Tags

Type your tag names separated by a space and hit enter

Transoral robotic surgery for upper airway pathology in the pediatric population.
Laryngoscope. 2017 01; 127(1):247-251.L

Abstract

OBJECTIVES/HYPOTHESIS

The purpose of this study is to present one of the largest case series of pediatric transoral robotic surgery (TORS) in the upper airway demonstrating a wide range of ages and indications.

STUDY DESIGN

A retrospective case series at an academic tertiary referral center from August 2010 to September 2014.

METHODS

The da Vinci surgical robot (Intuitive Surgical, Inc., Sunnyvale, CA) was used on 16 pediatric patients for 18 procedures. A variety of upper airway pathologies and reconstructions in children with a wide range of ages and weights were treated. No lingual tonsillectomies or base-of-tongue reductions were included.

RESULTS

Sixteen children (6 males) underwent 18 TORS procedures, including resection of hamartoma (n = 1), repair of laryngeal cleft (n = 7), removal of saccular cyst (n = 2), release of pharyngeal or esophageal strictures (n = 2), and excision of lymphatic malformations (n = 4). Patient ages ranged from 14 days to 15 years. There were no intraoperative complications. All patients had successful robotic access, and no patients had conversions to open or traditional endoscopic surgery. Hospital courses varied with duration ranging from 1 to 20 days. The median follow up was 22 months.

CONCLUSION

Applying TORS to the pediatric population can be feasible and safe for appropriate airway pathologies. Because many patients are small in size, there is inherent risk in using robotic instruments and scopes transorally. Pearls in this series include a standardized two-robot experienced attending team and longitudinal airway follow-up.

LEVEL OF EVIDENCE

4 Laryngoscope, 127:247-251, 2017.

Authors+Show Affiliations

Department of Otolaryngology/Head and Neck Surgery, University of North Carolina Hospitals, Chapel Hill, North Carolina.Department of Otolaryngology/Head and Neck Surgery, University of North Carolina Hospitals, Chapel Hill, North Carolina.Department of Otolaryngology/Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, U.S.A.Department of Otolaryngology/Head and Neck Surgery, University of North Carolina Hospitals, Chapel Hill, North Carolina.Department of Otolaryngology/Head and Neck Surgery, University of North Carolina Hospitals, Chapel Hill, North Carolina.Department of Otolaryngology/Head and Neck Surgery, University of North Carolina Hospitals, Chapel Hill, North Carolina.Department of Otolaryngology/Head and Neck Surgery, University of North Carolina Hospitals, Chapel Hill, North Carolina.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

27320495

Citation

Zdanski, Carlton J., et al. "Transoral Robotic Surgery for Upper Airway Pathology in the Pediatric Population." The Laryngoscope, vol. 127, no. 1, 2017, pp. 247-251.
Zdanski CJ, Austin GK, Walsh JM, et al. Transoral robotic surgery for upper airway pathology in the pediatric population. Laryngoscope. 2017;127(1):247-251.
Zdanski, C. J., Austin, G. K., Walsh, J. M., Drake, A. F., Rose, A. S., Hackman, T. G., & Zanation, A. M. (2017). Transoral robotic surgery for upper airway pathology in the pediatric population. The Laryngoscope, 127(1), 247-251. https://doi.org/10.1002/lary.26101
Zdanski CJ, et al. Transoral Robotic Surgery for Upper Airway Pathology in the Pediatric Population. Laryngoscope. 2017;127(1):247-251. PubMed PMID: 27320495.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Transoral robotic surgery for upper airway pathology in the pediatric population. AU - Zdanski,Carlton J, AU - Austin,Grace K, AU - Walsh,Jonathan M, AU - Drake,Amelia F, AU - Rose,Austin S, AU - Hackman,Trevor G, AU - Zanation,Adam M, Y1 - 2016/06/19/ PY - 2016/03/01/received PY - 2016/04/13/revised PY - 2016/04/25/accepted PY - 2016/6/21/pubmed PY - 2017/8/9/medline PY - 2016/6/21/entrez KW - Laryngeal cleft KW - lymphatic malformation KW - pediatric airway KW - saccular cyst KW - transoral robotic surgery (TORS) SP - 247 EP - 251 JF - The Laryngoscope JO - Laryngoscope VL - 127 IS - 1 N2 - OBJECTIVES/HYPOTHESIS: The purpose of this study is to present one of the largest case series of pediatric transoral robotic surgery (TORS) in the upper airway demonstrating a wide range of ages and indications. STUDY DESIGN: A retrospective case series at an academic tertiary referral center from August 2010 to September 2014. METHODS: The da Vinci surgical robot (Intuitive Surgical, Inc., Sunnyvale, CA) was used on 16 pediatric patients for 18 procedures. A variety of upper airway pathologies and reconstructions in children with a wide range of ages and weights were treated. No lingual tonsillectomies or base-of-tongue reductions were included. RESULTS: Sixteen children (6 males) underwent 18 TORS procedures, including resection of hamartoma (n = 1), repair of laryngeal cleft (n = 7), removal of saccular cyst (n = 2), release of pharyngeal or esophageal strictures (n = 2), and excision of lymphatic malformations (n = 4). Patient ages ranged from 14 days to 15 years. There were no intraoperative complications. All patients had successful robotic access, and no patients had conversions to open or traditional endoscopic surgery. Hospital courses varied with duration ranging from 1 to 20 days. The median follow up was 22 months. CONCLUSION: Applying TORS to the pediatric population can be feasible and safe for appropriate airway pathologies. Because many patients are small in size, there is inherent risk in using robotic instruments and scopes transorally. Pearls in this series include a standardized two-robot experienced attending team and longitudinal airway follow-up. LEVEL OF EVIDENCE: 4 Laryngoscope, 127:247-251, 2017. SN - 1531-4995 UR - https://www.unboundmedicine.com/medline/citation/27320495/Transoral_robotic_surgery_for_upper_airway_pathology_in_the_pediatric_population_ L2 - https://doi.org/10.1002/lary.26101 DB - PRIME DP - Unbound Medicine ER -