Background: Cosmetic outcome after submandibular gland (SMG) surgery has greatly improved since the development of robotic surgery through a trans-hairline approach. However, the bulky sizes of robotic arms and the rigid design of camera and instruments in the current multiarm robotic systems increased the surgical difficulty. Methods: Clinical and preclinical studies demonstrated the surgical configuration and procedures of robotic trans-hairline SMG resection using a flexible, single-port, and multiarm systems. Results: The surgical procedures of trans-hairline approach for SMG resection could be successfully performed using the flexible single-port (SP) robotic system in the preclinical study. The unique features include an easier docking procedure, different viewing angles, the use of the third arm, and coordination of instrument positions without a bedside assistant, which are unavailable in current multiarm robotic systems. Conclusions: This study demonstrates the feasibility and the advantages of applying the flexible, SP robotic system in SMG resection through the trans-hairline approach.
Bibliographical noteFunding Information:
The authors thank the Ministry of Science and Technology and the National Taiwan University Hospital, and the staff of the Eighth Core Lab, Department of Medical Research, the National Taiwan University for their support. The authors also thank Paul Lilagan, MSE, Michael Ikeda, BS, Christie Draper, PhD, the da Vinci SP Engineering Team, and the Intuitive Surgical Inc. (Sunnyvale, CA) for providing access to the da Vinci SP robotic surgical system and laboratory.
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