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Are new and young generations of surgeons more aware of transoral robotic surgery than older ones? An international survey

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Abstract

The objective of this study is to investigate adoption, perception, and awareness of otolaryngologist-head neck surgeons (OTO-HNS) toward transoral robotic surgery (TORS) according to the surgeon experience. A total of 1,383 OTO-HNS of YO-IFOS and IFOS received an online survey dedicated to the adoption, perception, and awareness toward TORS. The following outcomes were compared between residents and fellows, young/middle-aged and older OTO-HNS: awareness/perception; indications; advantages; barriers and expected improvements of TORS practice. From the 357 responders (26%), 147 participants were residents and fellows; while 105 and 105 OTO-HNS reported 10 to 19, and more than 20 years of practice. The main barriers of using TORS included the cost and the availability of robot, and the lack of training opportunity. The better view of the operative field and the shorter patient hospital stay were considered as the main advantages. Older surgeons trust more likely in TORS benefits (p = 0.001) and surgical field view advantages (p = 0.037) compared to younger participants. TORS is an important surgical minimal invasive approach for the future for 46% of residents and fellows versus 61% of older OTO-HNS (p = 0.001). Compared to older OTO-HNS, residents and fellows reported more frequently that the lack of training opportunity is the main barrier of TORS (52% versus 12%; p = 0.001). Residents and fellows did not share the same expectations of robot improvement for the future than older OTO-HNS. Experienced OTO-HNS had better perception and trust toward TORS than residents and fellows. Residents and fellows identified the lack of training opportunity as the main barrier to the use of TORS. TORS access and training programs need to be improved in academic hospitals for residents and fellows.

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Acknowledgements

The authors would like to acknowledge the YO-IFOS staff and all persons that had spread the survey, and all scientific societies that contributed to spread the survey.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Authors have no financial disclosures.

Author information

Authors and Affiliations

  1. Department of Otolaryngology and Head and Neck Surgery, Division of Broncho-Esophagology, EpiCURA Hospital, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium

    Jerome R. Lechien

  2. Department of Otolaryngology and Head and Neck Surgery, Foch Hospital, Paris Saclay University, Paris, France

    Jerome R. Lechien & Stephane Hans

  3. Elsan Polyclinic of Poitiers, Poitiers, France

    Jerome R. Lechien

  4. Department of Otolaryngology-Head and Neck Surgery, CHU Saint-Pierre, Brussels, Belgium

    Jerome R. Lechien

  5. Laboratory of Anatomy and Cell Biology, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMONS), Avenue du Champ de mars, 6, B7000, Mons, Belgium

    Jerome R. Lechien

Authors
  1. Jerome R. Lechien
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Contributions

JR Lechien: conduct the study, write the paper. S Hans: statistical analysis.

Corresponding author

Correspondence to Jerome R. Lechien.

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Appendix 1

Appendix 1

Priorities for future

Propositions of improvement

Residents/fellows

Young and middle aged

Older

P value

Access outcomes

 Better access to oropharynx

24 (16)

7 (7)

37 (35)

0.001

 Better access to supraglottic larynx

21 (14)

6 (6)

52 (49)

0.001

 Better access to glottis

19 (13)

8 (8)

53 (51)

0.001

 Better access to hypopharynx

18 (12)

9 (9)

59 (56)

0.001

 Better access to nasal fossae

9 (6)

2 (2)

23 (22)

0.001

 Better access to nasopharynx

15 (10)

3 (3)

30 (29)

0.001

Devices

 GPS tracking based on MRI/CT

13 (9)

4 (4)

45 (43)

0.001

 Laser (i.e., CO2)

14 (10)

8 (8)

67 (64)

0.001

 Integration of NBI system

11 (8)

2 (2)

33 (31)

0.001

 Better strength back

8 (5)

0 (0)

25 (24)

0.001

 Flexible instruments/smaller arms

23 (16)

7 (7)

68 (65)

0.001

  1. MRI/CT magnetic resonance imaging/computed tomodensitometry, NBI narrow banded imaging

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Lechien, J.R., Hans, S. Are new and young generations of surgeons more aware of transoral robotic surgery than older ones? An international survey. J Robotic Surg 17, 2065–2072 (2023). https://doi.org/10.1007/s11701-023-01619-6

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  • DOI: https://doi.org/10.1007/s11701-023-01619-6

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