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      Transoral robotic resection of large intramural, cervical esophageal lipoma—Report of a case and description of technique

      case-report

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          Abstract

          Transoral robotic surgery (TORS) has evolved into a common surgical modality used to treat primarily oropharyngeal malignant and benign pathologies. The single port Intuitive Surgical da Vinci surgical robotics system facilitates access to the hypopharynx and cervical esophagus. We aim to describe our approach and advantages of the technique.

          Abstract

          Transoral robotic surgery should be considered as a surgical approach for hypopharyngeal and cervical esophageal masses. The da Vinci single‐port (SP) robotic system conveys significant advantages in surgical dissection, exposure, and visualization.

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          Single-port transoral robotic surgery hypopharyngectomy.

          Abie H Mendelsohn, Georges Lawson (2021)
          Transoral robotic surgery (TORS) is an established treatment for many subsites of Head and Neck cancer. With the improved flexibility and access of the single-port (SP) robotic system, tumors within the distal upper aerodigestive tract can now be reached and successfully treated with all the published advantages of transoral endoscopic surgery. Here in we offer the first published surgical technique for SP TORS for resectable hypopharyngeal carcinoma. The video presented demonstrates many important aspects utilizing the enhanced robotic system, including adjustments of the semi-flexible endoscope and use of the third transoral surgical instrumentation. As previously reported, TORS hypopharyngectomy should be considered for resectable tumors to improve upon the deleterious effects of open surgical resection or chemoradiation therapy.
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            Preoperative predictors of difficult hypopharyngeal exposure by retractor for transoral robotic surgery

            Kazunori Fujiwara, Satoshi Koyama, Ryouhei Donishi … (2018)
            Introduction Transoral endoscopic surgeries provide excellent oncologic outcomes while preserving speech and swallowing ability. However, feasibility has been a major concern about transoral surgery. Therefore, ensuring visualization of the surgical field and sufficient working space is required. The aim of this study was to evaluate the parameters in the preoperative assessment that affect hypopharyngeal exposure. Methods Before transoral surgery, parameters regarding the patient’s neck and face such as modified Mallampati index, thyroid–mental distance (TMD), and ability to fully open the mouth were evaluated. Cephalometry and cervical spine radiography were performed preoperatively to evaluate the size of the mandible bone, mouth opening, and cervical spine extension. Mandibular bone parameters such as intergonion distance, mental–gonion distance, articulare–gonion distance, and aperture angle were measured. According to hypopharyngeal exposure using FKWO retractor, patients were divided into difficult hypopharyngeal exposure group (DHE) and non-difficult hypopharyngeal exposure group (non-DHE). Parameters were enrolled to evaluate the relationship between these parameters and DHE status. Results This study included 51 patients, 37 in the non-DHE group and 14 in the DHE group. On radiographic evaluation, there was a significant difference in the degree of cervical lordosis between non-DHE and DHE patients. A significantly higher proportion of DHE patients had a history of radiotherapy compared with non-DHE patients. Conclusion Patients with limited cervical extension and a history of previous radiotherapy might have difficult hypopharyngeal exposure during transoral surgery. This is the first report to suggest a classification system for hypopharyngeal exposure during transoral surgery.
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              Robotic surgery may improve overall survival for T1 and T2 tumors of the hypopharynx: an NCDB cohort study

              A. Finegersh, RS Vohra, B Panuganti … (2021)
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                Author and article information

                Contributors
                Bharat Akhanda Panuganti:
                ORCID: https://orcid.org/0000-0003-1149-9532
                bpanugan@gmail.com
                Journal
                Journal ID (nlm-ta): Clin Case Rep
                Journal ID (iso-abbrev): Clin Case Rep
                Journal ID (doi): 10.1002/(ISSN)2050-0904
                Journal ID (publisher-id): CCR3
                Title: Clinical Case Reports
                Publisher: John Wiley and Sons Inc. (Hoboken )
                ISSN (Electronic): 2050-0904
                Publication date (Electronic): 02 March 2023
                Publication date Collection: March 2023
                Volume: 11
                Issue: 3 ( doiID: 10.1002/ccr3.v11.3 )
                Electronic Location Identifier: e7009
                Affiliations
                [ 1 ] Department of Otolaryngology‐Head and Neck Surgery The University of Alabama at Birmingham Birmingham Alabama USA
                Author notes
                [*] [* ] Correspondence

                Bharat Akhanda Panuganti, The University of Alabama at Birmingham, Department of Otolaryngology, 1720 2nd Avenue South, Birmingham, AL 35294, USA.

                Email: bpanugan@ 123456gmail.com

                Author information
                https://orcid.org/0000-0003-1149-9532
                Article
                Publisher ID: CCR37009 Other ID: CCR3-2023-01-0132.R1
                DOI: 10.1002/ccr3.7009
                PMC ID: 9979959
                PubMed ID: 36873066
                SO-VID: 6f23f857-b06c-4ae9-bfd1-b7b04ba6905b
                Copyright © © 2023 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.
                License:

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                Date revision received : 01 February 2023
                Date received : 20 January 2023
                Date accepted : 13 February 2023
                Page count
                Figures: 4, Tables: 0, Pages: 4, Words: 1609
                Categories
                Subject: Case Report
                Subject: Case Report
                Custom metadata
                source-schema-version-number 2.0
                cover-date March 2023
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:6.2.5 mode:remove_FC converted:02.03.2023

                Keywords: dysphagia,esophageal lipoma,minimally invasive surgery,transoral robotic surgery
                Data availability:
                Keywords: dysphagia, esophageal lipoma, minimally invasive surgery, transoral robotic surgery

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