all the key landmarks...
March 16, 2018: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/29525139/transoral-robotic-excision-of-laryngeal-papillomas-with-flex%C3%A2-robotic-system-a-novel-surgical-approach
#12
Bernar Tan Wen Sheng, Patrick Wong, Constance Teo Ee Hoon
INTRODUCTION: Recurrent respiratory papillomatosis results in hoarseness, stridor and airway obstruction. Management is surgical, with most surgeons using microdebrider or laser. Transoral robotic surgery (TORS) has been successfully utilised for the excision of oropharyngeal malignancies and paediatric airway surgery. This is the first case report of TORS being used for the excision of laryngeal papillomas. CASE REPORT: A 36 year old Chinese female was diagnosed with juvenile onset recurrent respiratory papillomatosis...
May 2018: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/29519647/transoral-robotic-surgery-for-the-treatment-of-laryngeal-chondrosarcoma-a-case-report
#13
Ashley J Guthrie, Raymond L Chai
IMPORTANCE: Transoral robotic surgery has revolutionized the practice of head and neck surgery over the past decade, with indications now expanding to include laryngeal pathology. Although laryngeal chondrosarcoma is a rare entity, trends in otolaryngology literature suggest that it can frequently be managed with conservative approaches. We hope to inspire other head and neck surgeons to consider transoral robotic surgery for the treatment of such tumors so that outcomes data can be collected and studied...
May 2018: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/29496046/comparison-of-clinical-radiological-and-morphological-features-including-the-distribution-of-hpv-e6-e7-oncogenes-in-resection-specimens-of-oropharyngeal-squamous-cell-carcinoma
#14
Hani Ibrahim Channir, Katalin Kiss, Niclas Rubek, Jane Andersen, Jeanette Bæhr Georgsen, Gulla Søby Rathje, Birgitte Wittenborg Charabi, Christian von Buchwald, Christel Bræmer Lajer
BACKGROUND: Human papillomavirus (HPV)-driven oropharyngeal squamous cell carcinoma (OPSCC) represents a distinct tumour entity in comparison to HPV-negative OPSCC. The clinical, radiological, morphological features and distribution of HPV E6/E7 mRNA were investigated in resected specimens of OPSCC. METHODS: We retrieved formalin-fixed, paraffin-embedded whole section slides from 24 p16/HPV-DNA positive and 18 p16/HPV-DNA negative primary tumours and 16 corresponding metastases in patients with early-stage OPSCC who underwent planned curative or diagnostic primary transoral robotic surgery...
March 2018: Oral Oncology
https://www.readbyqxmd.com/read/29417393/introductory-tors-training-in-an-otolaryngology-residency-program
#15
Judd H Fastenberg, Marc J Gibber, Richard V Smith
Transoral robotic surgery (TORS) is becoming an integral part of the otolaryngology resident experience. While there is widespread agreement that a formal, validated curriculum for TORS training is needed for residents, none presently exists. The primary objective of this study is to evaluate an introductory resident curriculum for TORS training that could be easily adopted at other institutions. This is a prospective study of otolaryngology residents (PGY1-5) in an academic medical center from 2015 to 2016...
February 7, 2018: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/29417276/preliminary-experience-in-transoral-laryngeal-surgery-with-a-flexible-robotic-system-for-benign-lesions-of-the-vocal-folds
#16
Marc Remacle, Vyas M N Prasad
PURPOSE: This purpose of this case series is to present the first four cases utilizing micro-phonosurgical instrumentation designed specifically for use with a semi-flexible 'robotic' system-the Medrobotics Flex system and to evaluate the accessibility and feasibility of this platform in the context of transoral robotic surgery (TORS) for laryngeal surgery. METHODS: Four patients (3 female, 1 male; age range 49-79 years) were operated by the senior author at CHL-a tertiary hospital centre between 2016 and 2017...
March 2018: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29402545/the-ongoing-emergence-of-robotics-in-plastic-and-reconstructive-surgery
#17
S Struk, Q Qassemyar, N Leymarie, J-F Honart, H Alkhashnam, K De Fremicourt, A Conversano, J-B Schaff, F Rimareix, F Kolb, B Sarfati
Robot-assisted surgery is more and more widely used in urology, general surgery and gynecological surgery. The interest of robotics in plastic and reconstructive surgery, a discipline that operates primarily on surfaces, has yet to be conclusively proved. However, the initial applications of robotic surgery in plastic and reconstructive surgery have been emerging in a number of fields including transoral reconstruction of posterior oropharyngeal defects, nipple-sparing mastectomy with immediate breast reconstruction, microsurgery, muscle harvesting for pelvic reconstruction and coverage of the scalp or the extremities...
April 2018: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/29401548/-current-status-of-therapy-and-prophylaxis-of-oropharyngeal-carcinoma
#18
Andreas Dietz, Markus Pirlich, Susanne Wiegand
Incidence of oropharyngeal carcinoma (OPSCC) is increasing significantly worldwide. Due to its association with chronic tobacco/alcohol consumption, but increasingly also with the human papillomavirus HPV-16, oropharyngeal carcinoma is a genetically heterogeneous tumor group with high prognostic diversification. HPV-associated OPSCC respond significantly better to previous treatment concepts than non-HPV-associated. Both after primary surgical as well as after radiotherapie, radiochemotherapie and anti-EGFR treatment, this tumor group shows a significantly better survival...
February 2018: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/29397299/transoral-robotic-surgery-of-parapharyngeal-space-tumours-a-series-of-four-cases
#19
M G Maglione, A Guida, E Pavone, F Longo, C Aversa, S Villano, F Ionna
Tumours arising from the parapharyngeal space (PPS) represent less than 1% of all head and neck tumours. Salivary gland tumours account for 40-50% of PPS lesions and are located in the pre-styloid parapharyngeal space. Pleomorphic adenomas represent 80-90% of salivary tumours in the PPS. Recently, transoral robotic surgery (TORS) has become common in head and neck surgery as a minimally invasive procedure. Four cases of benign PPS tumour treated with TORS are presented here. Preoperative diagnosis was conducted by fine needle aspiration biopsy and magnetic resonance imaging, and the results were used to plan the correct surgical approach...
January 31, 2018: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29395278/tonsillectomy-sparing-transoral-robot-assisted-styloidectomy
#20
Sameep Kadakia, Ameya Jategaonkar, Ansley Roche, Raymond L Chai
Eagle Syndrome can present with a variety of symptoms and be caused by an elongated styloid process or calcified stylohyoid ligament. Patients failing medical management of this disorder may be treated with surgical excision of the styloid process. In the literature, transoral and transcervical approach have both been described. Although transoral approaches typically begin with a tonsillectomy, tonsil-sparing approaches have also been utilized. With the advent of robotic surgery, the potential for a tonsillectomy sparing approach has become a feasible alternative, preventing the pain and morbidity associated with adult tonsillectomy while continuing to provide superior exposure and instrumentation...
March 2018: American Journal of Otolaryngology
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