title: Novel uses of surgical robotics in head and neck surgery.
abstract: OBJECTIVE
  To demonstrate the utility of robotically assisted approaches in head and neck surgery.
  
  
  METHODS
  Two teenage patients, one with a solitary thyroid nodule who was scheduled for a right thyroid lobectomy and the other with intractable seizures who was scheduled for placement of a vagal nerve stimulator were offered the option of a robotically assisted technique using a transaxillary endoscopic approach.
  
  
  RESULTS
  Both procedures were completed successfully using the da Vinci surgical system (Intuitive Surgical, Sunnyvale, California). A 12 mm telescope and 5 mm instruments were used. There was sufficient mobility of the robotic arms despite the small working space. There were no complications, minimal pain in the axillary incisions, and patient satisfaction was high. Operative times were 4.5 and 4.2 hours, respectively.
  
  
  CONCLUSIONS
  Transaxillary, endoscopic, robotically assisted approaches to the head and neck are feasible. The addition of robotics improves surgical dexterity in a difficult-to-reach anatomic region. Patient satisfaction appears high because of the avoidance of a cervical incision.
authors.affiliation: Minimally Invasive Head and Neck Surgery Center, Iowa Methodist Medical Center/Blank Children's Hospital, Des Moines, Iowa 50309, USA. Lobet2@ihs.org
authors.forename: Thom E
authors.initials: TE
authors.lastname: Lobe
authors.forename: Simon K
authors.initials: SK
authors.lastname: Wright
authors.forename: Michael S
authors.initials: MS
authors.lastname: Irish
mesh_terms: D000293:Adolescent; D000328:Adult; D004599:Electric Stimulation Therapy / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D012371:Robotics / Q000295:instrumentation*; D012640:Seizures / Q000628:therapy*; D013965:Thyroidectomy / Q000295:instrumentation*; D014630:Vagus Nerve