The robotically-assisted oropharyngeal resection

Abstract

The robotic technologies every day exert an increasingly greater influence on the surgical technique, with the well documented clinical applicability in reconstructive plastic surgery and oncology. At the Department of plastic surgery of I.M. Sechenov First Moscow state medical university, we have gained an extensive experience with the surgical treatment of the patients requiring the major oral robotic intervention. A novel application has recently been documented for the purpose of robotic surgical assistance to the patients presenting with oncological pathology including cancer of the oropharyngeal wall at the early stages of development (T1N0M0). The objective of the present study was to develop and introduce into the clinical practice of the robot-assisted methods for the treatment of malignant neoplasms of the head and neck organs. A hybrid technique was applied, i.e. the combination of the robot-assisted trans-oral surgical intervention and the microsurgical radial flap mobilization to correct the postoperative defect following the extraction of the tumour. The combination of these methods provided the excellent clinical results and positive dynamics of the patients' condition, with the swell apparent improvement of the quality of life. The early patient activation was due to the application of the minimally invasive transoral surgical technique, with the swallowing ability being reinstated within 14 days after the intervention by virtue of the proper flap function. All the patients successfully underwent the robot-assisted surgical manipulations without complications. The shorter rehabilitation time during the postoperative period in these patients made it possible to quicker initiate chemotherapy and radiotherapy. This significantly improved the patient's quality of life and prognosis due to the combined approach to the treatment of head and neck oncology. It is concluded that the incorporation of the robotic assistance into the program of surgical treatment significantly increases the effectiveness of the treatment and makes possible the combined approach to the treatment of oncological patients with manageable tumours of the head and neck region.