Robot-Assisted Free Flap in Head and Neck Reconstruction.
10.5999/aps.2013.40.4.353
- Author:
Han Gyeol SONG
1
;
In Sik YUN
;
Won Jai LEE
;
Dae Hyun LEW
;
Dong Kyun RAH
Author Information
1. Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. dhlew@yuhs.ac
- Publication Type:Original Article
- Keywords:
Robotics;
Free tissue flaps;
Head and neck neoplasms
- MeSH:
Arteries;
Demography;
Forearm;
Free Tissue Flaps;
Glycosaminoglycans;
Head;
Head and Neck Neoplasms;
Hematoma;
Humans;
Neck;
Necrosis;
Oropharynx;
Robotics;
Thigh;
Thyroid Gland
- From:Archives of Plastic Surgery
2013;40(4):353-358
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Robots have allowed head and neck surgeons to extirpate oropharyngeal tumors safely without the need for lip-split incision or mandibulotomy. Using robots in oropharyngeal reconstruction is new but essential for oropharyngeal defects that result from robotic tumor excision. We report our experience with robotic free-flap reconstruction of head and neck defects to exemplify the necessity for robotic reconstruction. METHODS: We investigated head and neck cancer patients who underwent ablation surgery and free-flap reconstruction by robot. Between July 1, 2011 and March 31, 2012, 5 cases were performed and patient demographics, location of tumor, pathologic stage, reconstruction methods, flap size, recipient vessel, necessary pedicle length, and operation time were investigated. RESULTS: Among five free-flap reconstructions, four were radial forearm free flaps and one was an anterolateral thigh free-flap. Four flaps used the superior thyroid artery and one flap used a facial artery as the recipient vessel. The average pedicle length was 8.8 cm. Flap insetting and microanastomosis were achieved using a specially manufactured robotic instrument. The total operation time was 1,041.0 minutes (range, 814 to 1,132 minutes), and complications including flap necrosis, hematoma, and wound dehiscence did not occur. CONCLUSIONS: This study demonstrates the clinically applicable use of robots in oropharyngeal reconstruction, especially using a free flap. A robot can assist the operator in insetting the flap at a deep portion of the oropharynx without the need to perform a traditional mandibulotomy. Robot-assisted reconstruction may substitute for existing surgical methods and is accepted as the most up-to-date method.
