• Title/Summary/Keyword: Transoral surgery

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Transoral Robotic Surgery (경구강 로봇 수술)

  • Park, Young Min;Kim, Se-Heon
    • Korean Journal of Head & Neck Oncology
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    • v.31 no.2
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    • pp.1-5
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    • 2015
  • The role of transoral robotic surgery in the treatment of upper aerodigestive tract tumor has expanded in recent. Since the approval of the da Vinci system, the number of transoral robotic surgery has increased significantly. The main indications of transoral robotic surgery are tumors of oropharynx, hypopharynx, and larynxs. Transoral robotic surgery is a minimally invasive surgical approach that offers surgical access to the laryngopharynx without the morbidity of open surgeries while achieving excellent oncologic and functional outcomes. The appropriate application of transoral robotic surgery is still being investigated and previous studies supports transoral robotic surgery as a viable option in the management of upper aerodigestive tract tumor.

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Robotic Surgery in Head and Neck (두경부 영역에서의 로봇 수술)

  • Tae, Kyung;Shin, Kwang-Soo
    • Korean Journal of Bronchoesophagology
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    • v.16 no.1
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    • pp.27-32
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    • 2010
  • Organ preservation surgery and minimally invasive surgery have been developed during the past 20 years with major focus on transoral laser surgery, endoscopic surgery, and robotic surgery. Two major robotic surgeries in head and neck area are transoral robotic surgery (TORS) and robotic thyroidectomy. Transoral robotic surgery is a safe and efficacious method of surgical treatment of oropharyngeal. hypopharyngeal and laryngeal neoplasm. Advantages of the technique include adequate ability to visualize and manipulate lesions with two hands. TORS can provide magnified three dimensional views and overcome the limitation resulting from the "line of sight" which hinders transoral laser procedure. The swallowing function following transoral robotic surgery show superior and patients were able to retain or rapidly regain swallowing function in the majority of cases. Recently, robotic thyroidectomy has also been developed to overcome the [imitation of endoscopic thyroidectomy. Robotic thyroidectomy by a gasless unilateral axillo-breast or axillary approach using a da Vinci S Surgical Robot is a feasible and cosmetically excellent procedure. It can be a promising alternative to endoscopic thyroidectomy or conventional open thyroidectomy.

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Lasers and Robots: Recent Developments in Transoral Laser and Transoral Robotic Surgery

  • Padalhin, Andrew Reyes
    • Medical Lasers
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    • v.9 no.2
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    • pp.103-109
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    • 2020
  • Transoral microsurgery has come a long way as a go-to surgical intervention technique for head and neck cancers. This minimally invasive procedure had gained acceptance through comparative clinical studies against radical neck surgical procedures, radiotherapy, and chemotherapy. Laser technology has vastly improved the oncological outcomes of this procedure and brought about an appreciation of transoral laser surgery (TLM) as a mainstay for re-sectioning malignant tumors along the throat. As an established procedure, TLM has undergone several upgrades regarding the different energy devices used for cutting, ablation, and hemostasis. Continued advances in automation have eventually led to surgical robotics, resulting in the emergence of transoral robotic surgery (TORS) as a viable advanced alternative for TLM. Similarly, expansions and enhancements (image-based guidance, fluorescence spectroscopy, and advanced robotic system) have also been investigated as potential upgrades for TORS. This paper reviews a selection of publications on the significant technological advancements to TLM and TORS over the past five years.

Transoral $CO_2$ Laser Microsurgery for Glottic Carcinoma (성대암에서 $CO_2$ 레이저를 이용한 경구강절제술)

  • Chung, Phil-Sang;Moon, Tae-Hyun
    • Korean Journal of Bronchoesophagology
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    • v.16 no.1
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    • pp.20-26
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    • 2010
  • Transoral $CO_2$ Laser Microsurgery of glottic Carcinoma is replacing external approaches. The qualify of life after surgery for laryngeal cancer may be as important as complete resection of the tumor for patient. Transoral $CO_2$ laser cordectomy for the management of early laryngeal cancer has advantages with regard to oncological results, preservation of laryngeal functions, morbidity and cost in comparison to those of open surgery or radiation therapy. Moreover, transoral laser surgery can be a useful choice as a salvage surgery in radiation therapy failed early glottic cancer. A classification of laryngeal endoscopic cordectomies which included eight different types was described by the European laryngological Society in 2000. We will also introduce type VI which was newly proposed recently.

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A Clinical Review on the Transoral Approach to the Fractures of The Mandible (구내 접근법에 의한 하악골 골절 치료에 대한 임상적 고찰)

  • Park, Hyung-Sik;Kwon, Jun-Ho;Chung, Seong-Hoon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.11 no.1
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    • pp.79-86
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    • 1989
  • The is a retrospective study on the transoral approach to open reduction of the Mandibular fractures. Our study was based on a series of 64 patients with mandibular fractures among 99 patients of facial bone fractures who had been treated by transoral approach with or without extraoral approach at Department of Oral and Maxillofacial Surgery, Yonsei Medical Center, Yonsei University from January 1981 to October 1988. We studied favorite sites of open reduction, fixation methods, results and prognosis related to transoral approaches of Mandibular fractures, and which compared with extraoral approaches. The results obtained are as follows : 1. The transoral open reduction was used more frequently in Mandibular fractures(64.6%) than Midfacial bone fractures(35.4%). Among 64 patients of mandibular fractures, 47 patients(73.4%) were treated only by transoral approach and others(26.6%) were treated by both trans- and extra-oral approach. Among 92 sites of mandibular fractures, 75 sites(81.5%) were treated by transoral approach and 17(18.5%) were treated by extraoral approach. 2. The most favorite site for transoral approach compared with extraoral approach was Symphysis(100%), and Angle(62.5%) was next in order of frequency on Mandibular fractures. 3. Direct Interosseous Wiring(DIW) was most commonly used for fixation(64.6%) and Miniplate osteosynthesis was used next in 28.1%. 4. Simple(39.1%) and Compound(52.2%) fractures were frequently indicated for transoral approach, however comminuted fractures were rarely indicated. 5. The direction of fracture lines on Angle of the mandible did not influence to determine whether transoral approach should be selected or not. However this area seemed to be more difficult to reduce exactly by transoral procedure than other areas because simultaneous superior and inferior fixation was applied predominantly on this area. 6. The success rate of reduction and fixation analyzed from us was more excellent in Direct Interosseous Wiring(29/53=54.7%) than in Rigid Internal Fixation(9/29=31.0%). But it might be depended upon various factors as like as sugeon's skill. 7. The postoperative complication due to transoral open reduction of mandible was not high(12.0%) and this rate was similar with other published reports.

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Partial Necrosis of the Mandibular Proximal Segment Following Transoral Vertical Ramus Osteotomy

  • Kim, Somi;Kim, Sang Yoon;Kim, Gi-Jung;Jung, Hwi-Dong;Jung, Young-Soo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.36 no.3
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    • pp.131-134
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    • 2014
  • Transoral vertical ramus osteotomy (TOVRO) procedure can result in a variety of complications. Complications commonly reported include extensive bleeding due to major blood vessel injury, unpredictable fracture, postoperative infection, neurosensory deficit related Inferior alveolar nerve, insufficient osteosynthesis, and temporomandibular joint problem. The authors describe a case of partial necrosis of the mandibular proximal segment following TOVRO, a rarely reported complication. A 37-year-old otherwise healthy woman underwent Lefort l osteotomy and TOVRO to correct mandibular prognathism. Postoperatively, she developed pain and swelling in the right submandibular region and was found to have a partial necrosis of proximal segment.

Transoral Laser and Robotic Surgery (경구강 레이저 및 로봇 수술)

  • Roh, Jong-Lyel;Ryu, Chang Hwan
    • Korean Journal of Bronchoesophagology
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    • v.17 no.1
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    • pp.29-34
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    • 2011
  • Traditionally, the main strategy of treatment of the head and neck cancer was en bloc resection including adjacent normal tissues through wide incision. However, the procedures may leave severe functional deficit such as swallowing difficulty, aspiration, and wide neck scar. Therefore, many attempts have been made up to minimize these morbidities. Of them, the minimal invasive approach such as transoral laser microsurgery (TLM) and transoral robot surgery (TORS) have been spolighted as a sensible strategy for organ preservation of the head and neck cancer patients. Results of TLM are equivalent to those obtained by conventional surgery, with considerably less morbidity, less hospital time and better postoperative function. Oncologic results of TLM are equivalent to conventional surgery. TORS are safe, feasible, and promising but oncologic safety is not yet verified. This article covers to current application of TLM and TORS, their advantages and limitations, and future direction.

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Transoral Laser Excision of a Pyriform Sinus Cyst

  • Lee, Sang Joon;Chung, Phil-Sang;Chung, Sang Yong;Woo, Seung Hoon
    • Medical Lasers
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    • v.8 no.2
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    • pp.84-86
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    • 2019
  • Pyriform sinus cyst is a rare disease. This disease can be found by chance or appear as lymph nodes with cancer, infections, shortness of breath, or airway compromise, and can be an unusual cause of dysphonia. This paper presents a case of a pyriform sinus cyst in the pharyngeal wall of the left pyriform sinus, which presented as neck discomfort in a 63-year-old female. The plan was to remove this cyst with a transoral CO2 laser because a CO2 laser is a useful tool for removing cysts without bleeding and consuming time. The excision was performed successfully. Transoral laser pyriform sinus cyst excision is a simple, safe, and effective method for the treatment of pyriform sinus cysts. This procedure is likely to be used as a selective treatment when managing this condition.

OPEN REDUCTION AND TRANSORAL FIXATION USING TROCHAR FOR MANDIBULAR SUBCONDYLE FRACTURE (구강 접근과 트로카를 이용한 하악 과두하부 골절의 정복과 고정)

  • Hur, Jun-Young;Kim, Jong-Yun;Lim, Jae-Hyung;Park, Kwang-Ho;Huh, Jong-Ki
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.1
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    • pp.43-48
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    • 2010
  • The mandibular condyle fracture occurs at 15-30% frequency of whole mandibular fracture. The treatment of choice is open reduction or closed reduction. In many cases, closed reduction is preferred for treatment of condylar fracture because it is hard to approach to condyle and there is risk of surgical complications, such as nerve damage in open reduction. Open reduction, however, has some advantages like possibility of anatomical reduction, occlusal stability and rapid functional recovery. Furthermore, it is possible to retain original ramal heights and to decrease deviation during mouth opening. There are many surgical approaches for open reduction of subcondyle fracture. At present, transoral approach using trochar device is tried for effective and minimally invasive method for open reduction of subcondyle fracture. And the authors report the cases of reduction of subcondyle fracture with transoral approach using trochar device.

A Case of Lingual Thyroglossal Duct Cyst Treated by CO2 Laser via Transoral Approach (경구강 CO2 레이저를 이용하여 치료한 설갑상설관 낭종 1예)

  • Kim, Tae Hwan;Park, Jin Su;Lee, Sang Hyuk;Jin, Sung Min
    • Korean Journal of Head & Neck Oncology
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    • v.31 no.2
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    • pp.74-77
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    • 2015
  • A lingual thyroglossal duct cyst(LTGDC) is a rare congenital anomaly that account for only 0.5% to 2% of total thyroglossal duct cyst. LTGDC is frequently associated with respiratory problem in infants and pharyngeal foreign body sensation or dysphagia in adults. Because of its location and characteristics, lingual thyroid, dermoid cyst, and vallecular cyst should be included in differential diagnosis. Standard treatment for thyroglossal duct cyst is sistrunk's operation, but in terms of LTGDC, because of its location and cosmetic reasons, different kinds of treatments such as electrical cauterization, $CO_2$ laser, Robort surgery via transoral approach have been introduced. Recently authors encountered 21 years old woman with LTGDC and the mass was removed successfully via transoral approach using $CO_2$ laser. We report the clinical course with review of the literature.

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