Our Summary

This research paper discusses the use of robots in the surgical removal of oropharyngeal tumors, which are traditionally removed through an open surgical approach. This conventional method often requires a cut through the middle of the lower jawbone and has limitations such as poor visibility of the lower part of the throat, the use of rigid tools, and difficulty in removing tumors that extend into the upper part of the windpipe.

The paper explains that while the use of angled endoscopes, flexible lasers, and microscopic magnification may overcome some of these limitations, the linear movement of the instruments can make the surgery difficult.

The development of the Da Vinci Surgical System, a robotic surgical system, has made the removal of these tumors safer and more feasible. This is because the system provides a 3D view of the surgical area and the “wristed” movement of the surgical instruments that allows surgeons to operate in tight anatomical spaces.

However, the paper notes that this first-generation robot is continually being improved to provide more flexibility and movement, with developments like the FLEX Robotic System and the more recent Da Vinci Single Port System (SP).

The paper reviews the historical developments of robots used for transoral (through the mouth) surgeries, discusses the currently approved robotic systems, and highlights the future robots for this type of surgery. It also proposes an ideal robot for this surgery, highlighting the engineering technologies needed to address these challenges.

FAQs

  1. What are the limitations of traditional methods for resecting oropharyngeal tumors?
  2. How does the Da Vinci Surgical System enhance the process of removing oropharyngeal tumors?
  3. What are the advancements made in robotic systems for transoral robotic surgery (TORS)?

Doctor’s Tip

A helpful tip a doctor might tell a patient about robotic surgery is that it offers improved visualization, precision, and maneuverability compared to traditional surgical techniques. This can lead to more precise tumor removal with minimal damage to surrounding healthy tissue, potentially resulting in faster recovery times and reduced risk of complications. It’s important for patients to discuss the potential benefits and risks of robotic surgery with their doctor to determine if it is the right choice for their specific situation.

Suitable For

Patients who are typically recommended for robotic surgery include those with oropharyngeal tumors, head and neck cancer, and other conditions that require precise surgical resection in tight anatomical confines. Robotic surgery can provide better visualization, wristed maneuverability of instruments, and 3-dimensional magnification of the surgical field, making it a safe and effective option for certain patients.

Timeline

Before robotic surgery:

  1. Patient is diagnosed with oropharyngeal tumor
  2. Traditional open surgery is recommended for tumor resection
  3. Limitations of open surgery include midline mandibulotomy and poor visualization of the surgical field
  4. Alternative techniques such as angled endoscopes and flexible lasers may be considered, but have limitations
  5. Patient may be referred for robotic surgery as a minimally invasive option

After robotic surgery:

  1. Patient undergoes pre-operative evaluation and planning for robotic surgery
  2. Surgery is performed using the Da Vinci Surgical System or another approved robotic system
  3. Surgeon benefits from 3-dimensional magnification and wristed maneuverability of instruments
  4. Tumor is resected with oncologic margins, while preserving surrounding healthy tissue
  5. Patient experiences less pain, shorter hospital stay, and quicker recovery compared to traditional open surgery
  6. Follow-up care and monitoring are provided to ensure successful outcomes

What to Ask Your Doctor

  1. How does robotic surgery compare to traditional open surgery for treating oropharyngeal tumors?
  2. What are the potential benefits of robotic surgery for my specific case?
  3. What are the potential risks or complications associated with robotic surgery?
  4. How experienced is the surgical team in performing robotic surgeries for oropharyngeal tumors?
  5. Will I have a faster recovery time with robotic surgery compared to traditional surgery?
  6. Will I need any additional tests or imaging before undergoing robotic surgery?
  7. How long will the surgery take and how soon can I expect to return to normal activities?
  8. Will I need any additional treatments, such as radiation or chemotherapy, after robotic surgery?
  9. Are there any long-term effects or limitations I should be aware of after robotic surgery?
  10. Can you explain the specific robotic system that will be used for my surgery and how it works?

Reference

Authors: Poon H, Li C, Gao W, Ren H, Lim CM. Journal: Oral Oncol. 2018 Dec;87:82-88. doi: 10.1016/j.oraloncology.2018.10.020. Epub 2018 Oct 25. PMID: 30527249