Transoral robotic surgery using the thulium:YAG laser: a prospective study

Area of Science:

• Otolaryngology
• Surgical Oncology
• Robotic Surgery

Background:

• Transoral robotic surgery (TORS) is utilized for upper aerodigestive tract malignant neoplasms.
• Conventional electrocautery (EC:TORS) is the standard TORS energy device.
• Thulium:YAG laser (TY:TORS) offers potential advantages in precision and thermal control.

Purpose of the Study:

• To compare the feasibility, safety, and functional outcomes of TY:TORS versus EC:TORS.
• To evaluate TY:TORS in patients undergoing transoral resection of upper aerodigestive tract malignant neoplasms.

Main Methods:

• Prospective matched cohort study at a tertiary academic referral center.
• Fifteen patients undergoing TY:TORS were matched with 30 control patients undergoing EC:TORS.
• Outcomes assessed included feasibility, intraoperative events, and postoperative pain.

Main Results:

• Complete tumor excision with negative margins was achieved in all cases.
• TY:TORS showed a trend towards less estimated blood loss (87% vs. 63%).
• Significantly fewer intraoperative pharyngotomies (8% vs. 42%, P=.03) and less postoperative pain (P=.02) were observed with TY:TORS.

Conclusions:

• TY:TORS is a feasible and safe alternative to EC:TORS for upper aerodigestive tract cancer resection.
• TY:TORS may offer benefits due to decreased collateral thermal damage and improved visualization.
• Reduced intraoperative pharyngotomies and postoperative pain are key advantages of TY:TORS.