Transoral supraglottic laryngectomy using a next-generation single-port robotic surgical system

Background To investigate the feasibility of transoral robotic surgery (TORS) supraglottic laryngectomy (SGL) using a next-generation flexible surgical robot. Methods Preclinical human cadaver anatomic study of TORS SGL via en bloc resection. Results A single-port robotic surgical system (da Vinci Sp, Intuitive Surgical, Inc., Sunnyvale, California) provided sufficient access, reach, and visualization to perform TORS SGL. Access and exposure were achieved with a standard laryngo-pharyngoscope retractor. The remote center of the robotic system was located 10 cm from the maxillary alveolus. Three surgical instruments and one flexible camera could be deployed with minimal collision or restriction of arm movement. Conclusions Routine resection supraglottic cancers through TORS have been hindered by challenging exposure and visualization and limited instrument maneuverability deep within the laryngopharyngeal complex. This preclinical feasibility study demonstrates the technical feasibility for TORS SGL using a next-generation flexible surgical robot.