Endoscopic transoral oropharyngectomy using laparoscopic surgical instruments.

Abstract

Recently, several transoral approaches for minimally invasive surgery have been developed for oropharyngeal cancer. However, all approaches have certain disadvantages. Therefore, we built and examined new surgical environments for improving the situation. Endoscopic transoral resection using a pharyngeal retractor or distending laryngoscope, rigid videoendoscope, and laparoscopic surgical instruments was performed in 17 patients with oropharyngeal squamous cell carcinoma. Postoperative results regarding oncology and function as well as complications were documented. The 2-year relapse-free survival rate was 100%. Postoperative swallowing and speech function were satisfactory: 94.1% of cases scored ≤1 on the functional outcome swallowing scale (FOSS) and ≤1 on the communication score. Further, no perioperative mortality occurred. The improved surgical environment made it possible to perform a safe and reliable en bloc resection with a wide field of view and sufficient working space. Our system can be useful, although further studies on additional cases are required.