Submental Approach Robotic-Assisted Neck Dissection (SARAND) for Minimally Invasive Bilateral Neck Dissection: A Feasibility Cadaver Dissection Study.

BACKGROUND

Following promising initial results of the robotic-assisted extended "Sistrunk" approach (RESA) that uses a submental incision to hypopharyngeal and laryngeal tumors, bypassing the base of tongue, we report its further development: submental approach robotic-assisted neck dissection (SARAND), intended to enable bilateral neck dissections.

METHODS

Bilateral neck dissections (levels I-IV) were performed on three cadavers using both multiport and single-port robotic platforms.

RESULTS

We demonstrate the feasibility of performing levels I-IV dissections through a single submental incision with both robotic platforms. A central working space was established over the hyoid bone, and boom rotation enabled optimal access to all neck levels from I to IV.

CONCLUSION

SARAND appears to be a promising minimally invasive technique for both unilateral and bilateral neck dissection. It offers the potential to reduce neck morbidity compared to conventional approaches. Additionally, it potentially enables neck dissection and primary tumor excision via a median pharyngotomy during the same procedure.