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Erste Erfahrung in der transoralen Roboterchirurgie mit dem da-Vinci®-Chirurgiesystem

Initial experience with transoral robotic surgery using the da Vinci® surgical system

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Zusammenfassung

Transorale Roboterchirurgie (TORS) ist die Weiterentwicklung der transoralen Laserchirurgie. Dabei wird statt des Mikroskops bei der Resektion ein Endoskop verwendet, das ein dreidimensionales Bild vermittelt. Der HNO-Chirurg arbeitet an einer Konsole, über die er die Arbeitsarme des Patientenwagens kontrolliert. Diese Arme halten miniaturisierte chirurgische Instrumente, die – über den Mund des Patienten eingeführt – die Resektion von Tumoren erlauben. Die Exposition des Tumors wird über unterschiedliche Mundsperrer hergestellt. Die Verwendung von unterschiedlichen Endoskopen (0° und 30°), der Bewegungsradius der Instrumente von 540° und die im Endoskop eingebaute Zoomfunktion erscheinen beim transoralen Operieren von Vorteil. Wir berichten in diesem Artikel von unseren ersten Erfahrungen mit dieser Technik, die uns vielversprechend erscheint, jedoch in Deutschland noch entsprechenden klinischen Prüfungen unterzogen werden muss.

Abstract

Transoral robotic surgery (TORS) can be considered an extension of transoral microscopic laser surgery. The microscope is replaced by an endoscope that provides the surgeon with a three-dimensional view of the surgical field. The surgeon operates from a console that controls the arms of the patient cart. These arms hold miniaturized surgical instruments that are transorally inserted into the patient, enabling tumor resection. Exposure is ensured by various mouth gags. The use of various endoscopes (0°, 30°), a work radius of 540° for instruments, and a zoom function provides significant advantages over the common transoral laser techniques. With this article we report our first experience with this technique and believe that it may provide significant advantages. However, thorough clinical testing in Germany is required before conclusions can be drawn.

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Literatur

  1. Genden EM, Desai S, Sung CK (2009) Transoral robotic surgery for the management of head and neck cancer: a preliminary experience. Head Neck 31:283–289

    Article  PubMed  Google Scholar 

  2. Holsinger FC, Mcwhorter AJ, Menard M et al (2005) Transoral lateral oropharyngectomy for squamous cell carcinoma of the tonsillar region: I. Technique, complications, and functional results. Arch Otolaryngol Head Neck Surg 131:583–591

    Article  PubMed  Google Scholar 

  3. Holsinger FC, Sweeney AD, Jantharapattana K et al (2010) The emergence of endoscopic head and neck surgery. Curr Oncol Rep 12:216–222

    Article  PubMed  Google Scholar 

  4. Iseli TA, Kulbersh BD, Iseli CE et al (2009) Functional outcomes after transoral robotic surgery for head and neck cancer. Otolaryngol Head Neck Surg 141:166–171

    Article  PubMed  Google Scholar 

  5. Lee JY, O’malley BW Jr, Newman JG et al (2010) Transoral robotic surgery of the skull base: a cadaver and feasibility study. ORL J Otorhinolaryngol Relat Spec 72:181–187

    PubMed  Google Scholar 

  6. Moore EJ, Olsen KD, Kasperbauer JL (2009) Transoral robotic surgery for oropharyngeal squamous cell carcinoma: a prospective study of feasibility and functional outcomes. Laryngoscope 119:2156–2164

    Article  PubMed  Google Scholar 

  7. Mukhija VK, Sung CK, Desai SC et al (2009) Transoral robotic assisted free flap reconstruction. Otolaryngol Head Neck Surg 140:124–125

    Article  PubMed  Google Scholar 

  8. O’malley BW Jr, Quon H, Leonhardt FD et al (2010) Transoral robotic surgery for parapharyngeal space tumors. ORL J Otorhinolaryngol Relat Spec 72:332–336

    Google Scholar 

  9. O’malley BW Jr, Weinstein GS (2007) Robotic anterior and midline skull base surgery: preclinical investigations. Int J Radiat oncol Biol Phys 69:S125–S128

    Google Scholar 

  10. O’malley BW Jr, Weinstein GS (2007) Robotic skull base surgery: preclinical investigations to human clinical application. Arch Otolaryngol Head Neck Surg 133:1215–1219

    Article  Google Scholar 

  11. O’malley BW Jr, Weinstein GS, Snyder W et al (2006) Transoral robotic surgery (TORS) for base of tongue neoplasms. Laryngoscope 116:1465–1472

    Article  Google Scholar 

  12. Richmon JD, Pattani KM, Benhidjeb T et al (2010) Transoral robotic-assisted thyroidectomy: A preclinical feasibility study in 2 cadavers. Head Neck 2010 July 13: Epub ahead of print. PMID: 20629089

  13. Selber JC (2010) Transoral robotic reconstruction of oropharyngeal defects: a case series. Plast Reconstr Surg 126:1978–1987

    Article  PubMed  CAS  Google Scholar 

  14. Selber JC, Robb G, Serletti JM et al (2010) Transoral robotic free flap reconstruction of oropharyngeal defects: a preclinical investigation. Plast Reconstr Surg 125:896–900

    Article  PubMed  CAS  Google Scholar 

  15. Solares CA, Strome M (2007) Transoral robot-assisted CO2 laser supraglottic laryngectomy: experimental and clinical data. Laryngoscope 117:817–820

    Article  PubMed  Google Scholar 

  16. Wei WI, Ho WK (2010) Transoral robotic resection of recurrent nasopharyngeal carcinoma. Laryngoscope 120:2011–2014

    Article  PubMed  Google Scholar 

  17. Weinstein GS, O’malley BW Jr, Cohen MA et al (2010) Transoral robotic surgery for advanced oropharyngeal carcinoma. Arch Otolaryngol Head Neck Surg 136:1079–1085

    Article  PubMed  Google Scholar 

  18. Weinstein GS, O’malley BW Jr, Desai SC et al (2009) Transoral robotic surgery: does the ends justify the means? Curr Opin Otolaryngol Head Neck Surg 17:126–131

    Article  PubMed  Google Scholar 

  19. Weinstein GS, O’malley BW Jr, Snyder W et al (2007) Transoral robotic surgery: radical tonsillectomy. Arch Otolaryngol Head Neck Surg 133:1220–1226

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Klinik für Hals-, Nasen- Ohren-, Heilkunde, HNO-Universitätsklinik Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland

    C. Simon, B. El-Baba, T. Albrecht & P.K. Plinkert

  2. Department of Head and Neck Surgery, University of Texas, M.D. Anderson Cancer Center, Houston, USA

    F.C. Holsinger

Authors
  1. C. Simon
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  2. B. El-Baba
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  3. T. Albrecht
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  4. F.C. Holsinger
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  5. P.K. Plinkert
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Corresponding author

Correspondence to C. Simon.

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Simon, C., El-Baba, B., Albrecht, T. et al. Erste Erfahrung in der transoralen Roboterchirurgie mit dem da-Vinci®-Chirurgiesystem. HNO 59, 261–265 (2011). https://doi.org/10.1007/s00106-010-2254-z

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  • DOI: https://doi.org/10.1007/s00106-010-2254-z

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