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Perioperative safety, feasibility, and oncologic utility of transoral robotic surgery with da Vinci Xi platform

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Abstract

Transoral robotic surgery (TORS) is a common modality for treatment of oropharyngeal and laryngeal cancer. Current FDA approval extends to the da Vinci S and Si platforms. Many hospitals are adopting the da Vinci Xi platform. Reports of head and neck surgical outcomes with this platform are scant. This study reports outcomes of TORS procedures performed with the da Vinci Xi platform including perioperative adverse events, functional outcomes, and short-term local control. A retrospective review of TORS performed with the da Vinci Xi platform is undertaken. Twenty-two consecutive TORS cases with the Xi platform are reviewed. Procedures performed include radical tonsillectomy, base of tongue resection, and lingual tonsillectomy. Two bleeding events occurred (9% of cases), both of intermediate severity as per Mayo criteria. Three procedures resulted in positive margin status, early in the case series, and two were cleared with revision resection. One-year local control rate, where available, is 100%. There were no perioperative deaths, long-term gastrostomy dependence, or performance of tracheostomy. Advantages of this platform include ease of robot deployment and setup. Disadvantages include increased width of instrumentation compared with previous platforms with crowding of access. The availability of a specific robotic platform may be dictated by hospital-wide policy across service lines. This report suggests that the da Vinci Xi permits performance of TORS with safety and oncologic outcomes similar to previous platforms; however, long-term follow-up is needed.

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References

  1. ECRI Institute (2015) Robotic surgery: arm yourself with the latest information on pricing, performance, clinical efficacy, and safety. http://www.Ecri.org/robotinfo. Accessed Dec 2018

  2. Chen MM, Holsinger FC (2016) Morbidity and mortality associated with robotic head and neck surgery: an inquiry of the food and drug administration manufacturer and user facility device experience database. JAMA Otolaryngol Head Neck Surg 142(4):405–406

    Article  Google Scholar 

  3. Weinstein GS, O’Malley BW, Cohen MA, Quon H (2010) Transoral robotic surgery for advanced oropharyngeal carcinoma. Arch Otolaryngol Head Neck Surg 136(11):1079–1085

    Article  Google Scholar 

  4. Weinstein GS, O’Malley BW Jr, Magnuson JS, Carroll WR, Olsen KD, Daio L, Moore EJ, Holsinger FC (2012) Transoral robotic surgery: a multicenter study to assess feasibility, safety, and surgical margins. Laryngoscope 122(8):1701–1707

    Article  Google Scholar 

  5. Mehta V, Johnson P, Tassler A, Kim S, Ferris RL, Nance M, Johnson JT, Duvvuri U (2013) A new paradigm for the diagnosis and management of unknown primary tumors of the head and neck: a role for transoral robotic surgery. Laryngoscope 123(1):146–151

    Article  Google Scholar 

  6. Weinstein GS, O’Malley BW Jr, Snyder W, Sherman E, Quon H (2007) Transoral robotic surgery: radical tonsillectomy. Arch Otolaryngol Head Neck Surg 133(12):1220–1226

    Article  Google Scholar 

  7. O’Malley BW Jr, Weinstein GS, Snyder W, Hockstein NG (2006) Transoral robotic surgery (TORS) for base of tongue neoplasms. Laryngoscope 116(8):1465–1472

    Article  Google Scholar 

  8. Pollei TR, Hinni ML, Moore EJ, Hayden RE, Olsen KD, Casler JD, Walter LC (2013) Analysis of postoperative bleeding and risk factors in transoral surgery of the oropharynx. JAMA Otolaryngol Head Neck Surg 139:1212-1218

    Article  Google Scholar 

  9. de Almeida JR, Li R, Magnuson JS, Smith RV et al (2015) Oncologic outcomes after transoral robotic surgery: a multi-institutional study. JAMA Otolaryngol Head Neck Surg 141(12):1043–1051

    Article  Google Scholar 

  10. Asher SA, White HN, Kejner AE, Rosenthal EL, Carroll WR, Magnuson JS (2013) Hemorrhage after transoral robotic-assisted surgery. Otolaryngol Head Neck Surg 149(1):112–117

    Article  Google Scholar 

  11. Pollei TR, Hinni ML, Moore EJ et al (2013) Analysis of postoperative bleeding and risk factors in transoral surgery of the oropharynx. JAMA Otolaryngol Head Neck Surg 139:1212-1218

    Article  Google Scholar 

  12. Gorphe P, Von Tan J, El Bedoui S, Hartl DM, Auperin A, Qassemyar Q et al (2017) Early assessment of feasibility and technical specificities of transoral robotic surgery using the da Vinci Xi. J Robot Surg 11(4):455–461

    Article  Google Scholar 

  13. Weinstein GS, Quon H, Newman HJ, Chalian JA, Malloy K, Lin A, Desai A, Livolsi VA, Montone KT, Cohen KR, O’Malley BW (2012) Transoral robotic surgery alone for oropharyngeal cancer: an analysis of local control. Arch Otolaryngol Head Neck Surg 138(7):628–634

    Article  Google Scholar 

  14. United States Food and Drug Administration. (2018) “Off-Label” and Investigational use of marketed drugs, biologics, and medical devices—Information sheet. http://www.fda.gov/RegulatoryInformation/Guidances/ucm126486.htm. Accessed Dec 2018

  15. United States Food and Drug Administration (2006) Information sheet guidance for IRBs, clinical investigators, and sponsors: Frequently asked questions about medical devices. January 2006

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Authors and Affiliations

  1. Center for Professional Development and Simulation, Lahey Hospital and Medical Center, Burlington, MA, USA

    Fanny Gabrysz-Forget

  2. Department of Otolaryngology - Head and Neck Surgery, Boston University School of Medicine, Boston, MA, USA

    Taha Mur, Robert Dolan & Bharat Yarlagadda

  3. Division of Otolaryngology - Head and Neck Surgery, Lahey Hospital and Medical Center, Burlington, MA, USA

    Taha Mur, Robert Dolan & Bharat Yarlagadda

Authors
  1. Fanny Gabrysz-Forget
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  2. Taha Mur
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  3. Robert Dolan
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  4. Bharat Yarlagadda
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Corresponding author

Correspondence to Bharat Yarlagadda.

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Conflict of interest

Fanny Gabrysz-Forget, MD, Taha Mur, MD, Robert Dolan, MD, and Bharat Yarlagadda, MD, declare that they have no conflict of interest.

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Gabrysz-Forget, F., Mur, T., Dolan, R. et al. Perioperative safety, feasibility, and oncologic utility of transoral robotic surgery with da Vinci Xi platform. J Robotic Surg 14, 85–89 (2020). https://doi.org/10.1007/s11701-019-00938-x

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  • DOI: https://doi.org/10.1007/s11701-019-00938-x

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