School of Medicine and Health Sciences Poster Presentations

Initial Impressions with the Flexible Robot

Poster Number

201

Document Type

Poster

Status

Medical Student

Abstract Category

Clinical Specialties

Keywords

Transoral Robotic Surgery, Flexible Endoscope

Publication Date

Spring 2018

Abstract

Background: In 2000, the da Vinci surgical robot became the first FDA approved surgical robot for use in laparoscopic surgery. Since that day, its use has grown exponentially in fields such as abdominal, thoracic and pelvic procedures. Adoption in other specialties, however, has been limited. Due to design limitations, it is not suited for use in small or confined spaces. Use of the da Vinci in otolaryngology has been especially limited as many of the procedures involve the use of natural orifices and aligning the large arms in such a small space makes usability and visibility of the surgical site extremely difficult. Recently, a new surgical robot, the Medrobotics Flex robot, designed specifically for use in otolaryngology, hopes to address the shortcomings of the da Vinci robot in head and neck surgery. An improved robotic surgery experience in otolaryngology might help spur more widespread adoption.

Materials and Methods: A literature review was conducted using the PubMed database to investigate the effectiveness of both the da Vinci surgical robot and the Medrobotics Flex robot, focusing on their use in transoral robotic surgery. To do this, a MeSH search was done using the terms: otolaryngology and robotic surgery with keywords transoral, limited to the last 10 years. Parameters to be compared include: surgical site visualization, operative time, complication rate, length of hospital stay, cost and surgeon impressions.

Results: A total of six articles investigating the Medrobotics Flex robot and five articles investigating the da Vinci robot in transoral robotic surgery were analyzed. The data available for the Medrobotics Flex includes brief case studies, cadaveric studies and one larger clinical trial for FDA approval, focused primarily on surgical site visualization and feasibility where 75/80 surgical sites could be visualized and 72/80 could be treated.

Discussion: Despite the limited data available on the Medrobotics Flex robot, it is apparent that the flexible endoscope design with wristed instruments improves access to sites that were previously difficult to reach using traditional rigid endoscopes and instruments. Though some studies have shown potential benefits when using the da Vinci surgical robot in transoral robotic surgery, such as improved access, tremor reduction and 3D visualization, the increased cost and lack of haptic feedback has restricted adoption of the da Vinci in ENT. Additional studies are needed to develop inclusion exclusion criteria to better exploit the benefits of this new technology in head and neck surgery.

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Initial Impressions with the Flexible Robot

Background: In 2000, the da Vinci surgical robot became the first FDA approved surgical robot for use in laparoscopic surgery. Since that day, its use has grown exponentially in fields such as abdominal, thoracic and pelvic procedures. Adoption in other specialties, however, has been limited. Due to design limitations, it is not suited for use in small or confined spaces. Use of the da Vinci in otolaryngology has been especially limited as many of the procedures involve the use of natural orifices and aligning the large arms in such a small space makes usability and visibility of the surgical site extremely difficult. Recently, a new surgical robot, the Medrobotics Flex robot, designed specifically for use in otolaryngology, hopes to address the shortcomings of the da Vinci robot in head and neck surgery. An improved robotic surgery experience in otolaryngology might help spur more widespread adoption.

Materials and Methods: A literature review was conducted using the PubMed database to investigate the effectiveness of both the da Vinci surgical robot and the Medrobotics Flex robot, focusing on their use in transoral robotic surgery. To do this, a MeSH search was done using the terms: otolaryngology and robotic surgery with keywords transoral, limited to the last 10 years. Parameters to be compared include: surgical site visualization, operative time, complication rate, length of hospital stay, cost and surgeon impressions.

Results: A total of six articles investigating the Medrobotics Flex robot and five articles investigating the da Vinci robot in transoral robotic surgery were analyzed. The data available for the Medrobotics Flex includes brief case studies, cadaveric studies and one larger clinical trial for FDA approval, focused primarily on surgical site visualization and feasibility where 75/80 surgical sites could be visualized and 72/80 could be treated.

Discussion: Despite the limited data available on the Medrobotics Flex robot, it is apparent that the flexible endoscope design with wristed instruments improves access to sites that were previously difficult to reach using traditional rigid endoscopes and instruments. Though some studies have shown potential benefits when using the da Vinci surgical robot in transoral robotic surgery, such as improved access, tremor reduction and 3D visualization, the increased cost and lack of haptic feedback has restricted adoption of the da Vinci in ENT. Additional studies are needed to develop inclusion exclusion criteria to better exploit the benefits of this new technology in head and neck surgery.