Yonsei Med J.  2022 Aug;63(8):759-766. 10.3349/ymj.2022.63.8.759.

Methodology in Conventional Head and Neck Reconstruction Following Robotic Cancer Surgery: A Bridgehead Robotic Head and Neck Reconstruction

Affiliations
  • 1Department of Plastic and Reconstructive Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
  • 2Department of Otorhinolaryngology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea

Abstract

Purpose
Robotic head and neck surgery is widespread nowadays. However, in the reconstruction field, the use of robotic operations is not. This article aimed to examine methodologies for conventional head and neck reconstruction after robotic tumor surgery in an effort to obtain further options for future reconstruction manipulations.
Materials and Methods
A retrospective review of all patients who received head and neck robot surgery and conventional reconstructive surgery between October 2016 and September 2021.
Results
In total, 53 cases were performed. 67.9% of the tumors were greater than 4 cm. Regarding defect size, 47.2% of the lesions were greater than 8 cm. In terms of TNM stage, stage 3 disease was recorded in 26.4% and stage 4 in 52.8%. To make a deep and narrow field wider, we changed the patient’s posture in pre-op field, additional dissection was done. We used radial forearm flap mostly (62.2%).
Conclusion
Conventional head and neck reconstruction after robotic ENT cancer surgery is possible. One key step is to secure additional space in the deep and narrow space left after robotic surgery. For this, we opted for a radial forearm flap mostly. This can be performed as a bridgehead to perform robotic head and neck reconstruction.

Keyword

Head neck cancer; robotic surgery; plastic reconstructive surgery
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