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Transoral Robotic Surgery Using a Carbon Dioxide Flexible Laser for Tumors of the Upper Aerodigestive Tract

Authors

  • Shaun C. Desai BA,

    1. From the Department of Otolaryngology - Head and Neck Surgery, Mount Sinai School of Medicine, New York, NY, U.S.A.
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  • Chih-Kwang Sung MD, MS,

    1. From the Department of Otolaryngology - Head and Neck Surgery, Mount Sinai School of Medicine, New York, NY, U.S.A.
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  • David W. Jang MD,

    1. From the Department of Otolaryngology - Head and Neck Surgery, Mount Sinai School of Medicine, New York, NY, U.S.A.
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  • Eric M. Genden MD

    Corresponding author
    1. From the Department of Otolaryngology - Head and Neck Surgery, Mount Sinai School of Medicine, New York, NY, U.S.A.
    • Eric M. Genden, MD, Professor and Chairman, Department of Otolaryngology - Head and Neck Surgery, The Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1189 New York, NY 10029, U.S.A.
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Abstract

Objective: To determine the safety, feasibility, and efficacy of coupling transoral robotic technology with the flexible carbon dioxide (CO2) laser for various tumors of the oropharynx and supraglottic larynx.

Study Design: Prospective, pilot trial.

Methods: Eight patients were enrolled in an IRB-approved prospective trial for transoral robotic surgery with the aid of the flexible CO2 laser.

Results: Seven male patients with early carcinoma of the oropharynx or larynx successfully underwent tumor extirpation with the transoral robot and the flexible CO2 laser. We were unable to gain access to the supraglottic larynx in one female patient. The final pathology revealed seven patients with squamous cell carcinoma and one patient with adenoid cystic carcinoma. The flexible CO2 laser provided fine incisions with excellent hemostasis and minimal peripheral tissue injury. Additionally, the laser provided an excellent tool for raising pharyngeal flaps for reconstruction of the oropharynx.

Conclusion: The flexible CO2 laser offers a unique advantage of precise incisions and may provide a valuable tool for both tumor extirpation and the creation of flaps for transoral robotic reconstruction.

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