A robotic surgical assist arm is an adjustable multi-hinged arm that is clamped to the operating table. Advantages of surgical assist arms include the ability for a surgeon to operate with reduced assistants and improvement in surgical ergonomics by reducing lifting load on the assistant. This has been an increasingly common scenario during the Covid-19 pandemic given desired limitations of operative room personnel and PPE usage. The arm allows for steady and prolonged retraction without leading to muscle fatigue that can be precisely placed by the surgeon and adjusted rapidly and effortlessly. This creates a stable operative field for the surgeon to work with improved ergonomics. The use of robotic surgical assist arms for retraction has been described for various surgical disciplines, although its application in otolaryngology has not been illustrated.
The application of a robotic surgical assist arm to Otolaryngology will be demonstrated through illustrating its use in several procedures.
The robotic surgical assist arm has been used successfully for raising fibula and scapula free flaps, and performing laryngectomies, mandibulectomies and thyroidectomies for large goiters. Key portions of the procedures can be directly aided by the arm, limiting the need for an extra assistant and reducing the static lifting load experienced during retraction.
Using a robotic surgical assist arm offers the surgeon advantages and can be applied to various procedures in head and neck and reconstructive surgery. They may prove a valuable tool when personnel and PPE are limited such as during the Covid-19 pandemic, and can lead to improved operating room ergonomics. Further study on their use in Otolaryngology is warranted.