Endoscopic and Robotic Neck Surgery: Atlas of Head and Neck Surgery

Endoscopic and Robotic Neck Surgery: Atlas of Head and Neck Surgery


Preface

Twenty first century is characterized by globalization, aging population and society driven by scientific technology.
Look at how the smart phone changed our daily lives. It provided us with an environment of real time networking which
we only dreamed of merely ten years ago. The advancement of technology has not only changed our communication but also
our working environment, life style and life itself. In terms of medicine, many new technologies have risen with the
hope of eradicating disease. Personalized, preventive, predictive and participatory medicine will emerge and change our
pattern of practice in the very near future.

Head and neck is characterized by an area of diverse pathology, a condensed area of vital functions and an exposed area
of identity, sexuality and beauty. Any local treatment for head and neck cancer can make an issue of gross appearance.
For head and neck surgery, what has been changed since the introduction of radical neck dissection which was designed
by George Crile of Ohio in 1906. Area of resection level has changed from comprehensive to limited and selective, but
little has improved to the morbidity of external disfiguring scar from neck dissection.

The introduction of robotic surgery to the management of head and neck tumors has gained popularity for natural orifice
surgery. This was a great step of head and neck surgery from a mutilating toward a more functional and esthetic
surgery. Furthermore, it would be more desirable if neck metastasis could be treated with a more esthetic way.

Dr. Woong Youn Chung an endocrine surgeon in Severance Hospital of Yonsei University Health System designed the robotic
neck dissection of thyroid cancer in 2007. Dr. Yoon Woo Koh a head and neck surgeon designed and developed various
novel surgical approaches for benign and malignant diseases of the head and neck including neck dissection for squamous
cell carcinoma of head and neck in 2010. The two pioneer surgeons in Severance Hospital which was founded 1885 will
change the paradigm of thyroid and head and neck surgery. With the accumulation of surgical experiences of robotic neck
surgery, we hope this type of surgery will contribute to the happiness of our patients. We are currently on the verge
of changing the history of head and neck surgery to Esthetic head and neck surgery.

Eun Chang Choi, MD, PhD
Professor and Chairman
Department of Otorhinolaryngology
Yonsei University College of Medicine

CHAPTER 01 Endoscopic and Robotic Submandibular Gland Excision 1

INTRODUCTION 1
SURGICAL ANATOMY 1
INDICATIONS 1
CONTRAINDICATIONS 2
PREOPERATIVE CONSIDERATIONS 2
INSTRUMENTATIONS 2
OPERATIVE TECHNIQUE 2
POSTOPERATIVE CARE 6
SUMMARY 7
SUGGESTED READINGS 8

CHAPTER 02 Endoscopic Benign Neck Mass Excision via Transaxillary Approach 9

INTRODUCTION 9
SURGICAL ANATOMY 9
INDICATIONS AND CONTRAINDICATIONS 9
PREOPERATIVE CONSIDERATIONS 10
OPERATIVE TECHNIQUE 10
SURGICAL PROCEDURES 11
PITFALLS AND COMPLICATIONS 13
POSTOPERATIVE CARE 13
SUGGESTED READING 13

CHAPTER 03 Robot-assisted Excision of Neurogenic Tumor in the Neck 15

INTRODUCTION 15
SURGICAL ANATOMY 15
INDICATIONS 15
CONTRAINDICATIONS 15
PREOPERATIVE CONSIDERATIONS 16
INSTRUMENTATIONS 17
SURGICAL TECHNIQUE 17
POSTOPERATIVE CARE 19
SUMMARY 20
SUGGESTED READINGS 20

CHAPTER 04 Facelift Parotidectomy 23

INTRODUCTION 23
SURGICAL ANATOMY 23
INDICATIONS AND CONTRAINDICATIONS 23
PREOPERATIVE CONSIDERATIONS 24
OPERATIVE TECHNIQUE 24
TIPS AND PEARLS 27
PITFALLS AND COMPLICATIONS 28
POSTOPERATIVE CARE 28
SUMMARY 28
SUGGESTED READINGS 29

CHAPTER 05 Endoscopic Thyroidectomy via Axillo-Breast Approach 31

INTRODUCTION 31
SURGICAL ANATOMY 31
INDICATIONS AND CONTRAINDICATIONS 31
PREOPERATIVE CONSIDERATIONS 32
INSTRUMENTATIONS 32
OPERATIVE TECHNIQUE 32
POSTOPERATIVE CARE 37
TIPS AND PEARLS 37
PITFALLS AND COMPLICATIONS 38
SUMMARY 39
SUGGESTED READING 39

CHAPTER 06 Robotic Thyroidectomy via Transaxillary Approach 41

INTRODUCTION 41
SURGICAL ANATOMY 41
INDICATIONS AND CONTRAINDICATIONS 41
PREOPERATIVE CONSIDERATIONS 42
INSTRUMENTATIONS 42
OPERATIVE TECHNIQUE 43
TIPS AND PEARLS 47
PITFALLS AND COMPLICATIONS 48
POSTOPERATIVE CARE 48
SUMMARY 49
SUGGESTED READING 49

CHAPTER 07 Robotic Retroauricular Total Thyroidectomy 51

INTRODUCTION 51
SURGICAL ANATOMY 52
INDICATIONS AND CONTRAINDICATIONS 52
PREOPERATIVE CONSIDERATIONS 52
INSTRUMENTATIONS 53
OPERATIVE TECHNIQUE 53
POSTOPERATIVE CARE 58
SUMMARY 59
SUGGESTED READINGS 60

CHAPTER 08 Robotic Sistrunk’s Operation in Thyroglossal Duct Cyst 61

INTRODUCTION 61
SURGICAL ANATOMY 61
INDICATIONS AND CONTRAINDICATIONS 61
PREOPERATIVE CONSIDERATIONS 62
INSTRUMENTATIONS 62
OPERATIVE TECHNIQUE 63
POSTOPERATIVE CARE 64
SUMMARY 66
SUGGESTED READINGS 66
CHAPTER 09 Harmonic Scalpel-assisted Neck Dissection 67
INTRODUCTION 67
SURGICAL ANATOMY, INDICATIONS AND CONTRAINDICATIONS 67
PREOPERATIVE CONSIDERATIONS 67
OPERATIVE TECHNIQUE 68
TIPS AND PEARLS 70
PITFALLS 71
COMPLICATION 71
SUMMARY 72
SUGGESTED READING 72

CHAPTER 10 Endoscopic Selective Neck Dissection of Level I-III via Modified Facelift or Retroauricular Approach 73

INTRODUCTION 73
SURGICAL ANATOMY 73
INDICATIONS AND CONTRAINDICATIONS 73
PREOPERATIVE CONSIDERATIONS 74
INSTRUMENTATIONS 74
OPERATIVE TECHNIQUE 75
POSTOPERATIVE CARE 77
SUMMARY 78
SUGGESTED READINGS 79

CHAPTER 11 Robot-assisted Selective Neck Dissection of Level I-III via Modified Facelift or Retroauricular Approach 81

INTRODUCTION 81
SURGICAL ANATOMY 81
INDICATIONS 81
CONTRAINDICATIONS 82
PREOPERATIVE CONSIDERATIONS 82
INSTRUMENTATIONS 82
OPERATIVE TECHNIQUE 83
POSTOPERATIVE CARE 86
COMPLICATIONS 87
SUMMARY 87
SUGGESTED READINGS 88

CHAPTER 12 Facelift Parotidectomy in Conjunction with Robot-assisted Neck Dissection in Parotid Cancer 89

INTRODUCTION 89
SURGICAL ANATOMY 89
INDICATIONS AND CONTRAINDICATIONS 89
PREOPERATIVE CONSIDERATIONS 90
INSTRUMENTATIONS 90
OPERATIVE TECHNIQUE 91
TIPS AND PEARLS 94
PITFALLS AND COMPLICATIONS 94
POSTOPERATIVE CARE 94
SUMMARY 94
SUGGESTED READING 94

CHAPTER 13 Robot-assisted Selective Neck Dissection of Level II-V via Modified Facelift Approach in Laryngopharyngeal
Cancer 95

INTRODUCTION 95
INDICATIONS 95
CONTRAINDICATIONS 95
PREOPERATIVE CONSIDERATIONS 95
INSTRUMENTATION 96
OPERATIVE TECHNIQUE 96
TIPS AND PEARLS 99
COMPLICATION 100
POSTOPERATIVE CARE 100
SUMMARY 100
SUGGESTED READINGS 101

CHAPTER 14 Robot-assisted Modified Radical Neck Dissection via Modified Facelift or Retroauricular Approach 103

INTRODUCTION 103
SURGICAL ANATOMY 103
INDICATIONS 104
CONTRAINDICATIONS 104
PREOPERATIVE CONSIDERATIONS 104
INSTRUMENTATIONS 105
OPERATIVE TECHNIQUE 105
POSTOPERATIVE CARE 108
SUMMARY 110
SUGGESTED READINGS 111

CHAPTER 15 Robot-assisted Modified Radical Neck Dissection via Transaxillary and Retroauricular Approach in Papillary
Thyroid Carcinoma 113

INTRODUCTION 113
INDICATIONS 113
CONTRAINDICATIONS 113
INSTRUMENTATIONS 113
OPERATIVE TECHNIQUE 114
POSTOPERATIVE CARE 119
SUMMARY 119
SUGGESTED READINGS 120

CHAPTER 16 Free Flap Reconstruction after Robot-assisted Neck Dissection 121

INTRODUCTION 121
INDICATIONS AND CONTRAINDICATIONS 121
PREOPERATIVE CONSIDERATIONS 121
INSTRUMENTATION 121
OPERATIVE TECHNIQUE 122
TIPS AND PEARLS 124
COMPLICATION 124
POSTOPERATIVE CARE 124
SUMMARY 124
SUGGESTED READINGS 128

CHAPTER 17 Transoral Robotic Retropharyngeal Lymph Node Dissection 129

INTRODUCTION 129
SURGICAL ANATOMY 129
INDICATIONS AND CONTRAINDICATIONS 130
PREOPERATIVE CONSIDERATIONS 130
INSTRUMENTATIONS 131
OPERATIVE TECHNIQUE 131
POSTOPERATIVE CARE 134
SUMMARY 135
SUGGESTED READINGS 136
INDEX 137