The da Vinci robotic surgical system has transformed how oropharyngeal head and neck surgery can be delivered. The existing da Vinci Si model has challenges: the dimensions of this are larger than would be ideal for head and neck surgery and it also utilises three rigid instrument arms that must approach transoral anatomy from a trajectory outside of the surgical field. The newer da Vinci Sp model provides three fully articulating instruments through a single 25mm cannula entry port. This group attempts to compare the two robotic systems in tongue base resection on four human cadavers finding that surgical workflow was more streamlined with the Sp model. The new capabilities of simultaneous dissection, traction and counter-traction afforded by three working instruments were previously not possible with the older Si system of two rigid instrument arms. The da Vinci Sp version is not licensed for use in head and neck yet, but this feasibility study certainly highlighted the advantages of the single-port and three-instrument design, and the expanded capabilities for traction/counter traction and vessel dissection. 

Improved transoral dissection of the tongue base with a next generation robotic surgical system.
Chen M, Orosco R, Lim G, Holsinger C.
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Gentle Wong

Guy's and St Thomas' Hospitals, UK.

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