A Pilot Study Assessing Robotic Surgery in the Seated Position for Benign and Malignant Lesions of the Head and Neck

Overview

This study is designed to investigate if transoral surgery with the patient in the seated position utilizing the da Vinci® Robotic Surgical System (Intuitive Surgical, Inc., Sunnyvale, CA) will enable better visualization and expedited removal of benign and malignant tumors of the throat.

Full Title of Study: “A Pilot Study Assessing Robotic Surgery in the Seated Position for Benign and Malignant Lesions of the Head and Neck Using the da Vinci® Robotic Surgical Systems”

Study Type

  • Study Type: Interventional
  • Study Design
    • Intervention Model: Single Group Assignment
    • Primary Purpose: Other
    • Masking: None (Open Label)
  • Study Primary Completion Date: May 2020

Detailed Description

The da Vinci Robotic Surgical System (Intuitive Surgical, Inc., Sunnyvale, CA) being evaluated in this pilot study consists of 3 basic components: a surgeon's console, articulated mechanical arms and sterilizable instruments. The console includes a computer, video monitor and instrument controls, and is located in the operating room adjacent to the operating room table. The console is connected via computer to the mechanical arms holding the endoscope (surgical TV camera) and sterile surgical tools (e.g., forceps, scissors, electrocautery, etc.). These arms are located immediately adjacent to the patient on the operating room table. The surgeon sits at the console and controls the position and movement of the arms and surgical tools. The design of these tools is based upon well-established, commonly used surgical instruments. The da Vinci Robotic Surgical System (Intuitive Surgical, Inc., Sunnyvale, CA) is a "manual image-guided surgery" system that is computer enhanced rather than "computer guided robotic surgery" in which the surgeon programs the computer to do the surgery and the robot does the surgery (also known as a "milling" device). Use of the da Vinci Robotic Surgical System (Intuitive Surgical, Inc., Sunnyvale, CA) in the aforementioned configuration in fact facilitates an exact translation of the surgeon's hand and finger movements at the console to precise and tremor-free movements of the arms and instruments.

Interventions

  • Device: Transoral Robotic Surgery (TORS) with the daVinci Robotic Surgical System device
    • Patient’s will be having TORS surgery in a seated position

Arms, Groups and Cohorts

  • Other: Trans Oral Robotic Surgery (TORS)
    • Patient’s are having TORS surgery in a seated position

Clinical Trial Outcome Measures

Primary Measures

  • TORS surgery completion in the seated position
    • Time Frame: Measures assessed at time of intervention (during surgery)
    • Recording how many participants’ surgery was completed in the seated position

Secondary Measures

  • Length of participants’ surgical time
    • Time Frame: Measures assessed at time of intervention (during surgery)
    • Surgical start and stop times are recorded in the medical record
  • Estimated amount of blood loss during participants’ surgery
    • Time Frame: Measures assessed at time of intervention (during surgery)
    • Record blood loss during surgery as estimated by the lead surgeon

Participating in This Clinical Trial

Inclusion Criteria

  • Patient must present with indications for diagnostic or therapeutic surgery for benign or malignant diseases of the head and neck
  • Written informed consent

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: 90 Years

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • Mayo Clinic
  • Provider of Information About this Clinical Study
    • Principal Investigator: Eric J. Moore, M.D., PI – Mayo Clinic
  • Overall Official(s)
    • Eric J Moore, Principal Investigator, Mayo Clinic

Citations Reporting on Results

Moore EJ, Olsen SM, Laborde RR, GarcĂ­a JJ, Walsh FJ, Price DL, Janus JR, Kasperbauer JL, Olsen KD. Long-term functional and oncologic results of transoral robotic surgery for oropharyngeal squamous cell carcinoma. Mayo Clin Proc. 2012 Mar;87(3):219-25. doi: 10.1016/j.mayocp.2011.10.007.

Weinstein GS, O'Malley BW Jr, Magnuson JS, Carroll WR, Olsen KD, Daio L, Moore EJ, Holsinger FC. Transoral robotic surgery: a multicenter study to assess feasibility, safety, and surgical margins. Laryngoscope. 2012 Aug;122(8):1701-7. doi: 10.1002/lary.23294. Epub 2012 Jul 2.

Matjasko J, Petrozza P, Cohen M, Steinberg P. Anesthesia and surgery in the seated position: analysis of 554 cases. Neurosurgery. 1985 Nov;17(5):695-702.

Engelhardt M, Folkers W, Brenke C, Scholz M, Harders A, Fidorra H, Schmieder K. Neurosurgical operations with the patient in sitting position: analysis of risk factors using transcranial Doppler sonography. Br J Anaesth. 2006 Apr;96(4):467-72. Epub 2006 Feb 7.

Van Abel KM, Moore EJ. The rise of transoral robotic surgery in the head and neck: emerging applications. Expert Rev Anticancer Ther. 2012 Mar;12(3):373-80. doi: 10.1586/era.12.7. Review.

Moore EJ, Olsen KD, Martin EJ. Concurrent neck dissection and transoral robotic surgery. Laryngoscope. 2011 Mar;121(3):541-4. doi: 10.1002/lary.21435. Epub 2011 Jan 4.

Weinstein GS, O'Malley BW Jr, Desai SC, Quon H. Transoral robotic surgery: does the ends justify the means? Curr Opin Otolaryngol Head Neck Surg. 2009 Apr;17(2):126-31. doi: 10.1097/MOO.0b013e32832924f5. Review.

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