Tips and Tricks in Robotic H&N Surgery
The Versius Robotic Surgery System offers some notable differences compared to the da Vinci Robotic Surgery System. You can see the details here. One key distinction is that the Versius system doesn’t require cannulas to support the distal end of instruments or the endoscope. This can be an advantage for transorificial approaches where cannulas are not necessary (since there’s no percutaneous passage or gas insufflation), as seen in procedures like TransOral Robotic Surgery (TORS).
However, a drawback arises with the lack of distal support, leading to significant tremor with proximal instrument movements (though wrist movements remain stable). Until this issue is addressed, a workaround is needed to make TORS feasible.
A simple and effective solution involves using conventional vessel loops to tie the shaft of the instrument to the frame of the pharyngolaryngoscope. This elastic attachment stabilizes the instrument, solving the tremor while still allowing free movement.
J Granell. Sept 15, 2024
PD. The Versius Surgical System does not have the CE mark for TORS yet.