ICHNO-ECHNO 2022 - Abstract Book

S62

ICHNO-ECHNO 2022

Results A total of 36 index procedures were performed on 6 cadavers by 10 surgeons. 36/36 procedures were completed successfully. Lateral oropharyngectomy n=12, lateral tongue base resection n=12, partial supraglottic laryngectomy n=12. Surgical access was deem more limited in supraglottic laryngectomy than tongue base resection and lateral oropharyngectomy. Minor setup alterations were sufficient to allow good surgical access for all procedures to be performed. Instrument clashes were more common in supraglottic laryngectomy. All clashes were resolved with minor instrument adjustments. There were no device-related intra-operative complications. All surgeons reported that all procedures were feasible with the Versius surgical system. Conclusion This pre-clinical evaluation of a new, novel robotic system constitutes a phase 0 study in accordance with the IDEAL framework principles. This study reports that the Versius surgical system is safe and effective for minimally invasive transoral robotic surgery in a pre-clinical cadaveric setting. Feasibility of Versius to perform TORS was confirmed and the system performed favourably in all domains assessed. The system was usable by all participating surgeons from novice to expert. Further work in accordance with IDEAL principles is required to assess the suitability of this platform for application in the clinical domain. 1 Guys' and St Thomas' NHS Foundation Trust, Head and Neck Surgery, London, United Kingdom; 2 Kings College London, GKT medical school, London, United Kingdom Purpose or Objective This study reports a central London teaching hospitals’ institutional outcomes for patients with head and neck malignancy treated with primary surgical resection via transoral robotic surgery. Materials and Methods This is a prospective case series of all patients who underwent trans-oral robotic surgery for primary treatment of head and neck SCC between January 2018 and October 2021 at Guy’s Hospital (London, UK). All patients underwent comprehensive evaluation, staging (AJCC 7 th edition) and multidisciplinary meeting (MDM) review. Primary TORS was offered to patients following MDM discussion and adjuvant radiotherapy (RT) or chemoradiotherapy (CRT) was given according to protocol. Specimen margins were analysed as per PATHOS protocol. Patients treated as part of ongoing clinical trials and “off trial” were included for analysis. Functional swallow outcomes were assessed via the MD Anderson Dysphagia Index (MDADI) Results 34 patients underwent primary TORS for head and neck SCC. 33/34 had oropharyngeal SCC. 1/34 had supraglottic SCC. 4/34 were in the glossotonsilar region, 18/34 were tonsillar, 10/34 base of tongue and 1/34 posterior pharyngeal wall. 3/34 cases were salvage cases. 9/34 presented as carcinoma of unknown primary and underwent diagnostic TORS prior to formal treatment surgery. Median Follow up was 20 months (range 1-39 months). Overall survival (OS) and disease free survival (DSS) were 97% (1 salvage patient died from metastatic disease). 86% of patients had R0 margins, 14% had R1 margins (<1mm) and all presented with clinical or pathological adverse features. 16% were treated with surgery alone, 59% required adjuvant radiotherapy (RT) and 26% received adjuvant chemoradiotherapy (CRT). 30% of patients had a change from clinical to pathological staging, 15% of patients downgraded (75% due to neck staging) and 15% ofpatients upgraded (75% upstaged due to primary tumour). Considering early stage tumours (T1N0/1 and T2N0), 4 patients (80%) were R0. 40% avoided adjuvant treatment and 40% received RT. The remaining patient (20%) was treated with adjuvant CRT. 8% experienced post-operative bleeding from the primary site. all were managed conservatively and did not require operative intervention. 8% experienced deep neck collections requiring washout in theatre. Functional swallow outcomes reported via MDADI was similar for patients treated with surgery alone or with surgery and RT whereas its punctuation was decreased in patients that needed postoperative CRT. Conclusion Transoral robotic surgery is a safe and effective treatment method for oropharyngeal squamous cell carcinoma. To date oncological outcomes in our institution are promising especially in the context of primary surgical treatment. Functional outcomes of early OPSCC treated with primary surgery are promising however high triple modality treatment rates are associated with decreased functional outcomes in our cohort. In our institution transoral robotic surgery forms a key component of the treatment algorithm for early OPSCC. PO-0105 Institutional experience of transoral robotic surgery for head and neck squamous cell carcinoma J. Faulkner 1 , C. Leroy 1 , O. Williams 2 , A. Rovira 1 , J. Jeannon 1 , A. Arora 1

PO-0106 Use of the chimeric flap LD+SA for functional reconstruction after salvage glossectomy

A. Mordovskiy 1 , A. Polykov 2 , M. Ratushnyy 3 , I. Rebrikova 2

1 Moscow Research Oncological Institute named P. Herzen – the branch of State Organization «National Medical Research Center of Radiology» Ministry of Health of Russia, Department of Microsurgery , Moscow, Russian Federation; 2 Moscow