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European Archives of Oto-Rhino-Laryngology

, Volume 268, Issue 12, pp 1795–1801 | Cite as

Transoral robotic surgery for the management of head and neck tumors: learning curve

  • Georges Lawson
  • Nayla Matar
  • Marc Remacle
  • Jacques Jamart
  • Vincent Bachy
Head and Neck

Abstract

Transoral robotic surgery (TORS) is an emerging technique for the treatment of head and neck tumors. The objective of this study is to describe our first steps and present our experience on the technical feasibility, safety, and efficacy of TORS for the treatment of selected malignant lesions. From April 2008 to September 2009, 24 patients were enrolled in this prospective trial. Inclusion criteria were: adults with T1, T2 and selected T3 tumors involving the oral cavity, pharynx, and supraglottic larynx and a signed informed consent was obtained from the patient. Exclusion criteria were: tumors not accessible to TORS after unsuccessful attempts to expose properly the lesion to operate. The ethical committee’s approval was obtained to perform this study. Twenty-four patients were included in this study: 10 supraglottic tumors, 10 pharyngeal tumors and 4 oral cavity tumors. Nine patients had T1 tumors, 12 had T2 tumors, and 1 patient had a T3 tumor. In all cases, tumor resection could be performed by robotic surgery exclusively and negative resection margins were achieved with control by frozen section. None of them received intraoperative reconstruction. None of the patients required tracheotomy. There was no intraoperative complication related to the use of the robot. The average setup time was 24 ± 14 min (range 10–60 min). The average surgical time was 67 ± 46 min (range 12–180 min). Surgical and setup time decreased after the first cases. The mean hospital stay was 9 days. Oral feeding was resumed at 3 days. TORS seems to be a safe, feasible, minimally invasive treatment modality for malignant head and neck tumors with a short learning curve for surgeons already experienced in endoscopic surgery.

Keywords

Transoral robotic surgery Squamous cell carcinoma Learning curve Supraglottic neoplasms Pharyngeal neoplasms Oral cavity neoplasms Prospective study 

Notes

Acknowledgments

The authors would like to thank Mrs M.-B. Jacqmain for the illustrations.

Conflict of interest

None.

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Georges Lawson
    • 1
  • Nayla Matar
    • 2
  • Marc Remacle
    • 1
  • Jacques Jamart
    • 3
  • Vincent Bachy
    • 1
  1. 1.Otolaryngology-Head and Neck Surgery DepartmentLouvain University Hospital of Mont-GodinneYvoirBelgium
  2. 2.Otolaryngology-Head and Neck Surgery Department, Hotel Dieu de France Hospital, Bellevue Medical CenterSaint-Joseph UniversityBeirutLebanon
  3. 3.Scientific Support UnitLouvain University Hospital of Mont-GodinneYvoirBelgium

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