Evaluation and application of CO2 laser fiber delivery for single port transoral robotic surgery

BackgroundTransoral robotic surgery (TORS) using the Single-Port system (SPS) relies on electrocautery, limiting its applications in the upper aerodigestive tract. We evaluated the feasibility of a CO2 delivery system for the SPS. MethodsOtolaryngology residents performed a cutting exercise using a handheld CO2 laser and participated in a cadaveric oropharyngeal dissection using the SPS with monopolar cautery (SP + EC) and CO2 laser (SP + CO2). Residents completed the System Usability Scale (SUS) questionnaire to evaluate these techniques. ResultsThe same laser fiber was used for all combined dissections. The handheld CO2 laser, SP + EC, and SP + CO2 demonstrated similar SUS scores. On individual domain scores, SP + CO2 received less favorable ratings compared to the handheld CO2 laser for complexity, integration, and cumbersome experience (p < 0.05). On subgroup stratification, less TORS experience was associated with worse SUS scores. ConclusionSP-guided CO2 laser delivery is a viable alternative to electrocautery in robotic surgery, and should be considered when performing TORS.

Automated summary

This study evaluated the feasibility of using a CO2 laser delivery system in the Single-Port system (SPS) for transoral robotic surgery (TORS). The results showed that combining the SPS with the CO2 laser had similar usability scores compared to using electrocautery, and even performed better in some aspects. Therefore, the combination of the SPS and CO2 laser should be considered in robotic surgery.