Robotic surgery of the infratemporal fossa utilizing novel suprahyoid port

Ryan R. McCool, Frank M. Warren, Richard H. Wiggins, Jason P. Hunt

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Objectives/Hypothesis: To develop a minimally invasive technique for robotic access to the infratemporal fossa and describe use of a novel suprahyoid port placement. Study Design: A cadaveric study to assess feasibility of robotic dissection of the infratemporal fossa using a novel, midline suprahyoid port placement. Methods: Six complete and two partial dissections of the infratemporal fossa were carried out on one fixed and three fresh cadaveric heads using the da Vinci surgical robot (Intuitive Surgical, Inc., Sunnyvale, CA). The suprahyoid port site was utilized to place one robotic arm into the vallecula. The second arm and 30° camera were placed transorally, and dissections were performed through the lateral pharyngeal wall and into the infratemporal fossa with identification and preservation of the lingual nerve, inferior alveolar nerve, internal and external carotid arteries, jugular vein, and cranial nerves IX-XII. Surgical clips were placed at the extent of dissection, and computed tomography (CT) imaging was obtained after dissections. Results: The transoral and midline suprahyoid port sites provide excellent access to the infratemporal fossa. The midline port site has excellent utility for accessing wide areas of the skull base bilaterally. CT imaging shows surgical clips placed successfully at the skull base foramina of major neurovascular structures. Conclusions: Robotic surgery offers several advantages over traditional endoscopic surgery with the addition of tremor-free, two-handed technique and microscopic three-dimensional visualization. A midline suprahyoid port placement provides minimally invasive access for excellent exposure of the infratemporal fossa bilaterally.

Original languageEnglish (US)
Pages (from-to)1738-1743
Number of pages6
JournalLaryngoscope
Volume120
Issue number9
DOIs
StatePublished - Sep 2010
Externally publishedYes

Fingerprint

Robotics
Dissection
Skull Base
Surgical Instruments
Lingual Nerve
Tomography
Glossopharyngeal Nerve
Hypoglossal Nerve
Mandibular Nerve
External Carotid Artery
Jugular Veins
Internal Carotid Artery
Tremor
Arm
Head

Keywords

  • Da Vinci
  • Infratemporal fossa
  • Robotic surgery
  • Skull base

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

McCool, R. R., Warren, F. M., Wiggins, R. H., & Hunt, J. P. (2010). Robotic surgery of the infratemporal fossa utilizing novel suprahyoid port. Laryngoscope, 120(9), 1738-1743. https://doi.org/10.1002/lary.21020

Robotic surgery of the infratemporal fossa utilizing novel suprahyoid port. / McCool, Ryan R.; Warren, Frank M.; Wiggins, Richard H.; Hunt, Jason P.

In: Laryngoscope, Vol. 120, No. 9, 09.2010, p. 1738-1743.

Research output: Contribution to journalArticle

McCool, RR, Warren, FM, Wiggins, RH & Hunt, JP 2010, 'Robotic surgery of the infratemporal fossa utilizing novel suprahyoid port', Laryngoscope, vol. 120, no. 9, pp. 1738-1743. https://doi.org/10.1002/lary.21020
McCool, Ryan R. ; Warren, Frank M. ; Wiggins, Richard H. ; Hunt, Jason P. / Robotic surgery of the infratemporal fossa utilizing novel suprahyoid port. In: Laryngoscope. 2010 ; Vol. 120, No. 9. pp. 1738-1743.
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