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How to optimize laryngeal and hypopharyngeal exposure in transoral robotic surgery

Authors
 Armando De Virgilio ; Young Min Park ; Se-Heon Kim ; Seung Jae Baek ; Won Shik Kim 
Citation
 Auris Nasus Larynx, Vol.40(3) : 312~319, 2013 
Journal Title
 Auris Nasus Larynx 
ISSN
 0385-8146 
Issue Date
2013
Abstract
OBJECTIVE: The aim of this study was to present the various strategies adopted in our center to improve and overcome problems with exposure of the operative field in 48 patients who underwent TORS for the treatment of laryngeal and hypopharyngeal cancer. METHODS: We present our operative and preoperative treatment protocols for patients undergoing TORS for laryngeal and hypopharyngeal cancer. In particular, we emphasize the role of preoperative exposure assessment and the usefulness of simple measures to overcome problems with exposure of the operative field. RESULTS: In 12 patients (25%), we experienced difficult laryngeal-hypopharyngeal exposure. However the correct positioning of the robotic arms, the proper use of the laryngeal and tongue blade and some simple maneuvers, such as the anterior traction of the tongue and the partial epiglottectomy, ensured the feasibility of TORS with negative margins in all patients. CONCLUSION: In TORS, the exposure of larynx and hypopharynx can be difficult, but the adoption of certain methods may make it possible in most patients. An accurate preoperative evaluation under general anesthesia is the primary strategy for reducing the number of cases terminated intraoperatively. Currently, TORS is not feasible in all patients, but in our opinion, reductions in the size of robotic equipment and development of new devices will extend the application of TORS to a larger number of patients.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/86717
DOI
10.1016/j.anl.2012.07.017
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Otorhinolaryngology
Yonsei Authors
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Link
 http://www.sciencedirect.com/science/article/pii/S0385814612002052
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