Transoral robotic surgery for the management of XXXX : learning curve.

@entity1 @entity135 @entity5
Transoral robotic surgery (TORS) is an emerging technique for the treatment of @entity135 . The objective of this study is to describe our first steps and present our experience on the technical feasibility, safety, and efficacy of TORS for the treatment of selected malignant lesions. From April 2008 to September 2009, 24 @entity1 were enrolled in this prospective trial. Inclusion criteria were: adults with T1, T2 and selected T3 @entity5 involving the oral cavity, pharynx, and supraglottic larynx and a signed informed consent was obtained from the @entity1 . Exclusion criteria were: @entity5 not accessible to TORS after unsuccessful attempts to expose properly the lesion to operate. The ethical committee's approval was obtained to perform this study. Twenty-four @entity1 were included in this study: 10 supraglottic @entity5 , 10 pharyngeal @entity5 and 4 oral @entity5 . Nine @entity1 had T1 @entity5 , 12 had T2 @entity5 , and 1 @entity1 had a T3 @entity5 . In all cases, @entity5 resection could be performed by robotic surgery exclusively and negative resection margins were achieved with control by frozen section. None of them received intraoperative reconstruction. None of the @entity1 required tracheotomy. There was no intraoperative complication related to the use of the robot. The average setup time was 24      14  min (range 10-60  min). The average surgical time was 67      46  min (range 12-180  min). Surgical and setup time decreased after the first cases. The mean hospital stay was 9  days. Oral feeding was resumed at 3  days. TORS seems to be a safe, feasible, minimally invasive treatment modality for @entity135 with a short learning curve for surgeons already experienced in endoscopic surgery.
