Robotik in der Kopf-Hals-Chirurgie

Robot-assisted head and neck surgery

Zusammenfassung

In der klinischen Anwendung gibt es bereits einige für den Kopf-Hals-Bereich zugelassene Assistenzsysteme für die roboterassistierte Chirurgie (RAC). In Teilen des angloamerikanischen Raums hat sich die RAC im Oropharynx zum Standard entwickelt. Große systematische Studien, welche Vergleiche mit etablierten Standardverfahren anstellen, existieren bis heute nicht. Vielmehr wird in experimentellen Arbeiten beschrieben, schlecht zugängliche anatomische Regionen mittels RAC zu erreichen, oder aber es werden Machbarkeitsstudien zur Verwendung von transoraler robotischer Chirurgie (TORS) bei etablierten chirurgischen Operationen angestellt. Bei einem flächendeckenden Einsatz stellt sich bis heute die Frage der Finanzierung des Mehraufwands. Außerdem sollten die auf dem Markt befindlichen technischen Lösungen für einen standardisierten Einsatz in der Kopf-Hals-Chirurgie systematisch verbessert werden.

Abstract

Robot-assisted surgery (RAS) has already been approved for several clinical applications in head and neck surgery. In some Anglo-American regions, RAS is currently the common standard for treatment of oropharyngeal diseases. Systematic randomized studies comparing established surgical procedures with RAS in a large number of patients are unavailable so far. Experimental publications rather describe how to reach poorly accessible anatomical regions using RAS, or represent feasibility studies on the use of transoral robotic surgery (TORS) in established surgical operations. With general application of RAS in clinical practice, the question of financial reimbursement arises. Furthermore, the technical applications currently on the market still require some specific improvements for routine use in head and neck surgery.

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Correspondence to Prof. Dr. med. P. J. Schuler.

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Interessenkonflikt

P.J. Schuler, F. Boehm, L.R. Schild, J. Greve und T.K. Hoffmann haben keine finanzielle Unterstützung für die Autorenschaft oder Publikation dieses Artikels erhalten. Die Autoren haben an der klinischen Studie der Fa. Medrobotics (NCT02262247) teilgenommen.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Die Autoren P.J. Schuler und F. Boehm haben zu gleichen Teilen zum Manuskript beigetragen.

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Schuler, P.J., Boehm, F., Schild, L.R. et al. Robotik in der Kopf-Hals-Chirurgie. HNO 69, 131–139 (2021). https://doi.org/10.1007/s00106-020-00934-w

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Schlüsselwörter

  • Computerassistierte Chirurgie
  • Roboterunterstützte chirurgische Verfahren
  • Therapieergebnis
  • Kopf-Hals-Tumoren
  • Gesundheitskosten

Keywords

  • Computer-assisted surgery
  • Robotic surgical procedures
  • Treatment outcome
  • Head and neck neoplasms
  • Health care costs