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TransOral endoscopic UltraSonic Surgery (TOUSS): a preliminary report of a novel robotless alternative to TORS

机译:经口内镜超声手术(TOUSS):新型无机器人替代TORS的初步报告

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摘要

The objective of this study is to describe and evaluate the feasibility of TransOral UltraSonic Surgery (TOUSS), a new endoscopic alternative to transoral robotic surgery for approaching pharyngeal and laryngeal tumours based on ultrasonic scalpel as a resection tool. This is a prospective study on 11 consecutive patients with pharyngeal and supraglottic carcinomas between December 2013 and August 2014. All tumours were resected transorally with 35 cm ThunderbeatTM. Exposure was achieved using GyrusTM FK-retractor and Olympus ENDOEYE Flex 5 mm 2D/10 mm 3D deflecting tip video laparoscopes. We evaluated tumour staging, surgical margins, surgical time, blood transfusions, tracheostomy, enteral feeding, postoperative pain and hospital stay. The operating room setup and procedure are described. This series comprised seven early and four locally advanced carcinomas. The mean setup for TOUSS and resection time were 16 and 70.9 minutes. No major intraoperative complications were identified. The average time of nasogastric feeding tube dependence (n = 9) was 13 days. Gastrostomy was performed in one patient. The average hospital stay was 14.3 days. Postoperative pain was satisfactory treated with nonsteroidal anti-inflammatory drugs. We have described TOUSS as a new feasible and intuitive procedure to approach endoscopically pharyngeal and supraglottic tumours, with good intraoperative conditions and functional outcomes.
机译:这项研究的目的是描述和评估经口超声外科手术(TOUSS)的可行性,该经口超声外科手术是一种新的内窥镜替代经口机器人手术的新方法,该手术以超声手术刀为切除工具,用于治疗咽部和喉部肿瘤。这是一项对2013年12月至2014年8月期间连续11例咽喉癌和声门上癌患者的前瞻性研究。所有肿瘤均经35 cm ThunderbeatTM经口切除。使用GyrusTM FK伸缩器和Olympus ENDOEYE Flex 5毫米2D / 10毫米3D偏转尖端视频腹腔镜进行曝光。我们评估了肿瘤分期,手术切缘,手术时间,输血,气管切开术,肠内喂养,术后疼痛和住院时间。描述了手术室的设置和步骤。该系列包括七个早期和四个局部晚期癌。 TOUSS和切除时间的平均设置分别为16分钟和70.9分钟。没有发现重大的术中并发症。鼻胃饲管依赖的平均时间(n = 9)为13天。一名患者进行了胃造口术。平均住院时间为14.3天。用非甾体类抗炎药治疗术后疼痛令人满意。我们将TOUSS描述为一种新的可行且直观的方法,可通过内镜处理咽部和声门上肿瘤,并具有良好的术中条件和功能结局。

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