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Hybrid supracricoid partial laryngectomy with cricohyoidoepiglottopexy via transoral robotic surgery.

Abstract

OBJECTIVES/HYPOTHESIS

To describe a hybrid supracricoid partial laryngectomy with cricohyoidoepiglottopexy (hybrid SCPL-CHEP) combining limited transcervical and transoral robotic approaches.

STUDY DESIGN

Preclinical cadaveric study.

METHODS

Using six human cadavers in a series of three preclinical laboratories (July 2016-February 2018), we developed a novel hybrid technique for SCPL-CHEP. A flexible single-port robotic surgical system was utilized for the transoral aspects of the procedure.

RESULTS

Detailed procedural steps are defined: 1) transoral: mucosal incisions under direct visualization of the laryngopharynx (tumor resection); 2) transcervical: incision and mobilization of the larynx and pexis; and 3) transoral: mucosal closure. Hybrid SCPL-CHEP was technically feasible and allowed for complete transoral mucosal reconstruction. We discuss potential clinical significance of adding this TORS approach to conventional open SCPL-CHEP.

CONCLUSIONS

This hybrid technique for SCPL-CHEP provides two main advantages over the standard technique: direct visualization during tumor resection prior to laryngotomy and full closure of the laryngopharynx defect. These technical refinements might facilitate postoperative recovery and in turn make this larynx preservation procedure more accessible to patients and surgeons. A clinical trial evaluating the efficacy of hybrid SCPL-CHEP appears warranted to validate these observations.

LEVEL OF EVIDENCE

NA Laryngoscope, 2018.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Otolaryngology-Head and Neck Surgery, Yokohama City University, Yokohama, Japan.

    ,

    Division of Head and Neck Surgery, Department of Otolaryngology, Stanford University, Palo Alto, California, U.S.A.

    Division of Head and Neck Surgery, University of California San Diego, San Diego, California, U.S.A.

    Source

    The Laryngoscope : 2018 Dec 19 pg

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    30569529

    Citation

    Nakayama, Meijin, et al. "Hybrid Supracricoid Partial Laryngectomy With Cricohyoidoepiglottopexy Via Transoral Robotic Surgery." The Laryngoscope, 2018.
    Nakayama M, Holsinger FC, Orosco RK. Hybrid supracricoid partial laryngectomy with cricohyoidoepiglottopexy via transoral robotic surgery. Laryngoscope. 2018.
    Nakayama, M., Holsinger, F. C., & Orosco, R. K. (2018). Hybrid supracricoid partial laryngectomy with cricohyoidoepiglottopexy via transoral robotic surgery. The Laryngoscope, doi:10.1002/lary.27628.
    Nakayama M, Holsinger FC, Orosco RK. Hybrid Supracricoid Partial Laryngectomy With Cricohyoidoepiglottopexy Via Transoral Robotic Surgery. Laryngoscope. 2018 Dec 19; PubMed PMID: 30569529.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Hybrid supracricoid partial laryngectomy with cricohyoidoepiglottopexy via transoral robotic surgery. AU - Nakayama,Meijin, AU - Holsinger,F Christopher, AU - Orosco,Ryan K, Y1 - 2018/12/19/ PY - 2018/10/01/accepted PY - 2018/12/21/entrez KW - Laryngeal cancer KW - larynx preservation surgery KW - supracricoid partial laryngectomy KW - transoral robotic surgery JF - The Laryngoscope JO - Laryngoscope N2 - OBJECTIVES/HYPOTHESIS: To describe a hybrid supracricoid partial laryngectomy with cricohyoidoepiglottopexy (hybrid SCPL-CHEP) combining limited transcervical and transoral robotic approaches. STUDY DESIGN: Preclinical cadaveric study. METHODS: Using six human cadavers in a series of three preclinical laboratories (July 2016-February 2018), we developed a novel hybrid technique for SCPL-CHEP. A flexible single-port robotic surgical system was utilized for the transoral aspects of the procedure. RESULTS: Detailed procedural steps are defined: 1) transoral: mucosal incisions under direct visualization of the laryngopharynx (tumor resection); 2) transcervical: incision and mobilization of the larynx and pexis; and 3) transoral: mucosal closure. Hybrid SCPL-CHEP was technically feasible and allowed for complete transoral mucosal reconstruction. We discuss potential clinical significance of adding this TORS approach to conventional open SCPL-CHEP. CONCLUSIONS: This hybrid technique for SCPL-CHEP provides two main advantages over the standard technique: direct visualization during tumor resection prior to laryngotomy and full closure of the laryngopharynx defect. These technical refinements might facilitate postoperative recovery and in turn make this larynx preservation procedure more accessible to patients and surgeons. A clinical trial evaluating the efficacy of hybrid SCPL-CHEP appears warranted to validate these observations. LEVEL OF EVIDENCE: NA Laryngoscope, 2018. SN - 1531-4995 UR - https://www.unboundmedicine.com/medline/citation/30569529/Hybrid_supracricoid_partial_laryngectomy_with_cricohyoidoepiglottopexy_via_transoral_robotic_surgery L2 - https://doi.org/10.1002/lary.27628 DB - PRIME DP - Unbound Medicine ER -