Abstract
Objectives: The da Vinci Surgical Robotic System is a new and exciting technology undergoing considerable exploration and use in the fields of general surgery, cardiothoracic surgery, urology, and gynecology. Recently, we have reported our experience with the da Vinci in the laboratory setting and have reviewed its potential applications and current limitations in otolaryngology. Here we present a case report of the world's first da Vinci-assisted direct laryngoscopy and excision of a vallecular cyst in a human patient.
Methods: A 46-year-old female presented to our otolaryngology clinic with a 3- to 4-month history of progressive dysphagia and a sensation of “fullness” in her throat on swallowing. She denied any history of airway compromise or difficulty breathing, with the exception of mild dyspnea on exertion. Examination by flexible nasopharyngoscopy revealed a large vallecular cyst. After appropriate counseling and consent, she underwent excision of the lesion under direct laryngoscopy with the da Vinci on January 6, 2003.
Results: Direct laryngoscopy with a slotted Parson's laryngoscope was first performed. Following positioning of the da Vinci, the round-tip cautery instrument was used to surgically excise the lesion utilizing the da Vinci's 3-dimensional stereoscopic vision. Although we initially encountered some minor difficulties in the setup, the procedure was successfully performed with ease and without complication.
Conclusion: The da Vinci Surgical Robotic System offers exciting new applications in otolaryngology. Further work is needed to explore its numerous potential applications in our field.