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Transoral robotic surgery

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https://www.readbyqxmd.com/read/28314404/the-role-of-robotic-surgery-in-sinonasal-and-ventral-skull-base-malignancy
#1
REVIEW
Ralph Abi Hachem, Sanjeet Rangarajan, Andre Beer-Furlan, Daniel Prevedello, Enver Ozer, Ricardo L Carrau
Over the past decade, robotic surgery has gained wide popularity, making a significant impact on multiple surgical specialties. In the head and neck arena, transoral robotic surgery has proven to be safe and associated with acceptable oncological and superior functional outcomes for surgery of the oropharynx, hypopharynx, supraglottis, and glottis; thus, changing the paradigm for the management of tumors in these anatomic locations. Robotic surgery of the ventral skull base is at an early stage of development...
April 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28292318/transoral-robotic-surgery-with-radial-forearm-free-flap-reconstruction-case-control-analysis
#2
Vincent L Biron, Daniel A O'Connell, Brittany Barber, Jessica M Clark, Colin Andrews, Caroline C Jeffery, David W J Côté, Jeffrey Harris, Hadi Seikaly
BACKGROUND: The resection of large oropharyngeal tumors traditionally involves a lip-splitting mandibulotomy for adequate margin visualization and free flap reconstruction of the surgical defect. Transoral robotic surgery (TORS) has emerged as a technique that can resect large and complex oropharyngeal tumors, avoiding a lip-splitting approach. The aim of this study is to compare the lip-splitting mandibulotomy approach versus TORS for the management of advanced stage oropharyngeal carcinomas...
March 14, 2017: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28272799/positron-emission-tomography-computed-tomography-after-primary-transoral-robotic-surgery-for-oropharyngeal-squamous-cell-carcinoma
#3
Kealan Hobelmann, Adam Luginbuhl, Voichita Bar-Ad, William Keane, Joseph Curry, David Cognetti
OBJECTIVES/HYPOTHESIS: To assess the first post-treatment positron emission tomography/computed tomography (PET/CT) in prediction of disease-free survival after primary transoral robotic surgery (TORS) for oropharyngeal squamous cell carcinoma (OPSCC) with or without adjuvant chemoradiation. STUDY DESIGN: Retrospective review. METHODS: Ninety-five patients with OPSCC treated with primary TORS from 2010 to 2014 at a single tertiary academic center were evaluated with PET/CT...
March 8, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28252460/the-role-of-transoral-robotic-surgery-in-the-management-of-oropharyngeal-cancer
#4
Fernando L Dias, Fernando Walder, Fernando Danelon Leonhardt
PURPOSE OF REVIEW: The rising incidence of oropharyngeal squamous cell carcinoma (OPSCC), in large part as a result of the human papillomavirus (HPV), has driven a movement for the change in the management strategies. Renewed interest in minimally invasive approaches of endoscopic head and neck surgery led to introduction of transoral surgery, including transoral robotic surgery (TORS). RECENT FINDINGS: Several recent studies, based on large multi-institutional studies and systematic reviews of the literature, have shown excellent oncologic and functional outcomes with TORS for OPSCC...
March 1, 2017: Current Opinion in Oncology
https://www.readbyqxmd.com/read/28249654/transoral-robotic-surgery-for-management-of-cervical-unknown-primary-squamous-cell-carcinoma-updates-on-efficacy-surgical-technique-and-margin-status
#5
Mathew Geltzeiler, Sean Doerfler, Meghan Turner, William Greer Albergotti, Mark Kubik, Seungwon Kim, Robert Ferris, Umamaheswar Duvvuri
IMPORTANCE: Management of cervical unknown primary squamous cell carcinoma (CUP) has evolved with the introduction of transoral robotic surgery (TORS). OBJECTIVES: 1. To describe the efficacy of TORS lingual and palatine tonsillectomy in identifying the primary site of malignancy. 2. To explore how the extent of surgery affects diagnostic yield. 3. To report margin status of TORS resections. DESIGN, SETTING AND PARTICIPANTS: A retrospective, single-center cohort study utilizing a prospectively collected database of CUP patients in a high-volume tertiary referral center...
March 2017: Oral Oncology
https://www.readbyqxmd.com/read/28244405/cost-effectiveness-analysis-of-radiation-therapy-versus-transoral-robotic-surgery-for-oropharyngeal-squamous-cell-carcinoma
#6
Danielle Rodin, Lisa Caulley, Emily Burger, Jane Kim, Stephanie Johnson-Obaseki, David Palma, Alexander V Louie, Aaron Hansen, Brian O'Sullivan
PURPOSE: The objective of this study was to compare the cost-effectiveness of transoral robotic surgery (TORS) versus the standard treatment modality for oropharyngeal squamous cell carcinoma (OPSCC), radiation therapy (RT), in a subset of patients with early-stage OPSCC. METHODS AND MATERIALS: We developed a microsimulation state-transition model associated with RT and TORS for patients with clinically staged T1N0M0 to T2N1M0 OPSCC. Transition probabilities, utilities, and costs for each health state were estimated from recently published data and discounted by 3% annually over a lifetime time horizon...
March 15, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28236012/application-of-a-computer-assisted-flexible-endoscope-system-for-transoral-surgery-of-the-hypopharynx-and-upper-esophagus
#7
Daniel T Friedrich, M O Scheithauer, J Greve, N Rotter, J Doescher, T K Hoffmann, P J Schuler
Zenker's diverticulum is a common pathology in the transition zone of the posterior hypopharynx and esophagus. Surgical treatment is routinely performed by ENT and general surgeons. Besides the traditional open transcervical diverticulectomy, the introduction of transoral rigid treatment led to a paradigm change and is now the preferred treatment option for patients who are fit for general anesthesia. The implementation of interventional flexible endoscopy has opened another new micro-invasive approach for patients with high morbidity...
February 24, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28224280/predictors-of-success-in-combination-of-tongue-base-resection-and-lateral-pharyngoplasty-for-obstructive-sleep-apnea
#8
Chi Sang Hwang, Jin Won Kim, Sang Chul Park, Hyo Jin Chung, Chang-Hoon Kim, Joo-Heon Yoon, Hyung-Ju Cho
The base of the tongue has been recognized as a significant site of obstruction in patients with obstructive sleep apnea (OSA). Our aim was to determine the independent predictors of surgical success in tongue base resection combined with lateral pharyngoplasty for OSA. Thirty-one OSA patients who underwent endoscopie-guided coblator or transoral robotic tongue base resection in combination with lateral pharyngoplasty for the treatment of retroglossal obstruction between March 2012 and December 2015 were enrolled in this study...
February 21, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28196200/assessment-of-surgical-learning-curves-in-transoral-robotic-surgery-for-squamous-cell-carcinoma-of-the-oropharynx
#9
William G Albergotti, William E Gooding, Mark W Kubik, Mathew Geltzeiler, Seungwon Kim, Umamaheswar Duvvuri, Robert L Ferris
Importance: Transoral robotic surgery (TORS) is increasingly employed as a treatment option for squamous cell carcinoma of the oropharynx (OPSCC). Measures of surgical learning curves are needed particularly as clinical trials using this technology continue to evolve. Objective: To assess learning curves for the oncologic TORS surgeon and to identify the number of cases needed to identify the learning phase. Design, Setting, and Participants: A retrospective review of all patients who underwent TORS for OPSCC at the University of Pittsburgh Medical Center between March 2010 and March 2016...
February 9, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28188953/minimizing-adjuvant-treatment-after-transoral-robotic-surgery-through-surgical-margin-revision-and-exclusion-of-radiographic-extracapsular-extension-a-prospective-observational-cohort-study
#10
Benoit Morisod, Ioana I Venara-Vulpe, Stephen Alzuphar, Yan Monnier, Massimo Bongiovanni, Patric Hagmann, Hanan Bouchaab, Jean Bourhis, Christian Simon
BACKGROUND: We investigated in a prospective cohort of patients treated with trans-oral robotic surgery (TORS) for oropharyngeal cancer (OPC), who were selected for the absence of radiographic extra-capsular extension (ECS) and surgically revised for inadequate margins, the possibility of reducing adjuvant radiation (RT)/chemo-radiation therapy (CRT) without jeopardizing tumor control and functional outcome. METHODS: We conducted a prospective observational cohort of patients treated with TORS for oropharyngeal cancer...
February 11, 2017: Head & Neck
https://www.readbyqxmd.com/read/28177327/functional-outcomes-of-supraglottic-squamous-cell-carcinoma-treated-by-transoral-laser-microsurgery-compared-with-horizontal-supraglottic-laryngectomy-in-patients-younger-and-older-than-65-years
#11
C M Chiesa Estomba, F A Betances Reinoso, A I Lorenzo Lorenzo, J L Fariña Conde, J Araujo Nores, C Santidrian Hidalgo
The treatment of supraglottic carcinoma remains a controversial issue. Five accepted surgical and non-surgical oncological treatments have been currently established: standard horizontal supraglottic laryngectomy (HSL), supraglottic CO2 laser microsurgery (TLM), transoral robotic surgery, radiotherapy alone and radiotherapy in combination with chemotherapy. Some studies have shown that complications of head and neck surgeries increase significantly in patients over 65 years compared to younger patients. We designed a retrospective analysis to assess the rate of complications and functional outcomes of patients treated by TLM and HSL in cases of T1-T3 supraglottic squamous cell carcinomas (SCC) in a tertiary University Hospital...
December 2016: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28155047/transoral-robotic-thyroidectomy-a-preclinical-feasibility-study-using-the-da-vinci-xi-platform
#12
Jonathon O Russell, Salem I Noureldine, Mai G Al Khadem, Hamad A Chaudhary, Andrew T Day, Hoon Yub Kim, Ralph P Tufano, Jeremy D Richmon
Transoral thyroid surgery allows the surgeon to conceal incisions within the oral cavity without significantly increasing the amount of required dissection. TORT provides an ideal scarless, midline access to the thyroid gland and bilateral central neck compartments. This approach, however, presents multiple technical challenges. Herein, we present our experience using the latest generation robotic surgical system to accomplish transoral robotic thyroidectomy (TORT). In two human cadavers, the da Vinci Xi surgical system (Intuitive Surgical, Sunnyvale, CA, USA) was used to complete TORT...
February 2, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28139028/combined-endoscopic-transcervical-transoral-robotic-approach-for-resection-of-parapharyngeal-space-tumors
#13
Irit Duek, Moran Amit, Gill E Sviri, Ziv Gil
BACKGROUND: Parapharyngeal space tumors (PPSTs) pose exposure challenges; they are routinely resected by the transcervical approach using blunt/blind finger dissection, increasing the risk of tumor spillage and of neurovascular injury. Large PPSTs or those located high at the skull base often require mandibulotomy or an infratemporal fossa approach, baring considerable morbidity. METHODS: The novel minimally invasive approach described, utilizes endoscopic equipment introduced transcervically for circumferential separation of the tumor from the neurovascular structures of the skull base...
January 31, 2017: Head & Neck
https://www.readbyqxmd.com/read/28109475/predictors-of-extracapsular-extension-in-hpv-associated-oropharyngeal-cancer-treated-surgically
#14
Mathew Geltzeiler, Daniel Clayburgh, John Gleysteen, Neil D Gross, Bronwyn Hamilton, Peter Andersen, Daniel Brickman
OBJECTIVES: Extracapsular extension (ECE) in cervical metastatic lymph nodes remains an indication for adding chemotherapy for patients with oropharyngeal squamous cell carcinoma (OPSCC). The aim of this study is to identify specific imaging characteristics on computed tomography (CT) scan that are predictive of ECE in order to better risk stratify patients preoperatively. MATERIALS AND METHODS: A single cohort study was performed using a prospectively collected database of patients with HPV-related OPSCC who underwent transoral robotic surgery with cervical lymphadenectomy...
February 2017: Oral Oncology
https://www.readbyqxmd.com/read/28106661/swallowing-after-transoral-surgery-for-oropharyngeal-cancer-comparison-with-primary-chemoradiotherapy-outcomes
#15
Nicholas Dawe, James O'Hara
PURPOSE OF REVIEW: Survival equipoise is recognized between the contemporary surgical and oncological approaches to oropharyngeal squamous cell carcinoma treatment. Primary transoral surgery (TOS) options have emerged that utilize either laser or robotic techniques. Our review presents an overview of the evidence available for swallowing outcomes following TOS approaches and compares these with outcomes following primary oncological management. RECENT FINDINGS: Meta-analysis of swallow outcomes following TOS or (chemo)radiotherapy is not possible given the heterogeneity of the available data...
January 18, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28106658/transoral-surgery-vs-intensity-modulated-radiotherapy-for-early-supraglottic-cancer-a-systematic-review
#16
Mark S Swanson, Garren Low, Uttam K Sinha, Niels Kokot
PURPOSE OF REVIEW: To provide clinicians with a critical review of outcomes for endolaryngeal surgery and intensity-modulated radiation therapy (IMRT) for early-stage supraglottic cancer. RECENT FINDINGS: A total of 971 potential articles were reviewed, with inclusion of 14 studies comparing IMRT with transoral surgery. One study analyzed IMRT, one transoral robotic surgery, and the remaining were transoral laser microsurgery studies. A weighted average and 95% confidence interval of all surgery patients showed a local control of 90...
January 18, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28089208/the-reconstructive-options-for-oropharyngeal-defects-in-the-transoral-robotic-surgery-framework
#17
Giuseppe Meccariello, Filippo Montevecchi, Rossella Sgarzani, Andrea De Vito, Giovanni D'Agostino, Riccardo Gobbi, Chiara Bellini, Claudio Vicini
Transoral robotic surgery (TORS) is a fascinating new technique that has been proved to be a safe and feasible for selected oropharyngeal cancers. Furthermore, TORS offers several advantages in the treatment of locoregionally advanced cancers. Nevertheless, the careful selection of patients is the keypoint for a successful application of this therapeutic modality. However, the reconstruction of large oropharyngeal defects is challenging due to the restoration of velopharyngeal competency and swallowing. Moreover, the absence of mandibular splitting increases the difficulties faced by reconstructive surgeons...
March 2017: Oral Oncology
https://www.readbyqxmd.com/read/28064382/early-assessment-of-feasibility-and-technical-specificities-of-transoral-robotic-surgery-using-the-da-vinci-xi
#18
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
#19
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
#20
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
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