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Robotic assisted orbital surgery for resection of advanced periocular tumours - a case series report on the feasibility, safety and outcome.
- Source :
-
Eye (London, England) [Eye (Lond)] 2024 Jun; Vol. 38 (8), pp. 1496-1501. Date of Electronic Publication: 2024 Feb 22. - Publication Year :
- 2024
-
Abstract
- Purpose: Orbital surgery benefits from well-designed instrumentation that offers gentle tissue manipulation, high manoeuvrability and control. Nevertheless, in confined spaces, tissue manipulation must be accomplished with exceptionally high accuracy and precision. This is where robotic surgery offers an advantage. We aimed to evaluate a robotic-assisted surgical system's feasibility, safety and outcome in assisting tumour clearance.<br />Patients and Methods: A case series of patients with advanced periocular tumours undergoing robotic-assisted globe-sparing resection was performed using the DaVinci XI system (Intuitive Surgical, Inc). Institutional ethics and multidisciplinary approval were sought in all cases.<br />Results: Four patients with advanced periocular tumours underwent robotic-assisted orbital surgery at a mean age of 63 years (range 42-86). Two patients were diagnosed with squamous cell carcinoma, and two had basal cell carcinoma. One patient was found to have positive lymph nodes at the time of surgery and underwent simultaneous parotidectomy and lymph node clearance. Clear resection of the primary tumour was achieved in all patients; three patients underwent further resection due to narrow margins prior to reconstruction. Patients were follow-up for at least one year, and three remained disease-free. One patient with pre-existing extra-orbital disease developed metastatic disease four months post-op. All patients preserved vision peri-operatively, with no complaints of diplopia. Moderate ocular surface disease was noted in two patients.<br />Conclusion: Our series highlights the potential advantage of three-dimensional optics, multi-directional instrumentation and motion scaling technology to achieve globe-sparing tumour resection in advanced periocular tumours. However, further robotic instrumentation development is required for orbital surgery.<br /> (© 2024. The Author(s).)
- Subjects :
- Adult
Aged
Aged, 80 and over
Female
Humans
Male
Middle Aged
Carcinoma, Basal Cell surgery
Eyelid Neoplasms surgery
Ophthalmologic Surgical Procedures methods
Orbit surgery
Treatment Outcome
Carcinoma, Squamous Cell surgery
Carcinoma, Squamous Cell pathology
Feasibility Studies
Orbital Neoplasms surgery
Robotic Surgical Procedures methods
Subjects
Details
- Language :
- English
- ISSN :
- 1476-5454
- Volume :
- 38
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Eye (London, England)
- Publication Type :
- Academic Journal
- Accession number :
- 38388832
- Full Text :
- https://doi.org/10.1038/s41433-024-02932-6