title: Transoral robotic-assisted laryngeal cleft repair in the pediatric patient.
abstract: OBJECTIVE
  To assess the feasibility of performing robotic-assisted laryngeal cleft repair in the pediatric population.
  
  
  METHODS
  Retrospective chart review at a tertiary academic children's hospital.
  
  
  METHODS
  All patients underwent transoral robotic-assisted laryngeal cleft repair from March 2011 to June 2013. Demographics, robotic docking time, operative time, and postoperative course and swallowing function were collected and analyzed.
  
  
  RESULTS
  Five children, three male and two female, underwent successful transoral robotic-assisted laryngeal cleft repair for closure of a type I laryngeal cleft. Mean age at time of surgery was 21.6 months (standard deviation 6.1 months; range, 15-29 months). From case 1 to case 5, robotic docking time (18-10 minutes), robotic operative time (102-36 minutes), and total operating room time (173-105 minutes) decreased. There were no complications with time until extubation (range, 2-3 days), length of intensive care unit stay (range, 3-4 days), and total hospital stay (range, 3-5 days) within acceptable range following laryngeal cleft repair. Modified barium swallow (two patients) or fiberoptic endoscopic evaluation of swallowing (three patients) was performed postoperatively, with all patients showing complete resolution of penetration and aspiration. In addition, all patients experienced subjective resolution of dysphagia and/or choking with feeds postoperatively.
  
  
  CONCLUSIONS
  Transoral robotic-assisted laryngeal cleft repair may offer specific advantages over a traditional endoscopic approach. In our experience, the procedure was well tolerated and associated with definitive surgical cure in all patients. The scope of robotic technology continually expands and should be considered a feasible tool at an institution-based level.
authors.affiliation: University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
authors.forename: Rachel L
authors.initials: RL
authors.lastname: Leonardis
authors.forename: Umamaheswar
authors.initials: U
authors.lastname: Duvvuri
authors.forename: Deepak
authors.initials: D
authors.lastname: Mehta
mesh_terms: D002675:Child, Preschool; D000013:Congenital Abnormalities / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007223:Infant; D007830:Larynx / Q000002:abnormalities* / Q000601:surgery; D008297:Male; D009055:Mouth; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D012371:Robotics / Q000379:methods*
keywords: Robotic; laryngeal cleft repair; pediatric robotics; transoral robotics