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Three-port transoral robotic thyroidectomy without axillary incision:A preliminary report of 20 cases in China

World Journal of Otorhinolaryngology-Head and Neck Surgery 2023年第2期9卷 138-143页

作者： Bin Zhang Bikash Rai Kuang-yu Fei Zong-hui Han Michelle Savu Key Laboratory of Carcinogenesis and Translational Research(Ministryof Education) Department of Head andNeck SurgeryPeking University Cancer Hospital and InstituteBeijingChina Department of Surgery Beijing United Family HospitalBeijingChina

Objective:transoral scarless thyroid surgery has proven to be a popular alternative to traditional *** robotic thyroidectomy(TORT)has been reported using ports on the lower lip and *** axillary incision can further reduce scars on the ***,we present our preliminary data from the initial 20 consecutive patients to explore the feasibility of three-port TORT without axillary ***:From September 2017 to June 2019,we performed TORT at Beijing United Family Hospital using three intraoral ports without axillary incision via the da Vinci Si system with three robotic *** outcomes of the procedure were retrospectively ***:Among 20 patients(mean age 30±7 years;mean tumor size 1.64±0.96 cm),16 patients underwent unilateral thyroid lobectomy and four had total thyroidectomy with or without central neck *** patients had papillary thyroid carcinomas(PTC),one had a follicular thyroid carcinoma,and one had a thyroid *** mean surgical time was 221±68 *** mean number of retrieved central lymph nodes in the PTC patients was 5.6±*** was no permanent vocal cord palsy or hypocalcemia *** patient had transient vocal cord palsy,which resolved within 1 *** of the lower lip and the chin was observed in nine patients,and one patient had a first-degree burn of the skin flap due to the ***:Three-port TORT without axillary incision is feasible for selected patients and would be a potential alternative for remote-access thyroid surgery to avoid leaving scars on the neck or the armpit.

关键词： three port thyroid carcinoma thyroidectomy transoral robotic

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transoral endoscopic thyroidectomy with central neck dissection：experimental studies on human cadavers

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Chinese Medical Journal 2014年第6期127卷 1067-1070页

作者： Guo Peiyi Tang Zhiping Ding Zihai Chu Guoliang Yao Huosheng Pan Tao Wang Huaqiao Department of Orthopedics Sixth Affiliated Hospital Sun Yat-sen University Guangzhou Guangdong 510655 China Department of General Surgery Zhongshan Boai Hospital of Southern Medical University Zhongshan Guangdong 528400 China Department of Anatomy Southern Medical University Guangzhou Guangdong 510515 China Department of Anatomy Zhongshan School of Medicine Sun Yat-sen University Guangzhou Guangdong 510080 China

Background With the development of natural orifice trans-luminal endoscopic surgery, studies on transoral video-assistedthyroidectomy in preclinical experiments （e.g., human anatomy and animal trials） were progressing gradually. From 2009to 2011, embalmed human cadavers were dissected to define the anatomical location, surgical planes, and related neuraland vascular structures to create a safe transoral access to the front cervical spaces. Recently, experimental transoralendoscopic thvroidectomv was performed to verify the feasibility of this approach on 15 fresh specimens.

关键词： transoral endoscopic thyroidectomy central neck region video-assisted surgery

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transoral robotic surgery for obstructive sleep apnea syndrome: Principles and technique

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2017年第2期3卷 97-100页

作者： Claudio Vicini Filippo Montevecchi Riccardo Gobbi Andrea De Vito Giuseppe Meccariello Department of Head-Neck Surgery Otolaryngology Head-Neck and Oral Surgery UnitMorgagni Pierantoni Hospital Forli Italy

Objective:The present study is a review of transoral robotic surgery (TORS) for the treatment of obstructive sleep apnea-hypopnea syndrome (OSAHS).Methods:The review presents the experience of the robotic center that developed the technique with regards to patient selection,surgical method,and post-operative *** addition,the review provides results of a systematic review and meta-analysis of the complications and clinical outcomes of TORS when applied in the management of ***:The rate of success,defined as 50％ reduction of pre-operative AHI and an overall AHI ＜20 events/h,is achieved in up to 76.6％ of patients with a range between 53.8％ and 83.3％.The safety of this approach is reasonable as the main complication (bleeding) affected 4.2％ of patients (range 4.2％-5.3％).However,transient dysphagia (7.2％;range 5％-14％) does compromise the quality of life and must be discussed with patients ***:TORS for the treatment of OSAHS appears to be a promising and safe procedure for patients seeking an alternative to traditional *** patient selection remains an important consideration for successful implementation of this novel surgical approach requiring further research.

关键词： transoral robotic surgery TORS Partial glossectomy Midline glossectomy Posterior glossectomy Obstructive sleep apnea Sleep surgery

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Robotic transoral vestibular parathyroidectomy:Two case reports and review of literature

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World Journal of Clinical Cases 2018年第12期6卷 542-547页

作者： Yasar Ozdenkaya Cenk Ersavas Naciye Cigdem Arslan Department of General Surgery Medipol University

Advances in preoperative localization studies and de-mands for scarless surgery have promoted the inves-tigation for remote techniques in parathyroid surgery. transoral vestibular approach seems to provide the most comfortable and safest access to the neck. In this paper, we report our initial experience with robotic transoral ves-tibular parathyroidectomy(RTVP) in four patients with primary hyperparathyroidism. The surgery was perfor-med with the Da Vinci system through three trocars intro-duced from the lower lip vestibule. The procedure was converted to open in two patients due to inappropriate preoperative localization. The mean operative time was 169 min. No postoperative complications were seen. Patients were discharged on postoperative day 1. RTVP is a feasible and safe technique, which allows better surgical exposure and manipulation of the instruments. The advantages of transoral vestibular approach can be enhanced by robotics. Further studies are needed to analyze complications and costs.

关键词： transoral vestibular surgery Parathyroid adenoma Natural orifice transendoluminal surgery Robotics Parathyroidectomy

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transoral robotic surgery *** partial midline glossectomy for obstructive sleep apnea

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2017年第2期3卷 101-105页

作者： David Folk Mark D'Agostino Yale University Section of OtolaryngologyDepartment of SurgeryNew HavenCTUSA Middlesex Hospital MiddletownCTUSA

Objective:To compare sleep-related outcomes in obstructive sleep apnea hypopnea syndrome (OSAHS) patients following base of tongue resection via robotic surgery and endoscopic midline ***:This was a retrospective study.A total of 114 robotic and 37 endoscopic midline glossectomy surgeries were performed between July 2010 and April 2015 as part of single or multilevel *** were excluded for indications other than sleep apnea or if complete sleep studies were not ***,45 robotic and 16 endoscopic surgeries were included in the ***:In the robotic surgery group there were statistically significant improvements in AHI [(44.4 ± 22.6) events/h-(14.0 ± 3.0) events/h,P ＜ 0.001] Epworth Sleepiness Scale (12.3 ± 4.6 to 4.5 ± 2.9,P ＜ 0.001),and O2 nadir (82.0％ ± 6.1％ to 85.0％ ± 5.4％,P ＜ 0.001).In the endoscopic group there were also improvements in AHI (48.7 ± 30.2 to 27.4 ± 31.9,P =0.06),Epworth Sleepiness Scale (12.6 ± 5.5 to 8.3 ± 4.5,P =0.08),and O2 nadir (80.2％ ± 8.6％ to 82.7％ ± 6.5％,P =0.4).Surgical success rate was 75.6％ and 56.3％ in the robotic and endoscopic groups,*** volume of tissue removed was predictive of surgical success in the robotic cases (10.3 vs.8.6 ml,P =0.02).Conclusions:Both robotic surgery and endoscopic techniques for tongue base reduction improve objective measures of sleep *** success rates may be achieved with robotic surgery compared to traditional methods.

关键词： Sleep surgery transoral robotic surgery TORS Midline glossectomy Partial glossectomy Posterior glossectomy

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transoral Endoscopic Thyroidectomy with Central Neck Dissection

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中华医学杂志(英文版) 2015年第13期128卷 1838-1838页

作者： Benhidjeb Tahar Department of General VisceralBariatric and Endocrine SurgeryCenter for Minimally Invasive and Scarless SurgeryBurjeel Hospital The New European Surgical Academy

To the Editor: We have read with interest the article reported by Guo et al.,[1] who performed a transoral thyroidectomy with central neck dissection on human cadavers by using a sublingual combined b

关键词： transoral Thyroidectomy Dissection

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transoral surgery for morbid obesity

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World Journal of Gastrointestinal Endoscopy 2011年第11期3卷 201-208页

作者： Sabrena F Noria Dean J Mikami Department of Surgery Division of General and Gastrointestinal SurgeryCenter for Minimally Invasive SurgeryThe Ohio State UniversityColombusOH 43210United States Department of Surgery Division of General SurgeryTulane University School of MedicineNew OrleansLA 70112-2699United States

Obesity is a serious health problem in the United *** laparoscopic surgical procedures are effective in achieving weight loss and improving obesity-related co-morbidities,they are not without their limitations and consequently there is a growing demand for less invasive *** techniques,as both primary and revisional procedures,are promising in this regard as they may provide a safer and more cost-effective means of achieving meaningful weight *** aim of this paper is to review the currently available transoral approaches to weight loss,with a particular focus on those applied in human trials.

关键词： Obesity transoral techniques Humans

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transoral incisionless fundoplication for gastro-esophageal reflux disease: Techniques and outcomes

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2016年第2期7卷 179-189页

作者： Pier Alberto Testoni Giorgia Mazzoleni Sabrina Gloria Giulia Testoni Division of Gastroenterology and Gastrointestinal Endoscopy Vita-Salute San Raffaele University San Raffaele Scientific Institute

Gastro-esophageal reflux disease(GERD)is a verycommon disorder that results primarily from the loss of an effective antireflux barrier,which forms a mechanical obstacle to the retrograde movement of gastric *** can be currently treated by medical therapy,surgical or endoscopic transoral *** therapy is the most common approach,though concerns have been increasingly raised in recent years about the potential side effects of continuous longterm medication,drug intolerance or unresponsiveness,and the need for high dosages for long periods to treat symptoms or prevent *** too may in some cases have consequences such as longlasting dysphagia,flatulence,inability to belch or vomit,diarrhea,or functional dyspepsia related to delayed gastric *** the last few years,transoral incisionless fundoplication(TIF)has proved an effective and promising therapeutic option as an alternative to medical and surgical *** review describes the steps of the TIF technique,using the Esophy X®device and the MUSETM *** and their management are described in detail,and the recent literature regarding the outcomes is *** reconfigures the tissue to obtain a full-thickness gastroesophageal valve from inside the stomach,by serosato-serosa plications which include the muscle *** date the procedure has achieved lasting improvement of GERD symptoms(up to six years),cessation or reduction of proton pump inhibitor medication in about 75%of patients,and improvement of functional findings,measured by either p H or impedance monitoring.

关键词： Gastro-esophageal reflux disease transoral incisionless fundoplication Anterior fundoplication with ultrasonic surgical endostapler Esophy X MUSE Surgical fundoplication

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Advanced oropharyngeal squamous cell carcinoma: Pathogenesis, treatment, and novel therapeutic approaches

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World Journal of Clinical Oncology 2016年第1期7卷 15-26页

作者： Paul L Swiecicki Kelly M Malloy Francis P Worden Division of Hematology/Oncology Department of Internal Medicine University of Michigan Comprehensive Cancer Center Department of Otolaryngology University of Michigan Health System University of Michigan Comprehensive Cancer Center

Oropharyngeal cancer accounts for approximately 2.8% of newly cancer cases. Although classically a tobacco related disease, most cases today are related to infection with human papilloma virus(HPV) and present with locally advanced tumors. HPV related tumors have been recognized as a molecularly distinct entity with higher response rates to therapy, lower rates of relapse, and improved overall survival. Treatment of oropharyngeal cancer entails a multi-disciplinary approach with concomitant chemoradiation. The role of induction chemotherapy in locally advanced tumors continues to be controversial however large studies have demonstrated no difference in survival or time to treatment failure. Surgical approaches may be employed with low volume oropharyngeal cancers and with development new endoscopic tools, more tumors are able to be resected via an endoscopic approach. Given advances in the understanding of HPV related oropharyngeal cancer, ongoing research is looking at ways to minimize toxicities via de-intensification of therapy. Unfortunately, some patients develop recurrent or metastatic disease. Novel therapeutics are currently being investigated for this patient population including immunotherapeutics. This review discusses the current understanding of the pathogenesis of oropharyngeal cancer and treatment. We also discuss emerging areas of research as it pertains to de-intensification as well novel therapeutics for the management of metastatic disease.

关键词： Oropharyngeal cancer Human papilloma virus transoral robotic surgery Immunotherapy Metastatic head and neck squamous cell carcinoma

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Voice outcome measures after flexible endoscopic injection laryngoplasty

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2018年第2期4卷 130-134页

作者： Abdul-Latif Hamdan Marwan Rizk Elie Khalifee Georges Ziade Maher Kasti Department of Otolaryngology and Head & Neck Surgery American University of Beirut-Medical Center Lebanon Department of Anesthesiology American University of Beirut-Medical Center Lebanon Department of Otolaryngology Head & Neck Surgery Rafic Hariri University Hospital Lebanon

Objective: To report voice outcome measures after injection laryngoplasty using the transnasal or transoral flexible endoscopic technique. Methods: A retrospective review of all patients who underwent flexible endoscopic injection laryngoplasty between June 2010 and August 2016 was carried out. Only those patients who had pre- and post-injection voice outcome measures recorded were included. Voice outcome measures recorded included perceptual voice evaluation using GRBAS, Voice Handicap Index-10 (VHI-10), maximum phonation time (MPT) and closed quotient (CQ) before and after treat-ment. Results: Forty-six patients were identified, of which 32 had pre- and post-injection voice outcome measures recorded. There were 19 males and 13 females. The mean age was 56.97 years (range 20—86 years) and the most common indication was unilateral vocal fold paralysis. Thirteen patients had a transnasal flexible endoscopic injection), while 19 patients were in-jected transorally. Following injection laryngoplasty, there was significant improvement in the mean grade of dysphonia (2.81 vs. 1.22, P transoral route. Voice outcomes were comparable to those reported for other approaches. This tech-nique provides an alternative approach for the management of patients with vocal fold paral-ysis or glottal insufficiency.

关键词： Injection Laryngoplasty Transnasal transoral Flexible endoscopic Vocal fold paralysis

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