Technique of flap elevation for robot assisted selective neck dissection via retroauricular approach: a surgeon’s guide

  • Vishal RaoEmail author
  • Rachana Prasad
  • Anand Subash
  • Piyush Sinha
  • Kinjal Majumdar
Original Article


The retroauricular approach is being increasingly used in surgeries of head and neck in an attempt to avoid a disfiguring scar over the face or neck. The elevation of flap correctly is of paramount importance. The lateral to medial (vis-a vis posterior to anterior) approach can be challenging as the anatomical relations guiding the surgeon have a different orientation. The surgeons need to revisit the anatomy of the face and neck and identify reliable anatomical structures that will act as “new” landmarks to ensure proper dissection. 14 cases of robotic selective neck dissections and from January 2017 to January 2019 at Health Care Global Enterprises Ltd., Bangalore were included in the study. All the dissections were performed by a team of head and neck surgeon with experience in robotic surgery. In all the 14 cases, the step-wise surgical technique described was followed. One out of the 14 cases done had flap discolouration at the edge as it was thin. None of the patients had any wound dehiscence. This article tries to give a step to step description to enable the surgeon to raise the retroauricular flap safely and minimising the complications. Here, an attempt has been made to translate our experience to ensure standardisation of the technique with fewer complications.


Flap elevation Retroauricular approach Robot-assisted neck dissection Neck dissection Anatomical landmark 



There was no funding agency involved.

Compliance with ethical standards

Conflict of interest

No conflict of interest amongst authors and all authors have contributed towards the article. There are no financial affiliations and the authors Prof Vishal Rao, Dr. Rachana Prasad, Dr. Anand Subash, Dr. Piyush Sinha and Dr. Kinjal Mazumdar have nothing to disclose.

Ethical approval

IRB/Ethical Board approval was not required as a surgical technique is being described.

Informed consent

Informed consent was taken from all the patients undergoing the surgery.

Supplementary material

Supplementary file1 (MP4 268584 kb)


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Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2019

Authors and Affiliations

  • Vishal Rao
    • 1
    Email author
  • Rachana Prasad
    • 1
  • Anand Subash
    • 1
  • Piyush Sinha
    • 1
  • Kinjal Majumdar
    • 1
  1. 1.Department of Head and Neck OncologyHCG Cancer CentreBangaloreIndia

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