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Updated: Aug 2, 2025

Robotic Pancreatoduodenectomy for Pancreatic Head Cancer: a Case Report of a Standardized Technique
Published on: June 24, 2022
A novel technique in transoral robotic surgery: A case report of rotating and switching technique
Daisuke Nishikawa1, Shintaro Beppu1, Hidenori Suzuki1
1Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.
Background:
Transoral robotic surgery (TORS) for tongue base lesions located above the operative field is predominantly an upward procedure, which makes surgery difficult.
Methods:
To illustrate our technique for this procedure, we report the case of an 82-year-old male with a p16-negative oropharyngeal carcinoma of the tongue base who underwent TORS. The field of view was turned upside down, and the operation switched the typical left- and right-arm functions. The daVinci Xi was docked, the 0° endoscope was rotated 180°, and the first arm was switched to the right hand and the third arm to the left hand.
Results:
Although the lesion extended from the tongue base to the soft palate and mobile tongue, the planned resection line was followed.
Conclusions:
This technique improves operability by allowing downward manipulation and preventing the left and right arms from crossing. Further validation of the technique's effectiveness and safety is needed.

