A transoral highly flexible robot: Novel technology and application

Area of Science:

• Head and Neck Oncology
• Surgical Robotics
• Medical Device Innovation

Background:

• Organ preservation surgery is critical in head and neck oncology, aiming to enhance patient quality of life and reduce treatment morbidity.
• Transoral robotic surgery (TORS) was developed to improve upon traditional surgical methods, but current systems like the da Vinci Surgical System have limitations due to rigid instruments.
• The rigidity of existing robotic arms restricts maneuverability in complex 3D surgical spaces, hindering access to critical anatomical structures.

Purpose of the Study:

• To evaluate the feasibility of using a highly flexible robot for transoral visualization of the endolarynx.
• To determine if this flexible robot can access anatomical landmarks without requiring laryngeal suspension.
• To address the limitations of rigid instruments in current transoral robotic surgery.

Main Methods:

• The study investigated the feasibility of transoral robotic visualization of the endolarynx using a highly flexible robotic system.
• Human cadavers (two fresh, four preserved) were utilized for the feasibility assessment.
• Standard mouth retractors were employed to facilitate the introduction of the flexible robot into the endolarynx.

Main Results:

• The flexible robot successfully achieved unhampered visualization of the endolarynx in all tested cadaver specimens.
• Laryngeal suspension was not required for visualization, simplifying the surgical procedure.
• The use of standard mouth retractors proved effective for robot delivery into the endolarynx.

Conclusions:

• Flexible robot technology presents a solution to overcome the need for laryngeal suspension and the constraints of rigid instruments in current robotic surgery.
• The demonstrated feasibility of achieving physical and visual access to the endolarynx paves the way for future research.
• Subsequent studies will focus on the feasibility of employing this flexible robot with flexible instrumentation for transoral robotic procedures.