Robotic Selective Neck Dissection Research Articles

Feasibility of transoral robotic selective neck dissection with or without a postauricular incision for papillary thyroid carcinoma: A pilot study.

BackgroundThe study aimed to evaluate the feasibility of transoral robotic selective neck dissection (SND) with or without a postauricular incision for papillary thyroid carcinoma (PTC).MethodsWe studied 14 patients with PTC who underwent robotic SND via the transoral or combined transoral and postauricular approaches.ResultsThe transoral approach was performed on 10 patients for dissection of levels III and IV. An additional postauricular incision was made on 4 patients for dissection of level II in addition to levels III, IV, and V. The operation was completed successfully in 13 patients, except 1 patient with the procedure conversion due to uncontrolled bleeding from the internal jugular vein. The mean numbers of removed lymph nodes in the lateral compartment were 23.1 ± 9.4 and 38.3 ± 8.5 in the transoral and combined groups. Transient recurrent laryngeal nerve palsy occurred in 1 patient, transient hypoparathyroidism in 3 patients, and chyle leakage in 1 patient. There were no hematomas, mental nerve injuries, surgical space infections, or CO2 embolisms.ConclusionTransoral robotic SND is feasible with or without a postauricular incision.

Comparison of Robotic versus Conventional Lateral Neck Dissection for Differentiated Thyroid Carcinoma

Objectives: In advances in robotic thyroidectomy, we have performed robotic lateral neck dissection by a gasless unilateral axillo-breast (GUAB) or axillary (GUA) approach for differentiated thyroid carcinoma (DTC) to avoid long visible scars in the neck. The aim of this study is to evaluate technical feasibility and efficacy of robotic lateral neck dissection compared with conventional neck dissection. Methods: We studied 72 patients with DTC who underwent total thyroidectomy with robotic selective neck dissection by GUAB or GUA approach (23 cases) or conventional open neck dissection (49 cases) in the unilateral neck between January 2010 and July 2013. Results: The mean age and body mass index was lower, and female sex was more common in the robotic group compared with the open group ( P < .05). Stage was more advanced in the open group ( P < .05). The mean total operative time was significantly longer in the robotic group (319 ± 65 minutes) than the conventional group (214 ± 110 minutes; P < .001). The mean number of lymph nodes removed in the lateral compartment was not different between the 2 groups (24.7 ± 11.3 in the robotic group and 30.9 ± 17.7 in the conventional group, P = .091). The postoperative complication did not differ between the 2 groups. Postoperative cosmetic satisfaction was superior in the robotic group than the conventional group ( P < .05). Conclusions: Robotic lateral selective neck dissection by GUAB or GUA approach is comparable to conventional lateral neck dissection in selected patients with DTC and provides better postoperative cosmesis than conventional neck dissection.

Robot‐assisted selective neck dissection combined with facelift parotidectomy in parotid cancer

Robot-assisted neck dissection in patients with head and neck cancer has been demonstrated to be feasible. We conceived a surgical technique of surgery for parotid cancer with the robotic system via a gasless modified facelift (MFL) approach. A detailed surgical technique is provided. In a 28-year-old female patient with parotid cancer, the disease was treated with primary tumor resection with robotic selective neck dissection I to III via an MFL incision. Robot-assisted selective neck dissection I to III combined with primary tumor resection was successfully conducted without any significant intraoperative complication, applying additional incision, or conversion to open conventional neck dissection. Videographic demonstration of the robotic-assisted neck dissection is included. Robot-assisted surgery via the MFL approach is a feasible and useful method with excellent cosmetic results for the surgical treatment in selected cases of parotid gland cancer.

Robotic Selective Neck Dissection by a Postauricular Facelift Approach: Comparison with Conventional Neck Dissection

The aim of this study was to investigate the feasibility and efficacy of robot-assisted neck dissection by a postauricular facelift approach in head and neck squamous cell carcinoma (HNSCC), compared with conventional neck dissection. Case series with chart review. University tertiary care hospital. Thirty HNSCC patients with clinically node negative necks (cN0) who underwent robot-assisted selective neck dissection (SND) by a postauricular facelift approach (11 patients, 12 necks) or conventional neck dissection (19 patients, 21 necks). The mean age was lower in the robotic group (P = .030). However, the distributions of gender and TNM stage did not differ between the two groups. The robotic SND was completed successfully in all patients. The mean operative time was longer in the robotic group (215 ± 56 min) than the conventional group (144 ± 43 min) (P < .001). The mean numbers of lymph nodes removed were 25.0 ± 7.4 and 28.9 ± 8.2 in the robotic and conventional group, respectively (P = .192), and the number of lymph nodes removed at each level also did not differ between the 2 groups. In addition, there was no significant difference in postoperative complications between the 2 groups, but cosmetic satisfaction was higher in the robot group (P = .002). Robot-assisted SND by a postauricular facelift approach is comparable to conventional neck dissection in selected patients with cN0 HNSCC and results in excellent postoperative cosmesis.

Robotic Selective Neck Dissection Using a Gasless Postauricular Facelift Approach for Early Head and Neck Cancer: Technical Feasibility and Safety

Abstract Background: Scarless and minimally invasive surgery is becoming popular in the head and neck area. We have developed a new robotic selective neck dissection procedure for head and neck squamous cell carcinoma (HNSCC) to avoid a long visible lateral neck scar. Here we report on the technical feasibility and safety of our procedure. We prospectively analyzed 4 patients with early HNSCC who underwent transoral robotic surgery (TORS) and concomitant robotic selective neck dissection via a gasless postauricular facelift approach using the da Vinci(®) Surgical System (Intuitive Surgical Inc., Sunnyvale, CA). Of these patients, 3 were male, and 1 was female. The mean age was 59.0±8.8 years. All patients had tongue cancer, with a clinically negative neck. Three patients were T1, and 1 patient was T2. All patients underwent partial glossectomy by TORS and elective robotic selective neck dissection including levels I, II, and III. The robotic selective neck dissection procedure was completed successfully in all patients. The mean operative time was 276±48 minutes. The mean number of lymph nodes removed was 19.3±7.3. Postoperative hematoma and transient marginal nerve palsy occurred in 1 patient each. Cosmetic satisfaction was excellent in all patients. Preliminary results indicate that robotic selective neck dissection via a gasless postauricular facelift approach is feasible and safe and allows for excellent postoperative cosmesis. Further studies are necessary to determine the oncologic safety and surgical completeness of this procedure compared with conventional neck dissection.

Robotically assisted selective neck dissection in parotid gland cancer

AbstractObjectives/Hypothesis:Robot‐assisted neck dissection (ND) in head and neck cancer patients has been demonstrated to be feasible. We hypothesized that surgery for parotid cancer could be achieved via a gasless modified facelift approach using the robotic system. We intended to evaluate the feasibility of robot‐assisted selective ND (SND) via a modified facelift (MFL) approach in parotid gland cancer.Study Design:Case series.Methods:Primary tumor resection with robotic SND I–III via MFL was performed in five patients with parotid gland cancer.Results:All cases of robot‐assisted SND I–III combined with primary tumor resection were successfully conducted without any significant intraoperative complication, applying additional incision or conversion to open conventional ND. The amount and duration of drainage, hospital stay, retrieved lymph nodes, and complications were generally acceptable. The postoperative scar was able to be completely hidden by the auricle and hair.Conclusions:Robotically assisted surgery via an MFL approach is a feasible and useful method, with excellent cosmetic results for the surgical treatment in selected cases of parotid gland cancer. Laryngoscope, 2013