Transoral robotic study of the vascular anatomy of the head and neck

Abstract

We aimed to explore, highlight and accurately identify the vascular anatomy of the oropharynx, hypopharynx and supraglottis utilizing the transoral robotic perspective. This was a case series using anatomic studies of cadaveric specimens. The cadavers were injected with red- and blue-dyed silicone through the arterial and venous systems to define the macro- and microvasculature. Following injection of the specimen, a da Vinci robotic surgical system was engaged to perform a transoral dissection of the oropharynx, hypopharynx and supraglottic regions. Dissection was carried out under high-definition optics. Vascular structures were identified and followed to their terminal branches. We successfully performed transoral robotic dissections of five fresh frozen cadaveric human heads which had been injected with dyed silicone. The injection technique and use of a high-definition magnifying camera allowed us to visualize and identify the vasculature of the head and neck in a unique fashion. The cadaveric model provides an excellent educational tool to aid in training. Additionally, the use of this model and the transoral approach has allowed us to identify vessels which typically may not be visible on routine dissection. We believe this to be very relevant in training and improving performance for safe and bloodless transoral robotic surgery. To our knowledge this is the first study using the transoral robotic approach to examine the vascular anatomy of the oropharynx and larynx.