Aims: To assess the feasibility of a flexible thulium laser coupled with a novel robotic introducer for head and neck cancers.
Methods: In a prospective nonrandomized clinical trial, 58 patients were evaluated. When indicated, transoral robotic surgery (TORS) with laser was performed using an Intuitive da Vinci S System with the Intuitive Surgical® Endo Wrist Introducer, 5Fr to hold and position thulium surgical laser fibers.
Results: Six patients underwent TORS with laser for early supraglottic and oropharyngeal squamous cell carcinomas. All approaches were successfully completed without the need for microscopic/open conversion or positive margins to the final pathological study. No intraoperative adverse events occurred and recovery was relatively quick, with no evidence of disease recurrence at the time of reporting, the short observation time notwithstanding.
Conclusions: In our preliminary experience, TORS with laser showed feasible and promising results. Further studies are mandatory to demonstrate thulium laser benefits in surgical and oncological practice.
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Article Synopsis
- The study aimed to gather insights from international experts on the efficacy and challenges of two minimally invasive surgical techniques, transoral laser microsurgery (TLM) and transoral robotic surgery (TORS), for treating supraglottic laryngeal tumors.
- A survey was conducted with 27 head and neck surgeons, finding that TLM generally took less setup time compared to TORS, although both techniques faced concerns about bleeding during surgery, particularly with TLM.
- Experts viewed TLM and TORS as largely equal in effectiveness, but noted that TORS offered better control over bleeding and improved visibility during the procedure.
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