Robotic nasopharyngectomy via combined endonasal and transantral port

A preliminary cadaveric study

Hyung Ju Cho, Ju Wan Kang, Hyun Jin Min, Hyo Jin Chung, Do Yang Park, Jong Gyun Ha, Seung Hak Baek, Joo Heon Yoon, Chang-Hoon Kim

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objectives/Hypothesis The objective of this study was to determine the potential role of a surgical robotic system in nasopharyngeal surgery using bilateral transantral or combined endonasal/transantral port. Study Design The da Vinci robot (Intuitive Surgical Inc., Sunnyvale, CA) was used to perform dissection of the skull base on a whole fresh-frozen cadaver. Methods Bilateral mega-antrostomy was done with the usual endoscopic sinus surgery equipment. To obtain an accessible bilateral working space, posterior septectomy was performed. Next, bilateral anterior maxillary windows were created through a gingivobuccal incision. The 8.5-mm-diameter 0° or 30° three-dimensional camera arm was introduced into a nostril. The two 5-mm-diameter articulating EndoWrist arms entered through the transantral or endonasal port. For the dissection, Maryland articulated forceps, needle driver, and monopolar spatula- or hook-type electrocauterizer were used. Results The 8.5-mm diameter of the camera arm was easily inserted into the nostril. Excellent access to the nasopharyngeal area from the level of the palate up to the skull base crossing the sphenoid prow was possible. Bilateral robotic arms were able to move inside the nasopharyngeal space, and the target dissection area could be accessed fully via the transantral or endonasal port. Conclusions This is the first report about the feasibility of bilateral transantral or combined transantral/endonasal port for robotic nasopharyngectomy. Robotic removal of the entire nasopharyngeal area was successfully achieved without transpalatal or facial skin incision. These new approaches may be applied to selected patients with nasopharyngeal carcinoma or other pathologic tumors involving the nasopharynx.

Original languageEnglish
Pages (from-to)1839-1843
Number of pages5
JournalLaryngoscope
Volume125
Issue number8
DOIs
Publication statusPublished - 2015 Jan 1

Fingerprint

Robotics
Dissection
Arm
Skull Base
Nasopharynx
Palate
Cadaver
Surgical Instruments
Needles
Equipment and Supplies
Skin
Neoplasms

All Science Journal Classification (ASJC) codes

  • Otorhinolaryngology

Cite this

Cho, Hyung Ju ; Kang, Ju Wan ; Min, Hyun Jin ; Chung, Hyo Jin ; Park, Do Yang ; Ha, Jong Gyun ; Baek, Seung Hak ; Yoon, Joo Heon ; Kim, Chang-Hoon. / Robotic nasopharyngectomy via combined endonasal and transantral port : A preliminary cadaveric study. In: Laryngoscope. 2015 ; Vol. 125, No. 8. pp. 1839-1843.
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abstract = "Objectives/Hypothesis The objective of this study was to determine the potential role of a surgical robotic system in nasopharyngeal surgery using bilateral transantral or combined endonasal/transantral port. Study Design The da Vinci robot (Intuitive Surgical Inc., Sunnyvale, CA) was used to perform dissection of the skull base on a whole fresh-frozen cadaver. Methods Bilateral mega-antrostomy was done with the usual endoscopic sinus surgery equipment. To obtain an accessible bilateral working space, posterior septectomy was performed. Next, bilateral anterior maxillary windows were created through a gingivobuccal incision. The 8.5-mm-diameter 0° or 30° three-dimensional camera arm was introduced into a nostril. The two 5-mm-diameter articulating EndoWrist arms entered through the transantral or endonasal port. For the dissection, Maryland articulated forceps, needle driver, and monopolar spatula- or hook-type electrocauterizer were used. Results The 8.5-mm diameter of the camera arm was easily inserted into the nostril. Excellent access to the nasopharyngeal area from the level of the palate up to the skull base crossing the sphenoid prow was possible. Bilateral robotic arms were able to move inside the nasopharyngeal space, and the target dissection area could be accessed fully via the transantral or endonasal port. Conclusions This is the first report about the feasibility of bilateral transantral or combined transantral/endonasal port for robotic nasopharyngectomy. Robotic removal of the entire nasopharyngeal area was successfully achieved without transpalatal or facial skin incision. These new approaches may be applied to selected patients with nasopharyngeal carcinoma or other pathologic tumors involving the nasopharynx.",
author = "Cho, {Hyung Ju} and Kang, {Ju Wan} and Min, {Hyun Jin} and Chung, {Hyo Jin} and Park, {Do Yang} and Ha, {Jong Gyun} and Baek, {Seung Hak} and Yoon, {Joo Heon} and Chang-Hoon Kim",
year = "2015",
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Cho, HJ, Kang, JW, Min, HJ, Chung, HJ, Park, DY, Ha, JG, Baek, SH, Yoon, JH & Kim, C-H 2015, 'Robotic nasopharyngectomy via combined endonasal and transantral port: A preliminary cadaveric study', Laryngoscope, vol. 125, no. 8, pp. 1839-1843. https://doi.org/10.1002/lary.25283

Robotic nasopharyngectomy via combined endonasal and transantral port : A preliminary cadaveric study. / Cho, Hyung Ju; Kang, Ju Wan; Min, Hyun Jin; Chung, Hyo Jin; Park, Do Yang; Ha, Jong Gyun; Baek, Seung Hak; Yoon, Joo Heon; Kim, Chang-Hoon.

In: Laryngoscope, Vol. 125, No. 8, 01.01.2015, p. 1839-1843.

Research output: Contribution to journalArticle

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T1 - Robotic nasopharyngectomy via combined endonasal and transantral port

T2 - A preliminary cadaveric study

AU - Cho, Hyung Ju

AU - Kang, Ju Wan

AU - Min, Hyun Jin

AU - Chung, Hyo Jin

AU - Park, Do Yang

AU - Ha, Jong Gyun

AU - Baek, Seung Hak

AU - Yoon, Joo Heon

AU - Kim, Chang-Hoon

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N2 - Objectives/Hypothesis The objective of this study was to determine the potential role of a surgical robotic system in nasopharyngeal surgery using bilateral transantral or combined endonasal/transantral port. Study Design The da Vinci robot (Intuitive Surgical Inc., Sunnyvale, CA) was used to perform dissection of the skull base on a whole fresh-frozen cadaver. Methods Bilateral mega-antrostomy was done with the usual endoscopic sinus surgery equipment. To obtain an accessible bilateral working space, posterior septectomy was performed. Next, bilateral anterior maxillary windows were created through a gingivobuccal incision. The 8.5-mm-diameter 0° or 30° three-dimensional camera arm was introduced into a nostril. The two 5-mm-diameter articulating EndoWrist arms entered through the transantral or endonasal port. For the dissection, Maryland articulated forceps, needle driver, and monopolar spatula- or hook-type electrocauterizer were used. Results The 8.5-mm diameter of the camera arm was easily inserted into the nostril. Excellent access to the nasopharyngeal area from the level of the palate up to the skull base crossing the sphenoid prow was possible. Bilateral robotic arms were able to move inside the nasopharyngeal space, and the target dissection area could be accessed fully via the transantral or endonasal port. Conclusions This is the first report about the feasibility of bilateral transantral or combined transantral/endonasal port for robotic nasopharyngectomy. Robotic removal of the entire nasopharyngeal area was successfully achieved without transpalatal or facial skin incision. These new approaches may be applied to selected patients with nasopharyngeal carcinoma or other pathologic tumors involving the nasopharynx.

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