Transoral Robotic Surgery Total Laryngectomy.

Area of Science:

• Robotic Surgery
• Head and Neck Surgery
• Surgical Oncology

Background:

• Transoral robotic surgery (TORS) offers minimally invasive approaches for head and neck procedures.
• Total laryngectomy (TL) is a standard treatment for advanced laryngeal cancers.
• Integrating TORS with TL (TORS-TL) presents potential benefits for patient outcomes.

Purpose of the Study:

• To demonstrate a standardized technique for transoral robotic surgical total laryngectomy (TORS-TL) using the da Vinci robotic system.
• To evaluate the feasibility and safety of the TORS-TL procedure.
• To present the application of TORS-TL in managing complex laryngeal conditions.

Main Methods:

• A 5-step surgical technique for TORS-TL was developed and described.
• The technique was initially demonstrated on fresh-frozen human cadavers.
• The procedure was subsequently applied to two patients with laryngeal squamous cell carcinoma (SCC) requiring salvage TL or managing laryngeal incompetence.

Main Results:

• Transoral robotic surgical total laryngectomy (TORS-TL) was successfully completed in all cadaveric and patient cases.
• Operative times for cadavers were approximately 55-65 minutes, while patient procedures took 210-235 minutes.
• No intraoperative or postoperative complications or surgical morbidity were associated with the da Vinci system during TORS-TL.

Conclusions:

• Transoral robotic surgical total laryngectomy (TORS-TL) is a safe, reliable, and effective method for treating laryngeal squamous cell carcinoma (SCC).
• The described step-by-step surgical technique for TORS-TL is efficient and reproducible.
• TORS-TL shows promise as a viable surgical option for selected patients with laryngeal malignancies.