Robot-assisted submandibular gland excision via modified facelift incision
© The Author(s). 2017
Received: 26 May 2017
Accepted: 12 July 2017
Published: 5 September 2017
The conventional transcervical resection for submandibular gland disease has some risks and an unsatisfactory cosmetic result. Recently, robot-assisted surgery has been developed as a plausible substitute for conventional surgery which provides an excellent cosmetic outcome.
The authors performed robot-assisted sialadenectomy via modified facelift incision using the da Vinci Xi surgical system (Intuitive Surgical Inc., CA, USA) with two endowrist arms (monopolar curved scissors and Maryland bipolar forceps) successfully in a 44-year-old female patient who suffered from sialolith and severe atrophic submandibular gland.
If similar studies are done in the future, this robot-assisted sialadenectomy may become established as an alternative to existing disadvantageous surgical methods.
The submandibular gland is vulnerable to non-neoplastic disorders (sialolithiasis and sialadenitis) due to its anatomic characteristics. The most common benign neoplasm is pleomorphic adenoma, and tumors of the submandibular gland are infrequently malignant . The conventional treatment method of transcervical resection has some risks such as paresis of the marginal branch of the facial nerve, lingual nerve paresis, xerostomia, and an unsatisfactory cosmetic result . Notwithstanding various techniques such as intraoral resection [3, 4] and endoscopic-assisted resection [5, 6] to reduce these complications, there are still postoperative discomforts, such as a temporary lack of function of lingual nerve and a temporary limitation of tongue movement . Recently, robot-assisted surgery has been developed as a plausible substitute for conventional surgery which provides an excellent cosmetic outcome [7, 8]. Earlier robot-assisted surgeries were performed via a retroauricular approach , recent surgeries are being performed via modified facelift incision (MFI) approach [9–11], the postoperative scar being completely hidden by the auricle and hair. In this paper, the authors report a case of robot-assisted submandibular sialoadenectomy via MFI.
SWJ, YKK, and YHC participated in the operation and are responsible for the data collection, drafting of the article, and the critical revision of the article. WN is responsible for the conception and design of the study, the critical revision of the article, and the approval of the article. YWK gave us some advises about robot surgery. All authors read and approved the final manuscript.
Ethics approval and consent to participate
The study was approved by the institutional review board of Yonsei Dental Hospital (IRB approval number 2-2017-0016).
The authors declare that they have no competing interests. The authors alone are responsible for the content and writing of the article.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
- Mizrachi A, Bachar G, Unger Y et al (2017) Submandibular salivary gland tumors: clinical course and outcome of a 20-year multicenter study. Ear Nose Throat J 96:E17–E20PubMedGoogle Scholar
- Springborg LK, Moller MN (2013) Submandibular gland excision: long-term clinical outcome in 139 patients operated in a single institution. Eur Arch Otorhinolaryngol 270:1441–6View ArticlePubMedGoogle Scholar
- Hong KH, Kim YK (2000) Intraoral removal of the submandibular gland: a new surgical approach. Otolaryngol Head Neck Surg 122:798–802View ArticlePubMedGoogle Scholar
- Miloro M (1999) Intraoral submandibular gland excision. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 88:661–3View ArticlePubMedGoogle Scholar
- Guerrissi JO, Taborda G (2001) Endoscopic excision of the submandibular gland by an intraoral approach. J Craniofac Surg 12:299–303View ArticlePubMedGoogle Scholar
- Parente Arias PL, Fernandez Fernandez MM, Varela Vazquez P, de Diego MB (2016) Minimally invasive video-assisted submandibular sialadenectomy: surgical technique and results from two institutions. Surg Endosc 30:3314–20View ArticlePubMedGoogle Scholar
- Kim CH, Koh YW, Kim D, Chang JW, Choi EC, Shin YS (2013) Robotic-assisted neck dissection in submandibular gland cancer: preliminary report. J Oral Maxillofac Surg 71:1450–7View ArticlePubMedGoogle Scholar
- Lee HS, Park DY, Hwang CS et al (2013) Feasibility of robot-assisted submandibular gland resection via retroauricular approach: preliminary results. Laryngoscope 123:369–73View ArticlePubMedGoogle Scholar
- Koh YW, Choi EC (2014) Robotic approaches to the neck. Otolaryngol Clin North Am 47:433–54View ArticlePubMedGoogle Scholar
- Koh YW, Chung WY, Hong HJ et al (2012) Robot-assisted selective neck dissection via modified face-lift approach for early oral tongue cancer: a video demonstration. Ann Surg Oncol 19:1334–5View ArticlePubMedGoogle Scholar
- Kim JYKW, Choi EC, Nam W (2016) The role of virtual surgical planning in the era of robotic surgery. Yonsei Med J 57:265–8View ArticlePubMedGoogle Scholar
- Scott Magnuson EMG J, Kuppersmith RB (2016) Robotic Head and Neck Surgery. Thieme, New YorkGoogle Scholar
- Eun Chang Choi YWK (2013) Atlas of head and neck surgery-endoscopic and robotic neck surgery. Panmun, SeoulGoogle Scholar
- Terris DJTK, Fee WE Jr (1994) Modified facelift incision for parotidectomy. J Laryngol Otol 108:574–8View ArticlePubMedGoogle Scholar
- Lohuis PJTM, Bonte K, van den Brekel MW, Balm AJ, Vermeersch HB (2009) Superficial parotidectomy via facelift incision. Ann Otol Rhinol Laryngol 118:276–80View ArticlePubMedGoogle Scholar
- Wasson JKH, Yeo J, Panesar J (2010) Cervicomastoidfacial versus modified facelift incision for parotid surgery: a patient feedback comparison. Ann R Coll Surg Engl 92:40–3View ArticlePubMedPubMed CentralGoogle Scholar
- Lee SYKY, Kim BG, Hong HJ, Jeong JH, Choi EC (2011) The extended indication of parotidectomy using the modified facelift incision in benign lesions: retrospective analysis of a single institution. World J Surg 35:2228–37View ArticlePubMedGoogle Scholar
- Lorenz KJBP, Höcherl D, Wilde F (2013) Improving the quality of life of parotid surgery patients through a modified facelift incision and great auricular nerve preservation. GMS Interdiscip Plast Reconstr Surg DGPW 16:1–7Google Scholar
- Grover NDSA (2013) Facelift approach for parotidectomy: an evolving aesthetic technique. Otolaryngol Head Neck Surg 148:548–56View ArticlePubMedGoogle Scholar
- de Vicente JCG-GM, de Villalaín L, Fernández-Valle Á (2015) Modified facelift approach combined with a superficial musculoaponeurotic system flap in the treatment of benign parotid tumors. J Craniomaxillofac Surg 43:1655–61View ArticlePubMedGoogle Scholar
- Bulut OCPP, Federspil PA (2016) Modified facelift incision for partial parotidectomy versus bayonet-shaped incision: a comparison using visual analog scale. Eur Arch Otorhinolaryngol 273:3269–75View ArticlePubMedGoogle Scholar
- Kang SW, Jeong JJ, Yun JS et al (2009) Robot-assisted endoscopic surgery for thyroid cancer: experience with the first 100 patients. Surg Endosc 23:2399–406View ArticlePubMedGoogle Scholar
- Lee KE, Choi JY, Youn YK (2011) Bilateral axillo-breast approach robotic thyroidectomy. Surg Laparosc Endosc Percutan Tech 21:230–6View ArticlePubMedGoogle Scholar
- Richmon JD, Holsinger FC, Kandil E, Moore MW, Garcia JA, Tufano RP (2011) Transoral robotic-assisted thyroidectomy with central neck dissection: preclinical cadaver feasibility study and proposed surgical technique. J Robot Surg 5:279–82View ArticlePubMedPubMed CentralGoogle Scholar
- Byrd JK, Duvvuri U (2013) Current trends in robotic surgery for otolaryngology. Curr Otorhinolaryngol Rep 1:153–7View ArticlePubMedPubMed CentralGoogle Scholar
- Greer Albergotti W, Kenneth Byrd J, De Almeida JR, Kim S, Duvvuri U (2014) Robot-assisted level II-IV neck dissection through a modified facelift incision: initial North American experience. Int J Med Robot 10:391–6View ArticlePubMedGoogle Scholar
- Shin YS, Choi EC, Kim CH, Koh YW (2014) Robot-assisted selective neck dissection combined with facelift parotidectomy in parotid cancer. Head Neck 36:592–5View ArticlePubMedGoogle Scholar
- Albergotti WG, Byrd JK, Nance M et al (2016) Robot-assisted neck dissection through a modified facelift incision. Ann Otol Rhinol Laryngol 125:123–9View ArticlePubMedGoogle Scholar
- Kim JY, Cho H, Cha IH, Nam W (2014) Esthetic neck dissection using an endoscope via retroauricular incision: a report of two cases. J Korean Assoc Oral Maxillofac Surg 40:27–31View ArticlePubMedPubMed CentralGoogle Scholar