Robotic‐Assisted Neck Dissection via Facelift Incision: Preliminary Findings in North American Patients

Abstract

Objectives: Describe the technique and lymph node yield of robotic-assisted neck dissection (RAND) via facelift incision in a North American cohort. Methods: Patients with squamous cell carcinoma of the head and neck at a tertiary hospital in 2012 were offered selective neck dissection via facelift incision. Operative time, estimated blood loss, complications, and lymph node yield were collected. Additionally, seven sequential open selective neck dissections were retrospectively reviewed for lymph node yield. A two-tailed t-test was used to compare nodal yield between the two groups (RAND vs open). Results: Four patients underwent five RANDs, including a simultaneous transoral robotic surgery base of tongue resection and one partial glossectomy. Four lateral neck dissections and one supraomohyoid neck dissection were performed. Mean operative time for the cohort was 4:29 +/- 1:33 (including extirpation); the average time for the three RAND only was 3:29 +/- 0:55. Average blood loss was 77 +/- 68 ml. The only complication was an intraoperative internal jugular vein injury, which was repaired with surgical clipping and suturing. The average number of lymph nodes removed was 29 in patients undergoing level 2-4 RAND, compared to 35.9 in the open group ( P = 0.28). Conclusions: Our preliminary experience suggests that RAND is feasible and safe in the North American population. Our data is also the first to demonstrate that nodal yield is the same between robotic-assisted and open lymphadenectomy. Further study will determine the learning curve for the procedure, and long-term oncologic follow up is needed.