Open AccessInitiating a Transoral Robotic Surgical Program: The First 30 Cases
Author(s) -
Cognetti David M.,
Luginbuhl Adam,
Nguyen Anthony
Publication year - 2011
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599811416318a89
Subject(s) - medicine , transoral robotic surgery , surgery , retractor , dissection (medical) , credentialing , neck dissection , cancer , medical education
Objective Establish the feasibility of initiating a transoral robotic surgery (TORS) program. Method Prospectively collected data for 30 patients treated with TORS at an academic institution. Main outcome measures were intraoperative times, complications, time to diet, time to discharge. Following FDA approval of TORS, the senior surgeon (DMC) completed the training for TORS. Credentialing included equipment training, porcine dissection, cadaver dissection, and case observation. Results Subsites included BOT, tonsil, parapharyngeal space, retromolar trigone, and supraglottis. Average retractor setup was 12 minutes. Surgical console time ranged from 8 to 205 minutes, averaging 64 minutes (±57 minutes). Variability was noted due to the learning curve at the beginning and increased complexity of cases toward the end. For radical tonsillectomies the surgical times for the final 3 patients averaged 32 minutes whereas the first 3 patients averaged 60 minutes. There were no major complications, tracheostomy was avoided in all patients, and average LOS was 2.3 days. Average time to oral diet was 1.2 days for the 24 patients discharged on a diet. Conclusion Efficient establishment of a TORS program is feasible. With appropriate training and preparation, this technology can be safely applied with acceptable operative times and minimal complications.