Feasibility of Transoral Robotic Total Laryngectomy With the Da Vinci Single Port Robotic System.

OBJECTIVES

To evaluate the feasibility of transoral robotic total laryngectomy using the Da Vinci Single Port (SP) Robotic System, to describe the surgical technique and discuss postoperative outcomes.

METHODS

A clinical case of a 69-year-old woman with recurrent squamous cell carcinoma of the right aryepiglottic fold was reviewed. Following prior surgical resection with positive margins and a previous history of chemoradiotherapy, salvage total laryngectomy was performed using the Da Vinci SP robotic platform. The procedure was conducted following a modified transoral robotic approach previously described for multiport systems.

RESULTS

Transoral robotic laryngectomy using the Da Vinci SP system was accomplished without needing conversion to a conventional open approach. The procedure consisted of a cervical dissection phase, transoral robotic resection, transoral pharyngeal reconstruction, and cervical closure. Total robotic console time was 51 min. Oral intake was resumed after a barium swallow 18 days postoperatively showed no signs of fistulization. At 6 months follow-up, no locoregional recurrence or delayed complications were observed.

CONCLUSION

Transoral robotic total laryngectomy using the Da Vinci SP system appears technically feasible and may offer several advantages compared to conventional open approach and multiport robotic systems. These include improved visualization, enhanced instrument maneuverability, limited cervical dissection and favorable functional recovery. Larger studies are required to evaluate reproducibility, long-term oncologic safety, and functional outcomes.

LEVEL OF EVIDENCE: 5.