Center for Professional Development and Simulation, Lahey Hospital and Medical Center, Burlington, MA, USA.
Department of Otolaryngology - Head and Neck Surgery, Boston University School of Medicine, Boston, MA, USA.
J Robot Surg. 2020 Feb;14(1):85-89. doi: 10.1007/s11701-019-00938-x. Epub 2019 Mar 1.
Transoral robotic surgery (TORS) is a common modality for treatment of oropharyngeal and laryngeal cancer. Current FDA approval extends to the da Vinci S and Si platforms. Many hospitals are adopting the da Vinci Xi platform. Reports of head and neck surgical outcomes with this platform are scant. This study reports outcomes of TORS procedures performed with the da Vinci Xi platform including perioperative adverse events, functional outcomes, and short-term local control. A retrospective review of TORS performed with the da Vinci Xi platform is undertaken. Twenty-two consecutive TORS cases with the Xi platform are reviewed. Procedures performed include radical tonsillectomy, base of tongue resection, and lingual tonsillectomy. Two bleeding events occurred (9% of cases), both of intermediate severity as per Mayo criteria. Three procedures resulted in positive margin status, early in the case series, and two were cleared with revision resection. One-year local control rate, where available, is 100%. There were no perioperative deaths, long-term gastrostomy dependence, or performance of tracheostomy. Advantages of this platform include ease of robot deployment and setup. Disadvantages include increased width of instrumentation compared with previous platforms with crowding of access. The availability of a specific robotic platform may be dictated by hospital-wide policy across service lines. This report suggests that the da Vinci Xi permits performance of TORS with safety and oncologic outcomes similar to previous platforms; however, long-term follow-up is needed.
经口机器人手术（TORS）是治疗口咽和喉癌的常用方法。目前，FDA 的批准范围仅限于达芬奇 S 和 Si 平台。许多医院正在采用达芬奇 Xi 平台。关于该平台进行头颈部手术结果的报告很少。本研究报告了达芬奇 Xi 平台进行 TORS 手术的结果，包括围手术期不良事件、功能结果和短期局部控制。对达芬奇 Xi 平台进行的 TORS 进行了回顾性研究。回顾性分析了 22 例连续采用达芬奇 Xi 平台进行的 TORS 手术。手术包括根治性扁桃体切除术、舌根切除术和舌扁桃体切除术。发生了 2 起出血事件（占病例的 9%），根据 Mayo 标准均为中度严重程度。3 例手术结果为阳性边缘状态，发生在病例系列早期，其中 2 例通过修正切除清除。可获得的 1 年局部控制率为 100%。无围手术期死亡、长期胃造口依赖或气管造口术。该平台的优势包括机器人部署和设置的便利性。缺点包括与前几代平台相比，仪器的宽度增加，导致通道拥挤。特定机器人平台的可用性可能由跨服务线的全院范围政策决定。本报告表明，达芬奇 Xi 允许安全有效地进行 TORS，其肿瘤学结果与前几代平台相似；然而，需要长期随访。
