We use cookies to offer you an optimal experience on our website. By browsing our website, you accept the use of cookies.

You must be logged in to watch this video. Click here to access your account, or here to register for free!

Transoral robotic surgery

J Selber, MD, MPH, FACS
Epublication WebSurg.com, Jul 2014;14(07). URL: http://websurg.com/doi/lt03enselber003

Ask a question to the author

You must be logged in to ask a question to authors. Click here to access your account, or here to register for free!
  • 224
  • 9
  • 2014-07-01
Share it
Access to oropharyngeal tumors has traditionally been using a transmandibular, translabial approach. Unfortunately, mandibulotomies and large pharyngotomies can result in significant postoperative morbidity and functional compromise. Because of the morbidity involved in some of these more aggressive resections, and the proven efficacy of chemoradiation in the treatment of some oropharyngeal cancers, there has been a paradigm shift away from ablative surgery. As long-term follow-up on these “organ-sparing” protocols have begun to take shape, however, significant morbidity and mortality has emerged with these therapies as well. Trans-oral robotic resections and reconstructions can provide the benefits of locoregional control without the morbidity of wide pharyngeal access or high-dose radiation. It can also prevent the use of external facial incisions and morbidity related to division of the mandible including hardware complications such as fistula. In addition, it can reduce and occasionally eliminate the need for radiation and its associated problems such as osteoradionecrosis and a functionless larynx. Transoral robotic tumor resection provides a challenge to the plastic surgeon because the cylinder of the oropharynx remains closed, making access to the oropharyngeal anatomy very difficult, particularly between the uvula and the epiglottis. The surgical robot, when positioned transorally, can allow the reconstructive surgeon to inset a variety of free and local flaps to perform complex reconstructions in challenging areas and meet the reconstructive demands of transoral resections.