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Oral and Maxillofacial Surgery
Published in: Oral and Maxillofacial Surgery 4/2020

01-12-2020 | Ultrasound | Original Article

Integrated surgery and radiology: trans-oral robotic surgery guided by real-time radiologist-operated intraoral ultrasound

Authors: Edward D. Green, Vinidh Paleri, John C. Hardman, Cyrus Kerawala, Francesco M. G. Riva, Alaa A. Jaly, Derfel ap Dafydd

Published in: Oral and Maxillofacial Surgery | Issue 4/2020

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Abstract

Purpose

We aimed to evaluate the feasibility and utility of intraoral ultrasound as a real-time guidance technique in trans-oral robotic surgery (TORS).

Methods

We report our early experiences of radiologist-operated intraoral ultrasound during TORS, providing information on tumour margin and important adjacent structures. Resection specimens were sonographically imaged for margin assessment.

Results

Four patients underwent ultrasound-guided TORS, with a close correlation between intraoperative and preoperative imaging in each case. The tumour was fully excised in three cases (one did not proceed due to difficult access). No ultrasound-related adverse events occurred, surgical margins were negative, and the treated patients are currently in a state of remission, with functional swallows.

Conclusion

Intraoperative ultrasound can allow previously inaccessible disease to be robotically resected with confidence. Sonographic interrogation of the resected specimen correlated closely with histological margin analysis, and a novel technique of using saline to improve ultrasound conductance and therefore image quality is described.
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Metadata
Title
Integrated surgery and radiology: trans-oral robotic surgery guided by real-time radiologist-operated intraoral ultrasound
Authors
Edward D. Green
Vinidh Paleri
John C. Hardman
Cyrus Kerawala
Francesco M. G. Riva
Alaa A. Jaly
Derfel ap Dafydd
Publication date
01-12-2020
Publisher
Springer Berlin Heidelberg
Published in
Oral and Maxillofacial Surgery / Issue 4/2020
Print ISSN: 1865-1550
Electronic ISSN: 1865-1569
DOI
https://doi.org/10.1007/s10006-020-00880-5

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