Transoral robotic surgery using a carbon dioxide flexible laser for tumors of the upper aerodigestive tract.
OBJECTIVE
To determine the safety, feasibility, and efficacy of coupling transoral robotic technology with the flexible carbon dioxide (CO2) laser for various tumors of the oropharynx and supraglottic larynx.


METHODS
Prospective, pilot trial.


METHODS
Eight patients were enrolled in an IRB-approved prospective trial for transoral robotic surgery with the aid of the flexible CO2 laser.


RESULTS
Seven male patients with early carcinoma of the oropharynx or larynx successfully underwent tumor extirpation with the transoral robot and the flexible CO2 laser. We were unable to gain access to the supraglottic larynx in one female patient. The final pathology revealed seven patients with squamous cell carcinoma and one patient with adenoid cystic carcinoma. The flexible CO2 laser provided fine incisions with excellent hemostasis and minimal peripheral tissue injury. Additionally, the laser provided an excellent tool for raising pharyngeal flaps for reconstruction of the oropharynx.


CONCLUSIONS
The flexible CO2 laser offers a unique advantage of precise incisions and may provide a valuable tool for both tumor extirpation and the creation of flaps for transoral robotic reconstruction.
Desai
Shaun C
SC
Department of Otolaryngology, Head and Neck Surgery, Mount Sinai School of Medicine, New York, NY 10029, USA.
Sung
Chih-Kwang
CK
Jang
David W
DW
Genden
Eric M
EM
D003528:Carcinoma, Adenoid Cystic / Q000473:pathology / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D004867:Equipment Design; D004869:Equipment Safety; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D020704:Laryngoscopes; D053685:Laser Therapy / Q000295:instrumentation*; D054020:Lasers, Gas / Q000627:therapeutic use*; D008297:Male; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D010865:Pilot Projects; D011446:Prospective Studies; D012371:Robotics / Q000295:instrumentation*; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*; D013524:Surgical Flaps; D020858:Tissue and Organ Harvesting / Q000295:instrumentation; D016896:Treatment Outcome