title: Early assessment of feasibility and technical specificities of transoral robotic surgery using the da Vinci Xi.
abstract: The latest generation Da Vinci®Xi™ Surgical System Robot released has not been evaluated to date in transoral surgery for head and neck cancers. We report here the 1-year results of a non-randomized phase II multicentric prospective trial aimed at assessing its feasibility and technical specificities. Our primary objective was to evaluate the feasibility of transoral robotic surgery using the da Vinci®Xi™ Surgical System Robot. The secondary objective was to assess peroperative outcomes. Twenty-seven patients, mean age 62.7 years, were included between May 2015 and June 2016 with tumors affecting the following sites: oropharynx (n = 21), larynx (n = 4), hypopharynx (n = 1), parapharyngeal space (n = 1). Eighteen patients were included for primary treatment, three for a local recurrence, and six for cancer in a previously irradiated field. Three were reconstructed with a FAMM flap and 6 with a free ALT flap. The mean docking time was 12 min. "Chopsticking" of surgical instruments was very rare. During hospitalization following surgery, 3 patients experienced significant bleeding between day 8 and 9 that required surgical transoral hemostasis (n = 1) or endovascular embolization (n = 2). Transoral robotic surgery using the da Vinci®Xi™ Surgical System Robot proved feasible with technological improvements compared to previous generation surgical system robots and with a similar postoperative course. Further technological progress is expected to be of significant benefit to the patients.
authors.affiliation: Department of Head and Neck Oncology, Gustave Roussy, 114 rue Edouard Vaillant, 94805, Villejuif, France. Philippe.gorphe@gustaveroussy.fr.
authors.forename: Philippe
authors.identifier: http://orcid.org/0000-0001-7604-4964
authors.initials: P
authors.lastname: Gorphe
authors.affiliation: Department of Head and Neck Oncology, Oscar Lambret, Lille, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Von Tan
authors.affiliation: Department of Head and Neck Oncology, Oscar Lambret, Lille, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: El Bedoui
authors.affiliation: Department of Head and Neck Oncology, Gustave Roussy, 114 rue Edouard Vaillant, 94805, Villejuif, France.
authors.forename: Dana M
authors.initials: DM
authors.lastname: Hartl
authors.affiliation: Department of Head and Neck Oncology, Gustave Roussy, 114 rue Edouard Vaillant, 94805, Villejuif, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Auperin
authors.affiliation: Department of Head and Neck Oncology, Gustave Roussy, 114 rue Edouard Vaillant, 94805, Villejuif, France.
authors.forename: Quentin
authors.initials: Q
authors.lastname: Qassemyar
authors.affiliation: Department of Head and Neck Oncology, Gustave Roussy, 114 rue Edouard Vaillant, 94805, Villejuif, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Moya-Plana
authors.affiliation: Department of Head and Neck Oncology, Gustave Roussy, 114 rue Edouard Vaillant, 94805, Villejuif, France.
authors.forename: François
authors.initials: F
authors.lastname: Janot
authors.affiliation: Department of Head and Neck Oncology, Oscar Lambret, Lille, France.
authors.forename: Morbize
authors.initials: M
authors.lastname: Julieron
authors.affiliation: Department of Head and Neck Oncology, Gustave Roussy, 114 rue Edouard Vaillant, 94805, Villejuif, France.
authors.forename: Stephane
authors.initials: S
authors.lastname: Temam
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005240:Feasibility Studies; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000601:surgery; D007822:Laryngeal Neoplasms / Q000601:surgery; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000601:surgery; D010610:Pharyngeal Neoplasms / Q000601:surgery; D011446:Prospective Studies; D065287:Robotic Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome
keywords: Peroperative outcomes; Postoperative complications; Transoral robotic surgery (TORS); da Vinci® Xi™ Surgical System Robot