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Robotic nasopharyngectomy via combined endonasal and transantral port: a preliminary cadaveric study

 Hyung-Ju Cho  ;  Ju Wan Kang  ;  Hyun Jin Min  ;  Hyo Jin Chung  ;  Do Yang Park  ;  Jong Gyun Ha  ;  Seung Hak Baek  ;  Joo-Heon Yoon  ;  Chang-Hoon Kim 
 LARYNGOSCOPE, Vol.125(8) : 1839-1843, 2015 
Journal Title
Issue Date
Cadaver ; Equipment Design ; Humans ; Microsurgery/methods* ; Mouth ; Nasal Cavity ; Nasopharynx/surgery* ; Natural Orifice Endoscopic Surgery/methods* ; Nose ; Reproducibility of Results ; Robotics/instrumentation*
Robot ; endoscope ; nasopharyngeal carcinoma ; nasopharynx
OBJECTIVES/HYPOTHESIS: The objective of this study was to determine the potential role of a surgical robotic system in nasopharyngeal surgery using bilateral transantral or combined endonasal/transantral port. STUDY DESIGN: The da Vinci robot (Intuitive Surgical Inc., Sunnyvale, CA) was used to perform dissection of the skull base on a whole fresh-frozen cadaver. METHODS: Bilateral mega-antrostomy was done with the usual endoscopic sinus surgery equipment. To obtain an accessible bilateral working space, posterior septectomy was performed. Next, bilateral anterior maxillary windows were created through a gingivobuccal incision. The 8.5-mm-diameter 0° or 30° three-dimensional camera arm was introduced into a nostril. The two 5-mm-diameter articulating EndoWrist arms entered through the transantral or endonasal port. For the dissection, Maryland articulated forceps, needle driver, and monopolar spatula- or hook-type electrocauterizer were used. RESULTS: The 8.5-mm diameter of the camera arm was easily inserted into the nostril. Excellent access to the nasopharyngeal area from the level of the palate up to the skull base crossing the sphenoid prow was possible. Bilateral robotic arms were able to move inside the nasopharyngeal space, and the target dissection area could be accessed fully via the transantral or endonasal port. CONCLUSIONS: This is the first report about the feasibility of bilateral transantral or combined transantral/endonasal port for robotic nasopharyngectomy. Robotic removal of the entire nasopharyngeal area was successfully achieved without transpalatal or facial skin incision. These new approaches may be applied to selected patients with nasopharyngeal carcinoma or other pathologic tumors involving the nasopharynx.
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1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Chang Hoon(김창훈) ORCID logo https://orcid.org/0000-0003-1238-6396
Yoon, Joo Heon(윤주헌)
Chung, Hyo Jin(정효진)
Cho, Hyung Ju(조형주) ORCID logo https://orcid.org/0000-0002-2851-3225
Ha, Jong Gyun(하종균) ORCID logo https://orcid.org/0000-0002-2712-1297
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