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Gasless transaxillary robot-assisted neck dissection: a preclinical feasibility study in four cadavers

 Yoo Seob Shin  ;  Hyun Jun Hong  ;  Yoon Woo Koh  ;  Woong Youn Chung  ;  Hye Yeon Lee  ;  Jae Min Hong  ;  Chi Sang Hwang  ;  Jae Won Chang  ;  Eun Chang Choi 
 YONSEI MEDICAL JOURNAL, Vol.53(1) : 193-197, 2012 
Journal Title
Issue Date
Cadaver ; Endoscopy/instrumentation ; Endoscopy/methods ; Feasibility Studies ; Female ; Head and Neck Neoplasms/surgery* ; Humans ; Male ; Neck/blood supply ; Neck/innervation ; Neck/surgery ; Neck Dissection/instrumentation* ; Neck Dissection/methods* ; Neoplasms, Squamous Cell/surgery* ; Robotics/methods* ; Thyroid Neoplasms/surgery*
Trans-axillary ; robotic ; neck dissection ; cadaver ; squamous cell carcinoma ; endoscope
PURPOSE: We hypothesized that comprehensive neck dissection could be achieved via a gasless transaxillary approach using a robotic system. We intended to evaluate the accessibility of level I, IIB and VA nodes with transaxillary robot-assisted neck dissection of four cadavers. MATERIALS AND METHODS: Transaxillary robotic neck dissection was performed in four cadavers through a 7-cm longitudinal incision at the anterior axilla and a 0.8-cm-sized incision in the chest wall. RESULTS: We successfully performed neck dissection from level II to V in all four cadavers. However, dissection of levels IIB and VA, which lie on the cephalic portion of the spinal accessory nerve, was difficult. Vital structures, including the internal jugular vein, carotid artery, vagus nerve, phrenic nerve, superior thyroid artery and hypoglossal nerve, were successfully identified and preserved. CONCLUSION: Our results demonstrate the feasibility of robot-assisted neck dissection using a transaxillary approach. We suggest that gasless, transaxillary robotic neck dissection is a promising technique for treating nodal metastasis in thyroid cancers or in selected squamous cell carcinomas of the head and neck. However, some modification of the approach might be needed when performing comprehensive neck dissections of all levels of the neck.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Anatomy (해부학교실) > 1. Journal Papers
Yonsei Authors
Koh, Yoon Woo(고윤우)
Lee, Hye Yeon(이혜연) ORCID logo https://orcid.org/0000-0001-6945-1967
Chung, Woong Youn(정웅윤)
Choi, Eun Chang(최은창)
Hong, Hyun Jun(홍현준)
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