Evaluation and application of CO2 laser fiber delivery for single port transoral robotic surgery |
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Authors: | Juan D San Juan Abie H Mendelsohn |
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Institution: | UCLA David Geffen School of Medicine Department of Head and Neck Surgery, Los Angeles, California, USA |
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Abstract: | Background Transoral robotic surgery (TORS) using the Single-Port system (SPS) relies on electrocautery, limiting its applications in the upper aerodigestive tract. We evaluated the feasibility of a CO2 delivery system for the SPS. Methods Otolaryngology residents performed a cutting exercise using a handheld CO2 laser and participated in a cadaveric oropharyngeal dissection using the SPS with monopolar cautery (SP + EC) and CO2 laser (SP + CO2). Residents completed the System Usability Scale (SUS) questionnaire to evaluate these techniques. Results The same laser fiber was used for all combined dissections. The handheld CO2 laser, SP + EC, and SP + CO2 demonstrated similar SUS scores. On individual domain scores, SP + CO2 received less favorable ratings compared to the handheld CO2 laser for complexity, integration, and cumbersome experience (p < 0.05). On subgroup stratification, less TORS experience was associated with worse SUS scores. Conclusion SP-guided CO2 laser delivery is a viable alternative to electrocautery in robotic surgery, and should be considered when performing TORS. |
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Keywords: | CO2laser single-port da Vinci transoral robotic surgery |
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