Transoral Robotics Supracricoid Hemilaryngopharyngectomy

Traditional open surgical approaches for hypopharyngeal carcinomas carry a great risk of developing treatment-related morbidity. Transoral robotic surgery (TORS) is an established treatment modality for head and neck cancer and can minimise this morbidity. Owing to the access and improved flexibility of the robotic system, hypopharyngeal tumours can now be reached and successfully treated with organ preservation, resulting in adequate function, especially in swallowing and phonation. In this study, we describe the surgical technique and clinical and oncological results for supracricoid hemilaryngopharyngectomy performed by transoral robotic surgery (TORS SCHLP) in a patient with hypopharyngeal carcinoma extending to the arytenoid mucosa. An interarytenoid sagittal cut extending to the cricoid cartilage was made. The epiglottis was split via a laterally placed vertical incision at the tumour-bearing side, extending to the anterior commissure. The inner perichondrium of the thyroid cartilage was peeled off. A horizontal cut in the postcricoid region was made, paying close attention to the safe surgical margins. A final cut, parallel to the cricoid cartilage, was made using curved scissors and the tumour was removed en bloc. In conclusion, TORS SCHLP should be considered for resectable tumours to avoid the undesirable consequences of open surgical resection.