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Robotic Surgery in Otolaryngology: Head & Neck Surgery
Nilesh R Vasan
SECTION 1: TRANSORAL ROBOTIC SURGERY (TORS)
CHAPTER 1:
Transoral Robotic Surgery for Tonsil Cancer
INTRODUCTION
RATIONALE FOR PROCEDURE
APPLIED ANATOMY-RADICAL TONSILLECTOMY
INDICATIONS AND CONTRAINDICATIONS
PREOPERATIVE ASSESSMENT
INSTRUMENTATION
General Surgical Instruments
Access Instruments
Robotic Instrumentation
OPERATIVE SETUP
OPERATIVE TECHNIQUE
EARLY POSTOPERATIVE CONSIDERATIONS
MANAGEMENT OF THE NECK
MANAGEMENT OF COMPLICATIONS
FOLLOW-UP
RESULTS
Feasibility
Oncologic Outcomes
Functional Outcomes
FUTURE DIRECTIONS
CONCLUSION
VIDEO LEGEND
CHAPTER 2:
Transoral Robotic Surgery for Base of Tongue Tumors
INTRODUCTION
Rationale for Procedure
Applied Anatomy
HISTORY
PHYSICAL EXAMINATION
Indications
Contraindications
Preoperative Workup
Radiographic Imaging
Endoscopy
Robotic Approach to the BOT
Instrumentation
Operative Setup
Operative Technique
Management of the Neck
Airway Management
POSTOPERATIVE CARE
COMPLICATIONS
RESULTS
Future Considerations
Pearls and Pitfalls
VIDEO LEGEND
CHAPTER 3:
Transoral Robotic Surgery—Hypopharynx
INTRODUCTION
Background
Rationale for Procedure
Applied Anatomy
Indications and Contraindications
Tumor Characteristics
Patient Characteristics
Preoperative Workup
Investigations
Radiology
Panendoscopy
Instrumentation
Exposure
Ablation
Reconstruction
Operative Setup with Robot
Anesthesia and Intubation
Tracheotomy
Setup
Operative Technique
Optimizing Access
Pyriform Sinus
Posterior Pharyngeal Wall
Neck
Complications and their Management
Follow-up
RESULTS
FUTURE DIRECTIONS
VIDEO LEGEND
CHAPTER 4:
Transoral Robotic Supraglottic Laryngectomy (TORS-SGL)
INTRODUCTION
RATIONALE FOR PROCEDURE
APPLIED ANATOMY
PATIENT SELECTION
PREOPERATIVE WORKUP
INSTRUMENTATION
OPERATIVE SETUP
Anesthesia
Patient Positioning
Transoral Exposure
da Vinci Robot Positioning
OPERATIVE TECHNIQUE: TORS-SGL
Pearls and Pitfalls
POSTOPERATIVE CARE
COMPLICATIONS AND THEIR MANAGEMENT
Intraoperative
Early Postoperative
Late Postoperative
EXPECTED OUTCOMES
Perioperative Values
Oncologic Outcomes
Functional Outcomes
CHOOSING AN SGL APPROACH
FUTURE DIRECTIONS
CHAPTER 5:
Transoral Robotic Surgery for Obstructive Sleep Apnea
INTRODUCTION
RATIONALE FOR PROCEDURE
APPLIED ANATOMY
INDICATIONS AND CONTRAINDICATIONS
PREOPERATIVE WORKUP
INSTRUMENTATION
OPERATIVE SETUP
OPERATIVE TECHNIQUE
COMPLICATIONS AND THEIR MANAGEMENT
FOLLOW-UP
RESULTS
FUTURE DIRECTIONS
VIDEO LEGEND
SECTION 2: THYROID
CHAPTER 6:
Transaxillary Robotic Thyroidectomy
INTRODUCTION
RATIONALE FOR PROCEDURE
APPLIED ANATOMY FOR ROBOTIC THYROID SURGERY
INDICATIONS AND CONTRAINDICATIONS FOR ROBOTIC THYROIDECTOMY WITH OR WITHOUT RADICAL NECK DISSECTION
Preoperative Workup
INSTRUMENTATION
OPERATIVE SETUP WITH ROBOT
Robotic Thyroidectomy Setup
Patient Positioning
Robot Positioning and Docking
Robotic Radical Neck Dissection Setup
Patient Positioning
Robot Positioning and Docking
OPERATIVE TECHNIQUE
Actual Operation Procedure for Robotic Thyroidectomy
Actual Operation Procedure for Robotic Modified Radical Neck Dissection
PRESENT STATUS OF ROBOTIC THYROID SURGERY
QUESTIONS AND SOLUTIONS
FUTURE DIRECTIONS
VIDEO LEGEND
CHAPTER 7:
Robotic Thyroidectomy for American (Western) Patients
INTRODUCTION
ROBOTIC THYROIDECTOMY
INDICATION AND PATIENT SELECTION
Robotic Transaxillary Thyroidectomy
Surgical Technique
Robotic Facelift Thyroidectomy
Surgical Technique
COMPLICATIONS
CONCLUSION
CHAPTER 8:
Robotic Thyroidectomy—Facelift Approach
INTRODUCTION
RATIONALE FOR PROCEDURE
APPLIED ANATOMY (FOR ROBOTIC SURGERY)
INDICATIONS AND CONTRAINDICATIONS
PREOPERATIVE WORKUP
INSTRUMENTATION
Pocket Creation
Robot Dissection
Wound Closure
OPERATIVE SETUP WITH ROBOT
OPERATIVE TECHNIQUE
COMPLICATIONS AND THEIR MANAGEMENT
FOLLOW-UP
RESULTS
FUTURE DIRECTIONS
VIDEO LEGEND
SECTION 3: HEAD AND NECK RECONSTRUCTION
CHAPTER 9:
Transoral Robotic Surgery in Head and Neck Reconstruction
INTRODUCTION
RATIONALE FOR PROCEDURE
APPLIED ANATOMY
INDICATIONS
CONTRAINDICATIONS
PREOPERATIVE WORKUP
INSTRUMENTATION
OPERATIVE SETUP WITH ROBOT
OPERATIVE TECHNIQUE
COMPLICATIONS AND THEIR MANAGEMENT
Pearls and Pitfalls
FOLLOW-UP
RESULTS
FUTURE DIRECTIONS
VIDEO LEGEND
SECTION 4: ROBOTIC PROCEDURES IN EVOLUTION
CHAPTER 10:
Robot-Assisted Neck Dissection via a Modified Facelift or Retroauricular Approach
INTRODUCTION
RATIONALE FOR PROCEDURE
APPLIED ANATOMY
INDICATIONS
CONTRAINDICATIONS
PREOPERATIVE WORKUP
Choice of Surgical Approach
Preoperative Imaging
Precautions for Anesthesia
INSTRUMENTATIONS
OPERATIVE TECHNIQUES
Step 1 Positioning of the Patient
Step 2 Skin Incision Design
Step 3 Skin Flap Elevation
Step 4 Upper ND Under Direct Vision
Step 5 Robot-assisted Neck Dissection Technique
Step 6 Finishing the Operation
COMPLICATIONS AND THEIR MANAGEMENT
Possible Postoperative Complications from Therapeutic RAND
FOLLOW-UP
RESULTS
FUTURE DIRECTIONS
CHAPTER 11:
Robotic-Assisted Skull Base Surgery
INTRODUCTION
TECHNIQUES
Approach to the Anterior Cranial Fossa
Approach to the Pituitary Fossa
Approach to the Nasopharynx
Approach to the Infratemporal Fossa
SKULL BASE RECONSTRUCTION
OPTICAL LIMITATIONS
ERGONOMIC LIMITATIONS
DISSECTION LIMITATIONS
RECONSTRUCTIVE LIMITATIONS
CONCLUSION
CHAPTER 12:
Robotic-Assisted Surgery for Nasopharyngeal Tumors
INTRODUCTION
RATIONALE FOR PROCEDURE
APPLIED ANATOMY
INDICATIONS AND CONTRAINDICATIONS
Indications
Characteristics of the Tumor
Contraindications
PREOPERATIVE WORKUP
INSTRUMENTATION
OPERATIVE SETUP AND OPERATIVE TECHNIQUE
Patient Placement
Palatal Split and Exposure of the Nasopharynx
Docking of the Patient Cart
Operative Techniques at the Console
Incorporation of Transnasal Endoscopic Resection
Coverage of the Nasopharynx after Resection
Closure of the Palatal Wound
POSTOPERATIVE CARE
COMPLICATIONS
FOLLOW-UP
RESULTS
FUTURE DIRECTIONS
VIDEO LEGEND
CHAPTER 13:
Robot-Assisted Otologic and Neurotologic Surgery
INTRODUCTION
RATIONALE FOR THE USE OF ROBOTICS IN SURGERY OF THE TEMPORAL BONE
POTENTIAL APPLICATIONS IN OTOLOGIC AND NEUROTOLOGIC SURGERY
INDICATIONS AND CONTRAINDICATIONS
PREOPERATIVE WORKUP
COMPLICATIONS
CONCLUSION
INDEX
TOC
Index
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