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Review
. 2021 Mar 19;13(6):1398.
doi: 10.3390/cancers13061398.

Current Advances in Robotics for Head and Neck Surgery-A Systematic Review

Felix Boehm  1   2 , Rene Graesslin  1   2 , Marie-Nicole Theodoraki  1   2 , Leon Schild  1   2 , Jens Greve  1   2 , Thomas K Hoffmann  1   2 , Patrick J Schuler  1   2
Affiliations
Review

Current Advances in Robotics for Head and Neck Surgery-A Systematic Review

Felix Boehm et al. Cancers (Basel). .

Abstract

Background. In the past few years, surgical robots have recently entered the medical field, particularly in urology, gynecology, and general surgery. However, the clinical effectiveness and safety of robot-assisted surgery (RAS) in the field of head and neck surgery has not been clearly established. In this review, we evaluate to what extent RAS can potentially be applied in head and neck surgery, in which fields it is already daily routine and what advantages can be seen in comparison to conventional surgery. Data sources. For this purpose, we conducted a systematic review of trials published between 2000 and 2021, as well as currently ongoing trials registered in clinicaltrials.gov. The results were structured according to anatomical regions, for the topics "Costs," "current clinical trials," and "robotic research" we added separate sections for the sake of clarity. Results. Our findings show a lack of large-scale systematic randomized trials on the use of robots in head and neck surgery. Most studies include small case series or lack a control arm which enables a comparison with established standard procedures. Conclusion. The question of financial reimbursement is still not answered and the systems on the market still require some specific improvements for the use in head and neck surgery.

Keywords: TORS; costs; haptics; head and neck neoplasms; robotic surgical procedures; robotics.

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Conflict of interest statement

The authors received no financial contribution for the authorship or publication of this article. The authors participated in a clinical trial of the company Medrobotics (NCT02262247).

Figures

Figure 1
Figure 1
DaVinci Xi®. Multi-port robotic system with camera arm and several working arms for the use of different surgical instruments. Reproduced with kind permission from Intuitive Surgical®, Inc., Sunnyvale, CA, USA, © 2021.
Figure 2
Figure 2
PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flowchart depicting the number of identified articles and trials, those screened and final number included in the systematic review.
Figure 3
Figure 3
(a) DaVinci Single-Port (SP)® robotic system; (b) Single 2.5 cm cannula containing three instrument arms and an endoscope. Reproduced with kind permission from Intuitive Surgical®, Inc., Sunnyvale, CA, USA, © 2021.
Figure 4
Figure 4
RoboticScope®-system with a high-resolution 3D-camera and a head-mounted display. Reproduced with kind permission from BHS Technologies®, Innsbruck, Austria, © 2020.
Figure 5
Figure 5
Curved prototype of a video laryngoscope equipped with flexible instruments for laryngeal surgery. Reproduced with kind permission from Schuler et. al., Ulm University Medical Center, Ulm, Germany, © 2020.
Figure 6
Figure 6
Cirq®. Robot-assisted endoscope guidance system with a mechatronic arm consisting of several segments with 7 degrees of freedom and the possibility to attach a conventional endoscope. Reproduced with kind permission from Medineering/Brainlab®, Munich, Germany, © 2021.
See this image and copyright information in PMC

References

    1. Schuler P.J., Duvvuri U., Friedrich D.T., Rotter N., Scheithauer M.O., Hoffmann T.K. First use of a computer-assisted operator-controlled flexible endoscope for transoral surgery. Laryngoscope. 2015;125:645–648. doi: 10.1002/lary.24957. - DOI - PubMed
    1. Kang S.W., Lee S.C., Lee S.H., Lee K.Y., Jeong J.J., Lee Y.S., Nam K.H., Chang H.S., Chung W.Y., Park C.S. Robotic thyroid surgery using a gasless, transaxillary approach and the da Vinci S system: The operative outcomes of 338 consecutive patients. Surgery. 2009;146:1048–1055. doi: 10.1016/j.surg.2009.09.007. - DOI - PubMed
    1. Leal Ghezzi T., Campos Corleta O. 30 Years of Robotic Surgery. World J. Surg. 2016;40:2550–2557. doi: 10.1007/s00268-016-3543-9. - DOI - PubMed
    1. Albus J.S. NBS/RIA Robotics Research Workshop; Proceedings of the NBS/RIA Workshop on Robotic Research; Gaithersburg, MD, USA. 13–15 November 1979.
    1. Carrau R.L., Prevedello D.M., de Lara D., Durmus K., Ozer E. Combined transoral robotic surgery and endoscopic endonasal approach for the resection of extensive malignancies of the skull base. Head Neck. 2013;35:351–358. doi: 10.1002/hed.23238. - DOI - PubMed

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