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Transoral robotic

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...
March 3, 2018: American Journal of Otolaryngology
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...
March 1, 2018: American Journal of Otolaryngology
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
Raymond K Tsang, Eddy W Y Wong, Jason Y K Chan
BACKGROUND: The purpose of this study was to describe the use of a novel flexible, single-arm robot in performing a transoral radical tonsillectomy and retropharyngeal lymph node dissection. METHODS: A 63-year-old man with a T1N2bM0 (American Joint Committee on Cancer seventh edition classification) squamous cell carcinoma (SCC) of the left tonsil underwent a transoral robotic radical tonsillectomy and retropharyngeal lymph node dissection, followed by a left selective neck dissection of levels I to IV...
February 23, 2018: Head & Neck
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
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...
February 7, 2018: European Archives of Oto-rhino-laryngology
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...
February 2, 2018: Annales de Chirurgie Plastique et Esthétique
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
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
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...
January 23, 2018: American Journal of Otolaryngology
Özgül Topal
Open partial or total laryngectomies with or without radiotherapy (RT) or chemoradiotherapy (CRT) are the only mainstays in the treatment of laryngeal carcinomas. However, minimally invasive procedures such as transoral endoscopic carbondioxide laser microsurgery (TLM) or transoral robotic surgeries (TRS) are now being increasingly used in selected patients. The laryngeal framework is not disturbed in these procedures; therefore, the postoperative swallowing function improves more rapidly, and routine tracheotomy is not usually required...
March 2017: Turkish Archives of Otorhinolaryngology
Liqun Shan, Jianing Liu
BACKGROUND: Transoral thyroidectomy is a kind of "natural orifice transluminal endoscopic surgery (NOTES)" which is now being performed in increasing frequency. However, the safety and feasibility have not been concluded yet. MATERIALS AND METHODS: A systemic literature search was performed in Pubmed, Cochrane, and Embase databases to identify all studies written in English and published up to April 2017. The keywords used were "transoral endoscopic," "transoral robotic," "oral vestibular endoscopic," and "oral vestibular robotic" combined with "thyroidectomy" or "thyroid surgery...
January 31, 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Barry G Main, Natalie S Blencowe, Noah Howes, Sian Cousins, Kerry N L Avery, Alexander Gormley, Phil Radford, Daisy Elliott, Benjamin Byrne, Nicholas Wilson, Robert Hinchliffe, Jane M Blazeby
INTRODUCTION: Transoral robotic surgery (TORS) has been adopted in some parts of the world as an innovative approach to the resection of oropharyngeal tumours. The development, details and outcomes of early-to-later phase evaluation of this technique and the quality of evidence to support its adoption into practice have hitherto not been summarised. The aim of this review is to identify and summarise the early and later phase studies of, and evidence for, TORS and to understand how early phase studies report intervention development, governance procedures and selection and reporting of outcomes to optimise methods for using the Idea, Development, Exploration, Assessment, Long-term follow-up (IDEAL) framework for surgical innovation that informs evidence-based practice...
January 23, 2018: BMJ Open
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
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
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
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
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
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
Young Jun Chai, Hoon Yub Kim, Hong Kyu Kim, Sang Ho Jun, Gianlorenzo Dionigi, Angkoon Anuwong, Jeremy D Richmon, Ralph P Tufano
BACKGROUND: The surgical outcomes of a single surgeon's initial cases of transoral robotic thyroidectomy (TORT) were compared with the surgeon's initial cases of a bilateral axillo-breast approach (BABA) robotic thyroidectomy. METHODS: The medical reports were retrospectively reviewed. The BABA robotic thyroidectomies were performed between 2008 and 2009, and TORTs were performed between 2012 and 2016. RESULTS: Each group comprised 50 patients...
December 14, 2017: Head & Neck
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