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Article: Transoral endoscopic nasopharyngectomy with a flexible next-generation robotic surgical system
Title | Transoral endoscopic nasopharyngectomy with a flexible next-generation robotic surgical system |
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Authors | |
Keywords | nasopharyngeal carcinoma nasopharyngectomy nasopharynx Transoral robotic surgery |
Issue Date | 2016 |
Publisher | John Wiley & Sons, Inc. The Journal's web site is located at http://www.laryngoscope.com/ |
Citation | The Laryngoscope, 2016, v. 126 n. 10, p. 2257-2262 How to Cite? |
Abstract | Objectives/Hypothesis: To determine the feasibility of transoral endoscopic nasopharyngectomy without division of the soft plate using a flexible, next-generation robotic surgical system. Study Design: Preclinical anatomic study using four human cadavers. Methods: Transoral resection of the nasopharyngeal wall with en-bloc resection of the cartilaginous Eustachian tube and dissection of the parapharyngeal fat space. Results: The first flexible robotic surgical system has recently been described. We performed a series of laboratory experiments to determine whether this flexible system could be used to perform transoral robotic nasopharyngectomy. This novel system allowed docking of the patient-side cart at the side of the operating table. The cannula tip was placed approximately 12 cm from the edge of the retractor pointing superiorly toward the nasopharynx (NP). Retraction of the soft palate anteriorly and tonsillar pillars laterally with stay sutures expanded the velopharyngeal inlet, providing adequate space to deploy all four instruments (three surgical instruments and a camera) into the NP for dissection. All instruments could be deployed into the NP, without collision or restriction of joint movement in this cadaver model. Using this position and docking location, the new flexible surgical robot provided sufficient access, reach, and visualization to complete robotic nasopharyngectomy with en-bloc resection of the cartilaginous Eustachian tube. Conclusion: This feasibility study showed that transoral endoscopic nasopharyngectomy could be performed without compromising the integrity of the soft palate using a novel flexible robotic surgical system. Level of Evidence: N/A. Laryngoscope, 126:2257–2262, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc. |
Persistent Identifier | http://hdl.handle.net/10722/229511 |
ISSN | 2023 Impact Factor: 2.2 2023 SCImago Journal Rankings: 1.128 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Tsang, RKY | - |
dc.contributor.author | Holsinger, FC | - |
dc.date.accessioned | 2016-08-23T14:11:36Z | - |
dc.date.available | 2016-08-23T14:11:36Z | - |
dc.date.issued | 2016 | - |
dc.identifier.citation | The Laryngoscope, 2016, v. 126 n. 10, p. 2257-2262 | - |
dc.identifier.issn | 0023-852X | - |
dc.identifier.uri | http://hdl.handle.net/10722/229511 | - |
dc.description.abstract | Objectives/Hypothesis: To determine the feasibility of transoral endoscopic nasopharyngectomy without division of the soft plate using a flexible, next-generation robotic surgical system. Study Design: Preclinical anatomic study using four human cadavers. Methods: Transoral resection of the nasopharyngeal wall with en-bloc resection of the cartilaginous Eustachian tube and dissection of the parapharyngeal fat space. Results: The first flexible robotic surgical system has recently been described. We performed a series of laboratory experiments to determine whether this flexible system could be used to perform transoral robotic nasopharyngectomy. This novel system allowed docking of the patient-side cart at the side of the operating table. The cannula tip was placed approximately 12 cm from the edge of the retractor pointing superiorly toward the nasopharynx (NP). Retraction of the soft palate anteriorly and tonsillar pillars laterally with stay sutures expanded the velopharyngeal inlet, providing adequate space to deploy all four instruments (three surgical instruments and a camera) into the NP for dissection. All instruments could be deployed into the NP, without collision or restriction of joint movement in this cadaver model. Using this position and docking location, the new flexible surgical robot provided sufficient access, reach, and visualization to complete robotic nasopharyngectomy with en-bloc resection of the cartilaginous Eustachian tube. Conclusion: This feasibility study showed that transoral endoscopic nasopharyngectomy could be performed without compromising the integrity of the soft palate using a novel flexible robotic surgical system. Level of Evidence: N/A. Laryngoscope, 126:2257–2262, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc. | - |
dc.language | eng | - |
dc.publisher | John Wiley & Sons, Inc. The Journal's web site is located at http://www.laryngoscope.com/ | - |
dc.relation.ispartof | The Laryngoscope | - |
dc.rights | The Laryngoscope. Copyright © John Wiley & Sons, Inc. | - |
dc.rights | This is the peer reviewed version of the following article: The Laryngoscope, 2016, v. 126 n. 10, p. 2257-2262, which has been published in final form at DOI: 10.1002/lary.25970. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving. | - |
dc.subject | nasopharyngeal carcinoma | - |
dc.subject | nasopharyngectomy | - |
dc.subject | nasopharynx | - |
dc.subject | Transoral robotic surgery | - |
dc.title | Transoral endoscopic nasopharyngectomy with a flexible next-generation robotic surgical system | - |
dc.type | Article | - |
dc.identifier.email | Tsang, RKY: rkytsang@hku.hk | - |
dc.identifier.authority | Tsang, RKY=rp01386 | - |
dc.description.nature | postprint | - |
dc.identifier.doi | 10.1002/lary.25970 | - |
dc.identifier.scopus | eid_2-s2.0-84990179752 | - |
dc.identifier.hkuros | 262031 | - |
dc.identifier.volume | 126 | - |
dc.identifier.issue | 10 | - |
dc.identifier.spage | 2257 | - |
dc.identifier.epage | 2262 | - |
dc.identifier.isi | WOS:000386930800018 | - |
dc.publisher.place | United States | - |
dc.identifier.f1000 | 726431311 | - |
dc.identifier.issnl | 0023-852X | - |