Skip to main content
SpringerLink
Log in

Early assessment of feasibility and technical specificities of transoral robotic surgery using the da Vinci Xi

  • Original Article
  • Published:
Journal of Robotic Surgery Aims and scope Submit manuscript

Abstract

The latest generation Da Vinci® Xi™ Surgical System Robot released has not been evaluated to date in transoral surgery for head and neck cancers. We report here the 1-year results of a non-randomized phase II multicentric prospective trial aimed at assessing its feasibility and technical specificities. Our primary objective was to evaluate the feasibility of transoral robotic surgery using the da Vinci® Xi™ Surgical System Robot. The secondary objective was to assess peroperative outcomes. Twenty-seven patients, mean age 62.7 years, were included between May 2015 and June 2016 with tumors affecting the following sites: oropharynx (n = 21), larynx (n = 4), hypopharynx (n = 1), parapharyngeal space (n = 1). Eighteen patients were included for primary treatment, three for a local recurrence, and six for cancer in a previously irradiated field. Three were reconstructed with a FAMM flap and 6 with a free ALT flap. The mean docking time was 12 min. “Chopsticking” of surgical instruments was very rare. During hospitalization following surgery, 3 patients experienced significant bleeding between day 8 and 9 that required surgical transoral hemostasis (n = 1) or endovascular embolization (n = 2). Transoral robotic surgery using the da Vinci® Xi™ Surgical System Robot proved feasible with technological improvements compared to previous generation surgical system robots and with a similar postoperative course. Further technological progress is expected to be of significant benefit to the patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Weinstein GS, O’Malley BW Jr, Hockstein NG (2005) Transoral robotic surgery: supraglottic laryngectomy in a canine model. Laryngoscope 115:1315–1319

    Article  PubMed  Google Scholar 

  2. O’Malley BW Jr, Weinstein GS, Snyder W, Hockstein NG (2006) Transoral robotic surgery (TORS) for base of tongue neoplasms. Laryngoscope 116:1465–1472

    Article  PubMed  Google Scholar 

  3. Weinstein GS, O’Malley BW Jr, Snyder W et al (2007) Transoral robotic surgery: radical tonsillectomy. Arch Otolaryngol Head Neck Surg 133:1220–1226

    Article  PubMed  Google Scholar 

  4. O’Malley BW Jr, Weinstein GS (2007) Robotic skull base surgery: preclinical investigations to human clinical application. Arch Otolaryngol Head Neck Surg 133:1215–1219

    Article  PubMed  Google Scholar 

  5. Moore EJ, Olsen KD, Kasperbauer JL (2009) Transoral robotic surgery for oropharyngeal squamous cell carcinoma: a prospective study of feasibility and functional outcomes. Laryngoscope 119:2156–2164

    Article  PubMed  Google Scholar 

  6. Genden EM, O’Malley BW Jr, Weinstein GS et al (2012) Transoral robotic surgery: role in the management of upper aerodigestive tract tumors. Head Neck 34:886–893

    Article  PubMed  Google Scholar 

  7. Hans S, Badoual C, Gorphe P, Brasnu D (2012) Transoral robotic surgery for head and neck carcinomas. Eur Arch Otorhinolaryngol 269:1979–1984

    Article  PubMed  Google Scholar 

  8. Vergez S, Lallemant B, Ceruse P et al (2012) Initial multi-institutional experience with transoral robotic surgery. Otolaryngol Head Neck Surg 147:475–481

    Article  PubMed  Google Scholar 

  9. Weinstein GS, O’Malley BW Jr, Magnuson JS et al (2012) Transoral robotic surgery: a multicenter study to assess feasibility, safety, and surgical margins. Laryngoscope 122:1701–1707

    Article  PubMed  Google Scholar 

  10. de Almeida JR, Li R, Magnuson JS et al (2015) Oncologic outcomes after transoral robotic surgery: a multi-institutional study. JAMA Otolaryngol Head Neck Surg 141:1043–1051

    Article  PubMed Central  PubMed  Google Scholar 

  11. Holsinger FC, Ferris RL (2015) Transoral endoscopic head and neck surgery and its role within the multidisciplinary treatment paradigm of oropharynx cancer: robotics, lasers, and clinical trials. J Clin Oncol 33:3285–3292

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  12. Gross ND, Holsinger FC, Magnuson JS et al (2016) Robotics in otolaryngology and head and neck surgery: recommendations for training and credentialing: a report of the 2015 AHNS education committee, AAO-HNS robotic task force and AAO-HNS sleep disorders committee. Head Neck 38(Suppl 1):E151–E158

    Article  PubMed Central  PubMed  Google Scholar 

  13. Razafindranaly V, Lallemant B, Aubry K et al (2016) Clinical outcomes with transoral robotic surgery for supraglottic squamous cell carcinoma: experience of a french evaluation cooperative subgroup of GETTEC. Head Neck 38(Suppl 1):E1097–1101

    Article  PubMed  Google Scholar 

  14. Chen MM, Holsinger FC (2016) Morbidity and mortality associated with robotic head and neck surgery: an inquiry of the food and drug administration manufacturer and user facility device experience database. JAMA Otolaryngol Head Neck Surg 142:405–406

    Article  PubMed  Google Scholar 

  15. Aubry K, Vergez S, de Mones E et al (2016) Morbidity and mortality revue of the French group of transoral robotic surgery: a multicentric study. J Robot Surg 10:63–67

    Article  CAS  PubMed  Google Scholar 

  16. Asher SA, White HN, Kejner AE et al (2013) Hemorrhage after transoral robotic-assisted surgery. Otolaryngol Head Neck Surg 149:112–117

    Article  PubMed  Google Scholar 

  17. Chia SH, Gross ND, Richmon JD (2013) Surgeon experience and complications with transoral robotic surgery (TORS). Otolaryngol Head Neck Surg 149:885–892

    Article  PubMed  Google Scholar 

  18. Holsinger FC, McWhorter AJ, Menard M et al (2005) Transoral lateral oropharyngectomy for squamous cell carcinoma of the tonsillar region: I. Technique, complications, and functional results. Arch Otolaryngol Head Neck Surg 131:583–591

    Article  PubMed  Google Scholar 

  19. Holsinger FC (2016) A flexible, single-arm robotic surgical system for transoral resection of the tonsil and lateral pharyngeal wall: next-generation robotic head and neck surgery. Laryngoscope 126:864–869

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors are very grateful to Lorna Saint Ange for editing and to Professor Stéphane Hans and Professor Georges Lawson for their advices.

Author information

Authors and Affiliations

  1. Department of Head and Neck Oncology, Gustave Roussy, 114 rue Edouard Vaillant, 94805, Villejuif, France

    Philippe Gorphe, Dana M. Hartl, Anne Auperin, Quentin Qassemyar, Antoine Moya-Plana, François Janot & Stephane Temam

  2. Department of Head and Neck Oncology, Oscar Lambret, Lille, France

    Jean Von Tan, Sophie El Bedoui & Morbize Julieron

Authors
  1. Philippe Gorphe
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jean Von Tan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sophie El Bedoui
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Dana M. Hartl
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Anne Auperin
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Quentin Qassemyar
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Antoine Moya-Plana
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. François Janot
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Morbize Julieron
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Stephane Temam
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Philippe Gorphe.

Ethics declarations

Conflict of interest

Philippe Gorphe, Jean Von Tan, Sophie El Beboui, Dana M Hartl, Anne Auperin, Quentin Qassemyar, Antoine Moya-Plana, François Janot, Morbize Julieron, and Stéphane Temam declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gorphe, P., Von Tan, J., El Bedoui, S. et al. Early assessment of feasibility and technical specificities of transoral robotic surgery using the da Vinci Xi. J Robotic Surg 11, 455–461 (2017). https://doi.org/10.1007/s11701-017-0679-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11701-017-0679-z

Keywords

Search

Navigation