Da Vinci Single-Port for Transoral Retropharyngeal Lymph Node Dissection in Oropharyngeal Cancer.

BACKGROUND

A step-by-step demonstration of the transoral robotic surgical technique for retropharyngeal lymph node dissection and lateral oropharyngectomy utilizing the novel flexible da Vinci Single-Port (SP) system.

METHODS

This is a clinical human study of TORS retropharyngeal lymph node dissection with lateral oropharyngectomy utilizing the da Vinci Single-Port Robotic System (Intuitive Surgical, Sunnyvale, CA).

RESULTS

The da Vinci SinglePort (SP) system provided sufficient access, reach and visualization for the successful resection of the oropharyngeal lesion and the retropharyngeal lymphadenopathy with negative surgical margins. Two surgical instruments and one 3D camera arm were deployed with minimal collision or restriction of arm movement.

CONCLUSIONS

The recent introduction of the Single Port (SP) robotic system enhances maneuverability, allowing the safer, less invasive removal of difficult-to-reach RPLNs, reducing complications and enabling a magnified mobile view of the surgical site. Using up to 3 working arms and a flexible endoscope is especially useful in confined surgical spaces such as the oropharynx, supraglottic larynx or parapharyngeal space. At present, the limited number of reported cases prevents direct comparison with multiport systems regarding surgical outcomes and morbidity. Further studies with larger patient cohorts are necessary to validate these findings and assess long-term oncologic and functional outcomes.