Endoscopic assisted resection of base of tongue lesion: a case report

<p class="abstract">Surgery for the base of the tongue lesions can be challenging since this area is difficult to access and contains important neurovascular structures. External incision in the neck via an approach that varies from a transoral midline glossotomy approach to a lip-split mandibulotomy, which inevitably results in obvious scarring of the face and neck. Transoral robotic surgery can be considered for removal of these difficult neoplasms. But limitations of robotic surgery include the size and cost of the device, a learning curve, and safety concerns. Hence, alternative surgical approaches that allow for good exposure, complete tumour excision, low complication rates, low recurrence rates, and no postoperative neck scarring are preferred.</p>

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Transoral Robotic Surgery (TORS) for the Head and Neck: Current and Future Indications

International Journal of Head and Neck Surgery ◽

10.5005/jp-journals-10001-1027 ◽

2010 ◽

Vol 1 (3) ◽

pp. 133-140 ◽

Cited By ~ 4

Author(s):

Harry Quon ◽

Bert W O'Malley ◽

Gregory S Weinstein

Keyword(s):

Robotic Surgery ◽

Head And Neck ◽

Malignant Tumors ◽

Infratemporal Fossa ◽

Transoral Robotic Surgery ◽

Oncologic Outcomes ◽

Surgical Approaches ◽

Malignant Diseases ◽

Treatment Team ◽

Federal Drug Administration

Abstract Transoral robotic surgery (TORS) offers many technical advancements to existing endoscopic and transoral surgical approaches. This has faciliated a safer, less morbid and potentially more effective application of surgery to the management of both benign and malignant diseases in the head and neck. As this surgical approach gains widespread acceptance, it is important for all members of the treatment team to understand the strengths and current limitations especially when TORS is applied for malignant diseases. As of December 2009, Federal Drug Administration (FDA) has approved the use of the da Vinci® surgical system and TORS for selected malignancies of the oral cavity, pharynx and larynx and all benign disease. Of these sites, the greatest experience and longest duration of follow-up has been in the use of TORS for the management of oropharyngeal carcinomas where at least comparable oncologic outcomes and reduced long-term feeding tube dependency rates have been reported. Other anatomic sites where TORS has shown benefit based on preclinical studies and early human experiences include the larynx, hypopharynx, parapharyngeal space and infratemporal fossa for both benign and selected malignant tumors. Experience to date has demonstrated that the improved visualization with the robotic system offers the potential for improved oncologic resection with reduced morbidity. Based on present studies and outcomes data in conjunction with ongoing investigations, it is anticipated that TORS will make a major impact in the way we manage benign and malignant tumors within the head and neck and skull base.

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The Emerging Role of Robotic Surgery among Minimally Invasive Surgical Approaches in the Treatment of Hypopharyngeal Carcinoma: Systematic Review and Meta-Analysis

Journal of Clinical Medicine ◽

10.3390/jcm8020256 ◽

2019 ◽

Vol 8 (2) ◽

pp. 256 ◽

Cited By ~ 5

Author(s):

Armando De Virgilio ◽

Oreste Iocca ◽

Luca Malvezzi ◽

Pasquale Di Maio ◽

Raul Pellini ◽

...

Keyword(s):

Systematic Review ◽

Robotic Surgery ◽

Meta Analysis ◽

Survival Rates ◽

Functional Results ◽

Hypopharyngeal Cancer ◽

Surgical Approaches ◽

Hypopharyngeal Carcinoma ◽

Special Focus ◽

Complication Rates

The aim of this systematic review with meta-analysis was to investigate the available literature on transoral approaches in the treatment of hypopharyngeal squamous cell carcinoma, with a special focus on transoral robotic surgery (TORS). A systematic review was conducted according to the PRISMA (preferred reporting items for systematic reviews and meta-analyses) check-list, and 15 studies were included. Five of the included studies evaluated TORS, while ten studies focused on transoral laser microsurgery (TLM) for the treatment of early or advanced stage hypopharyngeal cancer. Overall, survival rates of TLM and TORS studies, analyzed together in the cumulative meta-analysis, were 66.4% (95% confidence interval (CI) 54.3%–76.7%) at 36+ months of follow up. The TORS subgroup showed a higher cumulative survival rate (85.5%, 95% CI 55.8%–96.5%) compared to TLM (58.5%, 95% CI 46.6%–69.6%). Cumulative data showed that 29.3% (95% CI 24.0%–35.3%) of deaths were attributable to cancer. The results were similar between TLM and TORS studies. The larynx function preservation cumulative rate was 94.3% (95% CI 91.8%–96.1%). The results were similar among the two subgroups. The present review supports the use of transoral approaches in the treatment of hypopharyngeal cancer. TORS is oncologically sound and provides excellent functional results with low complication rates.

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Update on Robotic Rectal Prolapse Treatment

Journal of Personalized Medicine ◽

10.3390/jpm11080706 ◽

2021 ◽

Vol 11 (8) ◽

pp. 706

Author(s):

Giampaolo Formisano ◽

Luca Ferraro ◽

Adelona Salaj ◽

Simona Giuratrabocchetta ◽

Andrea Pisani Ceretti ◽

...

Keyword(s):

Robotic Surgery ◽

Rectal Prolapse ◽

Length Of Hospital Stay ◽

Social Impairment ◽

Conventional Laparoscopy ◽

Complication Rates ◽

Recurrence Rates ◽

Lower Morbidity

Rectal prolapse is a condition that can cause significant social impairment and negatively affects quality of life. Surgery is the mainstay of treatment, with the aim of restoring the anatomy and correcting the associated functional disorders. During recent decades, laparoscopic abdominal procedures have emerged as effective tools for the treatment of rectal prolapse, with the advantages of faster recovery, lower morbidity, and shorter length of stay. Robotic surgery represents the latest evolution in the field of minimally invasive surgery, with the benefits of enhanced dexterity in deep narrow fields such as the pelvis, and may potentially overcome the technical limitations of conventional laparoscopy. Robotic surgery for the treatment of rectal prolapse is feasible and safe. It could reduce complication rates and length of hospital stay, as well as shorten the learning curve, when compared to conventional laparoscopy. Further prospectively maintained or randomized data are still required on long-term functional outcomes and recurrence rates.

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Polymorphous Low-Grade Adenocarcinoma of the Tongue Base Treated by Transoral Robotic Surgery

Case Reports in Otolaryngology ◽

10.1155/2015/981436 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Jeong Hong Kim ◽

Chang Lim Hyun ◽

Gil Chai Lim

Keyword(s):

Robotic Surgery ◽

Hypoglossal Nerve ◽

Surgical Excision ◽

Transoral Robotic Surgery ◽

Tongue Base ◽

Low Grade ◽

Minor Salivary Glands ◽

Complete Surgical Excision ◽

Rare Malignancy ◽

Base Of The Tongue

Polymorphous low-grade adenocarcinoma is a rare malignancy arising from the minor salivary glands in the aerodigestive system, most frequently the hard palate. The treatment of choice is wide surgical resection, and the efficacy of radiotherapy has not been confirmed. A 54-year-old male presenting with a mass at the base of the tongue performed transoral laser microsurgery. The pathologic diagnosis was polymorphous low-grade adenocarcinoma. Complete surgical excision was performed via transoral robotic surgery without a flap reconstruction of the surgical defect. Without complications of bleeding or injury to the hypoglossal nerve, proper surgical margins were obtained, and no recurrence was found after 6 months after surgery. The patient did not complain of dysphagia or aspiration. We conclude that, in surgery for tongue base tumors with unknown malignant potential, transoral robotic surgery can be considered for achieving a definite resection avoiding a mandibulotomy without complications of dysphagia or aspiration after confirmation of malignancy with a frozen biopsy.

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Lump at the back of my tongue. The lingual thyroid – a case report & narrative review of literature

10.22541/au.161164526.62849073/v1 ◽

2021 ◽

Author(s):

Joe Jabbour ◽

Nelson Agostinho ◽

Harinder Bains ◽

Peter Earls ◽

Louise Killen ◽

...

Keyword(s):

Case Report ◽

Robotic Surgery ◽

Airway Obstruction ◽

Surgical Procedure ◽

Upper Airway ◽

Transoral Robotic Surgery ◽

Lingual Thyroid ◽

Review Of Literature ◽

Base Of The Tongue ◽

Firm Mass

A 68-year-old male presented with a difficult airway secondary to a firm mass at the base of the tongue on intubation for an emergency general surgical procedure. Further workup confirmed a lingual thyroid with previous upper airway obstruction requiring a temporary tracheostomy. The mass was excised using transoral robotic surgery.

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