Demonstration of Transoral Surgery in Cadaveric Specimens with the Medrobotics Flex System
Demonstration of Transoral Surgery in Cadaveric Specimens with the Medrobotics Flex System
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DOI：
10.1002/lary.23512
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发表时间：
2013-05-01
期刊：
影响因子：
2.6
通讯作者：
Duvvuri, Umamaheswar
中科院分区：
文献类型：
--
作者：
Johnson, Paul J.;Serrano, Carlos M. Rivera;Duvvuri, Umamaheswar
目的/假设：使用人类尸体，我们研究了使用一种新的机器人平台Medrobotics Flex系统进行喉部入路和灵活工具输送的可行性，以促进在没有喉部悬吊的情况下进行咽喉手术。我们的初步试验，特别是评估该实验机器人系统的实用性会厌切除术和舌根切除术。研究设计：可行性;证据等级：NA.Methods：使用标准的口牵开器，Flex（TM）机器人通过医生控制器驱动到声门上区。在每种手术类型中，通过机器人的外部工具通道插入非交叉、柔性内窥镜工具，以牵开、烧灼和切除组织。模拟手术过程中进行的喉咽复合体，包括会厌切除术，舌根切除术，声带切除术。记录每次手术的组织暴露时间。每次会厌切除术的时间，以确定operation duration.Results：会厌切除术，舌根切除术，声带切除术成功地进行了无支撑喉镜。个体外科医生在第一次和第二次尝试之间显著缩短了手术时间（P = 0.03）。会厌切除术的平均时间为42分钟（N = 5，sigma = 28分钟）。结论：Medrobotics Flex系统作为头颈部肿瘤的手术工具具有很大的潜力。与其他手术机器人相比，Flex系统为喉内手术提供了方便的访问、视觉和灵活工具的三角测量。
Objectives/Hypothesis: Using human cadavers, we investigated the feasibility of using a new robotic platform, the Medrobotics Flex System, for laryngeal access and flexible tool delivery to facilitate the performance of pharyngolaryngeal procedures without laryngeal suspension. Our initial trials specifically assess the utility of this experimental robotic system for epiglottectomy and base of tongue resection.Study Design: Feasibility; Level of evidence: NA.Methods: Using standard mouth retractors, the Flex (TM) robot was driven via the physician controller to the supraglottic region. Non-crossing, flexible endoscopic tools were inserted through the robot's external tool channels to retract, cauterize, and remove tissue in each procedure type. Mock surgical procedures were performed on the laryngopharyngeal complex including epiglottectomy, base of tongue resection, and vocal cord excision. Time-to-tissue exposure was noted for each procedure. Each epiglottectomy was timed to determine operation duration.Results: Epiglottectomy, base of tongue resection, and vocal cord excision were successfully performed without suspension laryngoscopy. Individual surgeons improved the procedure time significantly (P = 0.03) between first and second attempts. Epiglottectomies were performed in an average time of 42 minutes (N = 5, sigma = 28 minutes).Conclusions: The Medrobotics Flex System demonstrates great potential as a surgical tool in head and neck oncology. Compared to other surgical robots, the Flex System offers facilitated access, vision, and triangulation of flexible tools for procedures in the endolarynx.