Robotic assisted reconstruction of the oropharynx.
OBJECTIVE
Oropharyngeal reconstruction has undergone significant advances over the last several decades. Transoral robotic surgery (TORS) is a new approach to managing tumors of this location and requires unique reconstructive principles.


RESULTS
The advent of TORS has popularized transoral approaches and has presented new challenges related to reconstruction. Although TORS provides a minimally invasive approach to the oropharynx, there is a paucity of data related to reconstruction of extensive defects following TORS. Our institutional practice is to reconstruct defects based on the Classification for Oropharyngeal Robotic Defects (CORD) classification system. The CORD system considers size, location, number of involved oropharyngeal subsites, pharyngocervical communication, and exposure of carotid artery to guide reconstruction. This system uses more advanced reconstructions to manage increasingly complex defects.


CONCLUSIONS
Herein, we present principles of robotic assisted oropharyngeal reconstruction and the method for applying the CORD system.
Mount Sinai Medical Center, New York, New York, USA.
John R
JR
de Almeida
Eric M
EM
Genden
D000465:Algorithms; D001184:Articulation Disorders / Q000209:etiology / Q000517:prevention & control; D002339:Carotid Arteries / Q000601:surgery; D017577:Cutaneous Fistula / Q000209:etiology / Q000517:prevention & control; D003680:Deglutition Disorders / Q000209:etiology / Q000517:prevention & control; D004750:Enteral Nutrition; D005402:Fistula / Q000209:etiology / Q000517:prevention & control; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D037981:Neck Dissection / Q000379:methods; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D009960:Oropharynx / Q000601:surgery*; D010159:Palate / Q000601:surgery; D010608:Pharyngeal Diseases / Q000209:etiology / Q000517:prevention & control; D011182:Postoperative Care; D011183:Postoperative Complications / Q000209:etiology; D011379:Prognosis; D019651:Plastic Surgery Procedures / Q000379:methods*; D012371:Robotics; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013524:Surgical Flaps