A novel flexible robot for the treatment of oropharyngeal carcinoma in transoral robotic surgery

Presentation: AHNS004
Topic: Technology and Implementation
Type: Oral
Date: Wednesday, April 18, 2018
Session: 9:05 AM - 10:00 AM Technology
Authors: Jason Chan1, Raymon Tsang2, F C Holsinger3, Eddy Wong1
Institution(s): 1The Chinese University of Hong Kong, 2The University of Hong Kong, 3Stanford University

Introduction: Transoral robotic surgery is advancing at a rapid pace. Recently a next generation novel flexible, single-port robotic surgical system - da Vinci SP (Intuitive Surgical Inc. Sunnyvale), has been described. Here we report on our experience of the system in the world's first clinical use in transoral robotic surgery for squamous cell carcinoma of the oropharynx

Methods: Prospective, single centre study consistent with a stage 1 (Innovation) study described in the Innovation, Development, Exploration, Assessment, Long-term Study (IDEAL) framework. The study was registered on www.ClinicalTrials.gov (NCT03010813).

Results: The da Vinci SP could be successfully used in transoral resection of the oropharynx in 5 patients. One patient had an unknown primary and underwent a tongue base resection (Tx), four patients had tonsillar primary and a lateral oropharyngectomy (two T1 and two T2). The patient-side cart was docked at 90 degrees with the mouth opened with a Boyle-Davis mouth gag in all cases. The single port cannula located 10-15 cm away from the mouth opening to enable deployment of both the wrist and elbow joints. The camera arm and three instrument arms easily fit transorally, the movement was smooth, without restriction and collision.  The extra arm significantly aided with traction for tumour resections. There were no conversions from the robotic procedure to an open approach and no adverse events related to the use of the da Vinci SP. All surgical margins were negative.

Conclusions: This first clinical study clearly demonstrate that the da Vinci SP system is safe and feasible to use in surgery of the oropharynx for oropharyngeal squamous cell carcinoma.