Venkatakarthikeyan C, Nair Swati, Gowrishankar M, Rao Soorya
Department of Otorhinolaryngology and Head and Neck Surgery, Apollo Main Hospital, Room No. 25B Sindoori Block, Ground Floor, 21 Greams Lane, Off Greams Road, Chennai, 600006 India.
Department of Otorhinolaryngology and Head and Neck Surgery, Apollo Main Hospital, C-304 Pawitra Apartments, Vasundhara Enclave, Delhi, 110096 India.
Indian J Otolaryngol Head Neck Surg. 2020 Mar;72(1):98-103. doi: 10.1007/s12070-019-01768-x. Epub 2019 Nov 26.
Robot assisted surgery of the head and neck is a relatively novel approach in the management of head and neck tumors. There are very few reported cases of robot-assisted surgery of the head and neck in pediatric population in the world literature and no report of such procedures in the Indian subcontinent. In this article we present three such cases we performed for the first time in the country. The first case is that of second branchial cleft cyst, the second is a 4-year-old boy with a tongue base cyst and the third patient is a 12-year-old girl with left parotid gland tumor. All the patients underwent successful Robotic surgeries. Case 1 underwent robotic excision of the cyst through a retroauricular hairline incision. Case 2 underwent transoral robotic excision of the tongue base cyst. Case 3 underwent robotic excision of the tumor through a modified facelift incision. The mean docking time for the robot was 12.33 min and approximate blood loss was less than 10 ml in all cases. The patient and their parents were extremely satisfied with the cosmetic outcomes of the surgery. Robot assisted surgery has the advantage of performing minimally invasive procedures within constrained spaces especially in children. The multiarticulated endowrist movements of the robotic arms combined with higher magnification and three-dimensional depth perception allows a precise surgery with better visualization in otherwise inaccessible areas resulting in better surgical outcome. With exceptional advantages of surgery, minimal blood loss and postoperative pain and better surgeon ergonomics, robotic technique is an effective and feasible option in Pediatric Head and neck Surgery.
机器人辅助头颈手术是头颈肿瘤治疗中一种相对新颖的方法。世界文献中报道的小儿头颈机器人辅助手术病例极少，印度次大陆尚无此类手术的报道。在本文中，我们介绍了我们在国内首次进行的三例此类手术。第一例是第二鳃裂囊肿，第二例是一名患有舌根囊肿的4岁男孩，第三例患者是一名患有左腮腺肿瘤的12岁女孩。所有患者均成功接受了机器人手术。病例1通过耳后发际线切口进行囊肿的机器人切除。病例2通过经口机器人手术切除舌根囊肿。病例3通过改良的面部提升切口进行肿瘤的机器人切除。机器人的平均对接时间为12.33分钟，所有病例的估计失血量均少于10毫升。患者及其父母对手术的美容效果非常满意。机器人辅助手术具有在受限空间内进行微创手术的优势，尤其是在儿童中。机器人手臂的多关节腕部运动与更高的放大倍数和三维深度感知相结合，能够在其他难以到达的区域进行精确手术，可视化效果更好，从而带来更好的手术效果。由于手术具有特殊优势、失血量极少、术后疼痛轻以及外科医生的人体工程学更佳，机器人技术在小儿头颈外科中是一种有效且可行的选择。
