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经口型声门上喉切除术,使用下一代单孔机器人手术系统。

Transoral supraglottic laryngectomy using a next-generation single-port robotic surgical system.

机构信息

Division of Head and Neck Surgery, Department of Surgery, University of California San Diego, California.

Division of Head and Neck Surgery, Department of Otolaryngology, Stanford University, California.

出版信息

Head Neck. 2019 Jul;41(7):2143-2147. doi: 10.1002/hed.25676. Epub 2019 Feb 18.

Abstract

BACKGROUND

To investigate the feasibility of transoral robotic surgery (TORS) supraglottic laryngectomy (SGL) using a next-generation flexible surgical robot.

METHODS

Preclinical human cadaver anatomic study of TORS SGL via en bloc resection.

RESULTS

A single-port robotic surgical system (da Vinci Sp, Intuitive Surgical, Inc., Sunnyvale, California) provided sufficient access, reach, and visualization to perform TORS SGL. Access and exposure were achieved with a standard laryngo-pharyngoscope retractor. The remote center of the robotic system was located 10 cm from the maxillary alveolus. Three surgical instruments and one flexible camera could be deployed with minimal collision or restriction of arm movement.

CONCLUSIONS

Routine resection supraglottic cancers through TORS have been hindered by challenging exposure and visualization and limited instrument maneuverability deep within the laryngopharyngeal complex. This preclinical feasibility study demonstrates the technical feasibility for TORS SGL using a next-generation flexible surgical robot.

摘要

背景

为了研究下一代柔性手术机器人在经口机器人手术(TORS)声门上喉切除术(SGL)中的应用可行性。

方法

通过整块切除进行 TORS SGL 的临床前人体尸体解剖研究。

结果

单端口机器人手术系统(da Vinci Sp,直觉外科公司,加利福尼亚州森尼韦尔)提供了足够的通道、可达性和可视化效果,可实现 TORS SGL。使用标准的喉咽镜牵开器即可获得通道和暴露。机器人系统的远程中心距离上颌牙槽 10 厘米。三个手术器械和一个柔性相机可以最小化碰撞或限制臂的运动。

结论

通过 TORS 常规切除声门上区癌症受到暴露和可视化困难以及器械在喉咽复合体深处的操作受限的阻碍。这项临床前可行性研究证明了使用下一代柔性手术机器人进行 TORS SGL 的技术可行性。

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