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Transoral robotic

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https://www.readbyqxmd.com/read/28196200/assessment-of-surgical-learning-curves-in-transoral-robotic-surgery-for-squamous-cell-carcinoma-of-the-oropharynx
#1
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
#2
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
#3
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
#4
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/28149815/professor-hoon-yub-kim-transoral-robotic-thyroidectomy-shows-promising-results-with-ideal-outcomes
#5
Crystal M Yan
No abstract text is available yet for this article.
December 2016: Gland Surgery
https://www.readbyqxmd.com/read/28139028/combined-endoscopic-transcervical-transoral-robotic-approach-for-resection-of-parapharyngeal-space-tumors
#6
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
#7
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
#8
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
#9
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
#10
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...
January 11, 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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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