Single-session, dual-site robotic surgery for synchronous primary malignancies of the oropharynx and thorax. Issue 8 (26th August 2020)

• Record Type: Journal Article
• Authors: Kelly, Mairead; Oikonomou, Georgios; Tornari, Chrysostomos; Ahmad, Imran; Bille, Andrea; Jeannon, Jean-Pierre; Arora, Asit
• Is Part Of: Journal of surgical case reports. Volume 2020:Issue 8(2020)
• Publication Date: 2020-08-26
• Subjects: transoral robotic surgery -- oropharyngeal cancer -- robot-assisted thoracic surgery -- dual-site robotic surgery; Surgery -- Periodicals; Surgery -- Case studies -- Periodicals; 617.005
• DOI: 10.1093/jscr/rjaa258
• Languages: English
• ISSNs: 2042-8812

Abstract

Abstract: Single-session, dual-site robotic surgery for synchronous malignancies is not widely reported. To our knowledge, there are no previous reports of transoral robotic surgery (TORS) and robot-assisted thoracic surgery (RATS) in a single sitting. A 49-year-old male presented with a neck lump. Biopsies and imaging proved synchronous primaries of the tonsil and lung. The morbidity of primary dual-site chemoradiotherapy, or open surgery, presented a management challenge. We therefore opted for sequential robotic resections, in a single sitting. The patient was discharged on Day 6 post-operatively and was able to start radiotherapy less than 3 weeks post-operatively. Undertaking TORS and RATS in a single sitting is feasible and safe. This approach allowed fast-tracking of adjuvant oncological therapy, arguably conveying the greatest chance of cure. We detail the rationale and utility of this novel approach and describe the surgical and anaesthetic challenges of two teams undertaking sequential robotic procedures in a single sitting.