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

Journal of Robotic Surgery volume 14, pages 85–89 (2020)Cite this article

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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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

Keywords

  • Transoral robotic surgery (TORS)
  • da Vinci Xi robot
  • Head and neck surgery
  • Perioperative outcomes
  • Oncologic outcomes