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Table of Contents
Vol. 72, No. 4, 2010
Issue release date: August 2010
Section title: Original Paper
ORL 2010;72:181–187
(DOI:10.1159/000276937)

Transoral Robotic Surgery of the Skull Base: A Cadaver and Feasibility Study

Lee J.Y.K.a · O’Malley, Jr. B.W.b · Newman J.G.b · Weinstein G.S.b · Lega B.a · Diaz J.b · Grady M.S.a
Departments of aNeurosurgery and bOtolaryngology, University of Pennsylvania, Philadelphia, Pa., USA

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: November 20, 2009
Accepted: April 01, 2010
Published online: July 29, 2010
Issue release date: August 2010

Number of Print Pages: 7
Number of Figures: 9
Number of Tables: 0

ISSN: 0301-1569 (Print)
eISSN: 1423-0275 (Online)

For additional information: http://www.karger.com/ORL

Abstract

Objective: The goal of this study was to determine the potential role as well as the current limitations of the da Vinci Surgical System robot in transoral surgery of the skull base. Methods: The da Vinci robot was used to perform dissections of the skull base on 7 cadaver heads with their neck and clavicles intact. Neurosurgeons and otolaryngologists familiar with all facets of the open microscopic, minimally invasive, endoscopic and transoral robotic surgical procedure proceeded with the approach to and dissection of the human skull base. Results: The da Vinci robot provided superb illumination and 3-dimensional depth perception. The 30- degree endoscope improved cephalad visualization, and the ‘intuitive’ nature of the da Vinci surgical robot arms provided an advantage by their ability to suture the dura at the level of the clivus. An entirely transoral route provides access to the middle and lower clivus as well as the infratemporal fossa, but access to the sellar region and anterior cranial fossa is limited via a purely transoral route. Tremor-free dural closure was successfully performed. Conclusion: Our findings suggest that transoral robotic surgery utilizing the da Vinci robot system holds great potential for skull base surgical resection of extradural and intradural tumors of the middle and lower clivus and infratemporal fossa. A collaborative approach with neurosurgeon and otolaryngologist alternating at the master console and bedside is a successful strategy. Further instrument development is necessary, and continued investigation is warranted.

© 2010 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: November 20, 2009
Accepted: April 01, 2010
Published online: July 29, 2010
Issue release date: August 2010

Number of Print Pages: 7
Number of Figures: 9
Number of Tables: 0

ISSN: 0301-1569 (Print)
eISSN: 1423-0275 (Online)

For additional information: http://www.karger.com/ORL


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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