Robotic microlaryngeal surgery: feasibility using a newly designed retractor and instrumentation

Area of Science:

• Robotic Surgery
• Head and Neck Surgery
• Laryngeal Surgery

Background:

• Robotic surgery is expanding in head and neck procedures but not yet routine for microlaryngeal surgery.
• Current retractors limit tongue and oral commissure retraction, larynx visualization, and robotic adaptability.
• Existing microlaryngeal surgery instrumentation is inadequate for robotic applications.

Purpose of the Study:

• To assess the feasibility of robotic microlaryngeal surgery (RMLS) using a novel robotic retractor.
• To adapt existing microlaryngeal instrumentation for robotic use.
• To achieve routine glottic exposure for RMLS.

Main Methods:

• A feasibility study was conducted using a newly designed robotic retractor in a cadaver model.
• Microlaryngeal instruments were adapted for the da Vinci Surgical Robot.
• The study aimed to evaluate glottic exposure and robotic instrument access.

Main Results:

• Robotic microlaryngeal surgery was successfully performed in a cadaver model.
• Procedures included microflap elevation, anterior commissure surgery, cordectomy, and arytenoidectomy.
• Photographic and video documentation confirmed the feasibility of the techniques.

Conclusions:

• A novel laryngeal robotic retractor and microlaryngeal instrumentation were developed and tested in a cadaver model.
• The system allows for glottic and anterior commissure exposure and robotic access for delicate endolaryngeal procedures.
• Further evaluation in an in vivo human model is required to determine the retractor's efficacy.