A Pilot Study of the Use of the DaVinci Robotic System for Otorhinolaryngology-Head and Neck Surgery
试验速览
- 阶段
- 不适用
- 入组人数
- 71
- 试验地点
- 2
- 主要终点
- ability to adequately visualize the operative field and complete planned surgery
研究概览
简要总结
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Patients included will have benign or malignant lesions with treatment plan for endoscopic resection or resection by other minimally invasive techniques.
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They will be offered a robotic approach to their surgery using the DaVinci robotic surgical system (intuitive Surgical, Inc.).
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The objectives are to evaluate our ability to adequately visualize the surgical field and perform the intended surgery without a higher complication rate.
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Secondary objective include evaluation of blood loss, length of hospital stay, complications while using the DaVinci robot system, and quality of life in subjects and historical controls undergoing similar surgery without the robot or radiation therapy.
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To evaluate recurrence, survival and other outcome data in robotic surgery patients compared with similar historical control groups (matched with respect to stage, prior and subsequent treatment, age, tumor HPV positivity) of patients who have undergone standard surgery without the robot or radiation/chemoradiation treatment as an alternative to surgery.
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Endpoints will be compared to historical controls.
详细描述
The da Vinci® Robotic Surgical System (Intuitive Surgical, Inc., Sunnyvale, CA) being evaluated in this pilot study consists of 3 basic components: a surgeon's console, articulated mechanical arms and sterilizable instruments. The console includes a computer, video monitor and instrument controls, and is located in the operating room adjacent to the operating room table. The console is connected via computer to the mechanical arms holding the endoscope (surgical TV camera) and sterile surgical tools (e.g., forceps, scissors, electrocautery, etc.). These arms are located immediately adjacent to the patient on the operating room table. The surgeon sits at the console and controls the position and movement of the arms and surgical tools. The design of these tools is based upon well-established, commonly used surgical instruments. The da Vinci® Robotic Surgical System (Intuitive Surgical, Inc., Sunnyvale, CA) is a "manual image-guided surgery" system that is computer enhanced rather than "computer guided robotic surgery" in which the surgeon programs the computer to do the surgery and the robot does the surgery (also known as a "milling" device).22 Use of the da Vinci® Robotic Surgical System (Intuitive Surgical, Inc., Sunnyvale, CA) in the aforementioned configuration in fact facilitates an exact translation of the surgeon's hand and finger movements at the console to precise and tremor-free movements of the arms and instruments.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •At least 18 years f age
- •Indications for diagnostic or therapeutic approaches for benign or malignant disease of the head and neck
- •Written informed consent
排除标准
- •Unexplained fever and/or untreated, active infection
- •Pregnancy
- •Previous head and neck surgery precluding transoral/endoscopic/robotic procedures
- •Presence of medical conditions contraindicating general anesthesia or transoral surgical approaches
结局指标
主要结局
ability to adequately visualize the operative field and complete planned surgery
时间窗: 1 day
次要结局
- blood loss compared to historical controls of endoscopic and minimally invasive procedures(1 day)
- Time to recurrence of tumor or other pathology for which procedure was performed(at recurrence of tumor or pathology)
- number of days hospitalized immediately after surgery(at discharge from hospital)
- Time from start of treatment to death(at time of death)
- complication rate compared to standard endoscopic and minimally invasive procedures(1 month)
- quality of life at early (1-3 months) and late (one year)(1 year)
研究者
Richard V. Smith, MD
Vice Chairman, Otorhinolaryngology/head and neck surgery
Montefiore Medical Center