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Combining a new CO2 laser wave guide with transoral robotic surgery: a feasibility study on four patients with malignant tumors

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Abstract

We present a series of patients treated by transoral robotic surgery (TORS) using a new CO2 laser wave guide (CO2 LWG) (Lumenis, Santa Clara, CA). Patients older than 18 years, with malignant pharyngo-laryngeal tumors were enrolled in this prospective study after signing an informed consent. Four patients were enrolled in the study. The mean age was 56 years. One patient had a T1 base of tongue tumor, two patients had supraglottic tumors (T1, T2), and one had a T1 palatine tonsil tumor. All the procedures could be performed using a Maryland forceps, a 0° endoscope and a CO2 LWG introduced via the robotic arm introducer. The laser parameters were: superpulse or continuous mode, 7–15 W, continuous delivery. The average set-up time was 30 min. The average surgical time was 94 min. No complications were noted due to the intraoperative use of the robot or the CO2 LWG. One laser fiber was used for each of the surgeries. The mean coagulation depth was 200 μm (range 100–300). The mean hospital stay was 6 days. The CO2 LWG is a reliable tool for TORS. It allowed more than 1 h of work without any trouble.

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References

  1. Hillel A, Kapoor A, Simaan N, Taylor R, Flint P (2008) Applications of robotics for laryngeal surgery. Otolaryngol Clin N Am 41:781–791

    Article  Google Scholar 

  2. Hockstein NG, O’Malley BW Jr, Weinstein GS (2006) Assessment of intraoperative safety in transoral robotic surgery. Laryngoscope 116:165–168

    Article  PubMed  Google Scholar 

  3. Rahbar R, Ferrari LR, Borer JG, Peters CA (2007) Robotic surgery in the pediatric airway: application and safety. Arch Otolaryngol Head Neck Surg 133:46–50

    Article  PubMed  Google Scholar 

  4. McLeod IK, Melder PC (2005) Da Vinci robot-assisted excision of a vallecular cyst: a case report. Ear Nose Throat J 84:170–172

    PubMed  Google Scholar 

  5. Weinstein GS, O’Malley BW Jr, Snyder W, Hockstein NG (2007) Transoral robotic surgery: supraglottic partial laryngectomy. Ann Otol Rhinol Laryngol 116:19–23

    PubMed  Google Scholar 

  6. O’Malley BW, Weinstein GS, Snyder W, Hockstein NG (2006) Transoral robotic surgery (TORS) for base of tongue neoplasms. Laryngoscope 116:1465–1472

    Article  PubMed  Google Scholar 

  7. Park YM, Kim WS, Byeon HK, De Virgilio A, Jung JS, Kim SH (2010) Feasibility of transoral robotic hypopharyngectomy for early-stage hypopharyngeal carcinoma. Oral Oncol 46(8):597–602

    Article  PubMed  Google Scholar 

  8. Weinstein G, O’Malley B, Snyder W, Sherman E, Quon H (2007) Transoral robotic surgery: radical tonsillectomy. Arch Otolaryngol Head Neck Surg 133(12):1220–1226

    Article  PubMed  Google Scholar 

  9. Moore E, Olsen K, Kasperbauer J (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 

  10. Lawson G, Matar N, Remacle M, Jamart J, Bachy V (2011) Transoral robotic surgery for the management of head and neck tumors: learning curve. Eur Arch Otorhinolaryngol 268:1795–1801

    Article  PubMed  Google Scholar 

  11. Remacle M, Hantzakos A, Eckel H, Evrard AS, Bradley PJ, Chevalier D, Djukic V, de Vincentiis M, Friedrich G, Olofsson J, Peretti G, Quer M, Werner J (2009) Endoscopic supraglottic laryngectomy: a proposal for a classification by the working committee on nomenclature, European Laryngological Society. Eur Arch Otorhinolaryngol 266(7):993–998

    Article  PubMed  Google Scholar 

  12. Lawson G, Matar N, Nolleveaux MC, Jamart J, Krug B, Delos M, Remacle M, Borght TV (2010) Reliability of sentinel node technique in the treatment of N0 supraglottic laryngeal cancer. Laryngoscope 120(11):2213–2217

    Article  PubMed  Google Scholar 

  13. Liboon J, Funkhouser W, Terris DJ (1997) A comparison of mucosal incisions made by scalpel, CO2 laser, electrocautery, and constant-voltage electrocautery. Otolaryngol Head Neck Surg 116:379–385

    Article  PubMed  CAS  Google Scholar 

  14. Koufman JA, Rees KJ, Frazier WD, Kilpatrick, Wright SC, Halum SL, Postma GN (2007) Office-based laryngeal laser surgery: a review of 443 cases using three wavelengths. Otolaryngology Head Neck Surg 137:146–151

    Article  Google Scholar 

  15. Ayari-Khalfallah S, Fuchsmann C, Froehlich P (2008) Thulium laser in airway diseases in children. Curr Opin Otolaryngol Head Neck Surg 16:55–59

    Article  PubMed  Google Scholar 

  16. Food and Drug Administration, Department of Health and Human Services (2005) 510(k) clearance: K050541 Omniguide BeamPath CO2 Mark I Laser Beam Delivery System

  17. Torres D, Weisberg O, Shapira G, Anastassiou Ch, Temelkuran B, Shurgalin M, Jacobs SA, Ahmad RU, Wang T, Kolodny U, Shapshay SM, Wang Z, Devaiah AK, Upadhyay UD, Koufman JA (2005) Omniguide photonic bandgap fibers for flexible delivery of CO2 laser energy for laryngeal and airway surgery. Proc SPIE 5686:310–321

    Article  Google Scholar 

  18. Shurgalin M, Anastassiou Ch (2008) A new modality for minimally invasive CO2 laser surgery: flexible hollow-core photonic bandgap fibers. Biomed Instrum Technol 42:318–325

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  20. Cheetham PJ, Truesdale MD, Lee DJ, Landman JM, Badani KK (2010) Use of a flexible carbon dioxide laser fiber for precise dissection of the neurovascular bundle during robot-assisted laparoscopic prostatectomy. J Endourol 24(7):1091–1096

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors would like to thank Mr Ch Deneffe for photograph editing.

Conflict of interest

Authors did not receive any financial support for the writing of this article. The material for the study (The laser unit and the CO2 laser wave guides) was provided by Lumenis, Santa Clara, CA, USA.

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Correspondence to Marc Remacle.

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The manuscript was accepted as an oral presentation at the American Broncho-Esophageal Association, COSM Meeting 27th April–1st May 2011, Chicago, USA.

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Remacle, M., Matar, N., Lawson, G. et al. Combining a new CO2 laser wave guide with transoral robotic surgery: a feasibility study on four patients with malignant tumors. Eur Arch Otorhinolaryngol 269, 1833–1837 (2012). https://doi.org/10.1007/s00405-011-1838-x

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  • DOI: https://doi.org/10.1007/s00405-011-1838-x

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