Transoral robotic surgery for upper airway pathology in the pediatric population.
The purpose of this study is to present one of the largest case series of pediatric transoral robotic surgery (TORS) in the upper airway demonstrating a wide range of ages and indications.



A retrospective case series at an academic tertiary referral center from August 2010 to September 2014.



The da Vinci surgical robot (Intuitive Surgical, Inc., Sunnyvale, CA) was used on 16 pediatric patients for 18 procedures. A variety of upper airway pathologies and reconstructions in children with a wide range of ages and weights were treated. No lingual tonsillectomies or base-of-tongue reductions were included.



Sixteen children (6 males) underwent 18 TORS procedures, including resection of hamartoma (n = 1), repair of laryngeal cleft (n = 7), removal of saccular cyst (n = 2), release of pharyngeal or esophageal strictures (n = 2), and excision of lymphatic malformations (n = 4). Patient ages ranged from 14 days to 15 years. There were no intraoperative complications. All patients had successful robotic access, and no patients had conversions to open or traditional endoscopic surgery. Hospital courses varied with duration ranging from 1 to 20 days. The median follow up was 22 months.



Applying TORS to the pediatric population can be feasible and safe for appropriate airway pathologies. Because many patients are small in size, there is inherent risk in using robotic instruments and scopes transorally. Pearls in this series include a standardized two-robot experienced attending team and longitudinal airway follow-up.



4 Laryngoscope, 127:247-251, 2017.
Department of Otolaryngology/Head and Neck Surgery, University of North Carolina Hospitals, Chapel Hill, North Carolina.
Carlton J
CJ
Zdanski
Department of Otolaryngology/Head and Neck Surgery, University of North Carolina Hospitals, Chapel Hill, North Carolina.
Grace K
GK
Austin
Department of Otolaryngology/Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, U.S.A.
Jonathan M
JM
Walsh
Department of Otolaryngology/Head and Neck Surgery, University of North Carolina Hospitals, Chapel Hill, North Carolina.
Amelia F
AF
Drake
Department of Otolaryngology/Head and Neck Surgery, University of North Carolina Hospitals, Chapel Hill, North Carolina.
Austin S
AS
Rose
Department of Otolaryngology/Head and Neck Surgery, University of North Carolina Hospitals, Chapel Hill, North Carolina.
Trevor G
TG
Hackman
Department of Otolaryngology/Head and Neck Surgery, University of North Carolina Hospitals, Chapel Hill, North Carolina.
Adam M
AM
Zanation
D000293:Adolescent; D001999:Bronchoscopy; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007828:Laryngoscopy; D008297:Male; D012140:Respiratory Tract Diseases / Q000601:surgery*; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures; D016896:Treatment Outcome
Laryngeal cleft; lymphatic malformation; pediatric airway; saccular cyst; transoral robotic surgery (TORS)