Transoral robotic cordectomy for early glottic carcinoma.

OBJECTIVES: We assessed the feasibility, safety, and efficacy of transoral cordectomy performed for early glottic cancer with the da Vinci Surgical System.

METHODS: Subjects with early cancer of the vocal cords who were treated with transoral robot-assisted cordectomy were included for study. Data regarding the ability to perform robot-assisted resection, volume of blood loss,robotic operating time,pathological margin status, postoperative extubation, complications, length of hospitalization, duration until start of oral nutrition, and need for a tracheotomy were evaluated.

RESULTS: Ten men with T1 glottic carcinoma underwent successful transoral robotic cordectomy with negative margins. The mean total robotic surgery time was 21.6 +/- 6.75 minutes (range, 10 to 31 minutes). In all cases, the total blood loss was less than 20 mL. One subject needed a short-term tracheotomy and a nasogastric tube. The other 9 subjects started oral nutrition 6 to 24 hours after operation. The mean duration of hospitalization was 4.1 +/- 2.23 days.

CONCLUSIONS: Transoral robotic cordectomy with the da Vinci Surgical System was found to be feasible, relatively safe, and effective. The lower morbidity rate was an advantage of this method. Transoral robotic surgery provides better exposure, visualization, and access than does transoral laser microsurgery. Cordectomy with transoral robotic surgery should be an alternative to external-approach cordectomy and transoral laser microsurgery.