ICHNO-ECHNO 2022 - Abstract Book

S61

ICHNO-ECHNO 2022

Conclusion Conclusion: CTA is an effective tool to measure flap thickness pre-operatively. Male, younger patients, and patients with high BMI are predicted to have thicker flaps. The surgeon should be prepared to make a better choice of flap based on these factors.

PO-0103 Free flap reconstruction, VSP and CBCT in the treatment of mandibular ameloblastomas

A. Piotrowska-Seweryn 1 , C. Szymczyk 1 , Ł . Krakowczyk 1 , J. Wierzgo ń 1 , R. Szumniak 1 , M. Grajek 2 , M. Dobrut 1 , D. Walczak 1 , G. Hadasik 1 , A. Maciejewski 1 1 Maria-Sklodowska Curie National Research Institute of Oncology, Gliwice Branch, Department of Oncological and Reconstructive Surgery, Gliwice, Poland; 2 Maria-Sklodowska Curie National Research Institute of Oncology, Gliwice Branch, , Department of Oncological and Reconstructive Surgery, Gliwice, Poland Purpose or Objective Ameloblastoma is the most common, locally aggressive odontogenic tumor. It comprises of about 1% of all head and neck neoplasms. It occurs mainly in young adults in their 3 rd and 4 th decade of life. It localizes in the mandible in about 80%. According to the 2017 WHO classification 4 types of ameloblastoma can be distinguished: ameloblastoma (previously referred to as solid / multicystic; the ‘conventional type’), unicystic, extraosseous / peripheral, malignant /metastatic. The most common type is the solid, multicystic one, characteristic for its aggressiveness and high risk of recurrence. The treatment of choice of mandibular ameloblastomas includes radical resection with consecutive reconstruction. In the study the authors present their experience in surgical treatment of mandibular ameloblastomas with vascularized free flap reconstructions. They discuss new technological possibilities that could improve the precision of reconstructive procedure and therefore result in better aesthetic outcome. Materials and Methods The retrospective study was conducted on a group of 21 patients who underwent segmental mandibulectomy with simultaneous microvascular free flap reconstruction due to mandibular ameloblastoma. A thorough clinical analysis with various aspects was performed. Tumors resected before 2017 were double checked patomorphologically and assigned to the corrected subtype group. Six patients were admitted to the department due to recurrent ameloblastoma. The most common localization of the tumor was the mandibular body (n=6) and body with ramus of the mandible (n=6). Results A total amount of 10 iliac crest free flaps and 12 fibular free flaps were performed. Complications were reported in 4 patients. A purulent oro-cutaneus fistula occurred in three patients. There was a flap failure of both ICF and FFF in one subject reported. The virtual surgical planning (VSP) with intraoperative cone beam computed tomography (CBCT) was used in the last three patients. Dentition implantation was conducted in 4 patients (3 simultaneously, 1 postponed). The mean follow-up was 5 years and 8 months. Conclusion Radical resection that covers radical segmental mandibulectomy with immediate microvascular free flap reconstruction is a first-line and only effective treatment of mandibular ameloblastomas, that eliminates the risk of recurrence. The width of surgical margins seems not to influence the recurrence rate. The choice of adequate free flap must be adapted to dimensions and localization of a tumor and to each patient individually. New technologies such as virtual surgical planning with 3D models and intraoperative cone beam computed tomography can make the reconstruction even more accurate, improving patient’s quality of life. 1 Kings College London, School of Biomedical Engineering and Image Sciences, London, United Kingdom; 2 Guy's and St Thomas' NHS Foundation Trust, Head and Neck Surgery, London, United Kingdom Purpose or Objective To evaluate the Versius surgical system (CMR Surgical, Cambridge, UK) in trans-oral robotic surgery applications within the oropharynx in a pre-clinical cadaveric setting in accordance with the IDEAL-D framework. Materials and Methods Cadaveric dissection sessions were undertaken to evaluate the ability of the system to perform all steps required for three index procedures; lateral oropharyngectomy, tongue base resection and partial supraglottic laryngectomy. Optimal operating room setup for this novel system was determined on preliminary studies. Ten consultant head and neck surgeons practicing in the UK, USA and Europe took part. Experience varied from newly appointed consultants with limited TORS experience to expert professors in the field. Outcome measures included surgical access to each anatomical site, feasibility of each procedural step, ergonomics of the operating surgeon, suitability of the robotic equipment, and overall feasibility. Evaluation of the system was reported via surgeon reported outcomes using a structured questionnaire and Likert Scale outcomes. Debrief sessions were analysed via structured qualitative methods. PO-0104 Evaluation of the Versius surgical system. A new robotic platform in head and neck surgery. J. Faulkner 1 , J. Jeannon 2 , A. Arora 2