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经达芬奇单孔系统施行的隔室经口机器人侧咽旁切除术:手术技术。

Compartmental Transoral Robotic Lateral Oropharyngectomy with the da Vinci Single-Port System: Surgical Technique.

机构信息

Department of Biomedical Sciences, Humanitas University, Milan, Italy.

Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Milan, Italy.

出版信息

Ann Surg Oncol. 2023 Sep;30(9):5728-5732. doi: 10.1245/s10434-023-13735-6. Epub 2023 Jul 6.

Abstract

BACKGROUND

Transoral robotic surgery (TORS) has renovated the surgical management of oropharyngeal squamous cell carcinoma (OPSCC), allowing a minimally invasive surgical approach with optimal oncological outcomes. The recent introduction of the da Vinci Single Port (SP) system resulted in a considerable improvement of TORS technique.

METHODS

In this video, we illustrate the transoral robotic lateral oropharyngectomy performed with the da Vinci SP system in a 50-year-old male patient suffering from a p16+ oropharyngeal squamous cell carcinoma cT4N1M0.

RESULTS

The transoral robotic lateral oropharyngectomy is illustrated step by step. The structures encountered during the resection are described, and the surgical margins are defined based on anatomical landmarks. The most critical regions encountered during resection are pointed out, and the tip and tricks of this surgery are reported.

CONCLUSIONS

A step-by-step transoral lateral oropharyngectomy is described to increase its reproducibility. The da Vinci SP system owns various benefits for performing transoral lateral oropharyngectomy due to the increased maneuverability in the narrower oral cavity working spaces.

摘要

背景

经口机器人手术(TORS)革新了口咽鳞状细胞癌(OPSCC)的外科治疗方式,使手术具有微创性并可获得最佳的肿瘤学效果。最近达芬奇单端口(SP)系统的引入使得 TORS 技术得到了显著改善。

方法

在这个视频中,我们展示了一名 50 岁男性患者接受达芬奇 SP 系统辅助的经口机器人侧咽切除术的过程,该患者患有 p16+口咽鳞状细胞癌 cT4N1M0。

结果

经口机器人侧咽切除术的步骤被逐步展示。我们描述了在切除过程中遇到的结构,并根据解剖学标志定义了手术切缘。我们指出了在切除过程中遇到的最关键区域,并报告了该手术的技巧和窍门。

结论

我们描述了一种分步式经口侧咽切除术,以提高其可重复性。达芬奇 SP 系统由于在更狭窄的口腔工作空间中具有更高的可操作性,因此在进行经口侧咽切除术方面具有多种优势。

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