Robotic-Assisted Lingual Tonsillectomy in the Pediatric Population

Abstract

Objectives:

Assess the feasibility and outcomes of robotic-assisted lingual tonsillectomy (RALT) in the pediatric population.

Methods:

Retrospective medical chart review performed using a tertiary care children’s hospital database identified 16 pediatric patients who underwent RALT from March 2011 through December 2012. Demographic data, comorbidities, robot docking time, operative time, surgical blood loss, and postoperative course, including complications in the immediate and longer-term postoperative period, were collected and analyzed.

Results:

All patients successfully underwent RALT using the daVinci Surgical Robot (Intuitive Surgical, Sunnyvale, CA). Endotracheal intubation was used in all cases and did not interfere with visualization of the oropharynx. Optimal retraction allowed visualization of pertinent structures and maximized transoral access. A significant learning curve from the first 5 surgical cases to subsequent cases with respect to robot docking time and surgical blood loss was observed (9 versus 3 minutes and 7.4 versus 3.2 ml respectively, P < .05). Operative time, estimated blood loss, and postoperative complication profile are within the expected and acceptable limitations for performing lingual tonsillectomy in the pediatric population.

Conclusions:

Technologic advances have allowed miniaturization of robotic instrumentation and have expanded the scope of surgical options for the pediatric airway. RALT is well-tolerated and can be performed in the pediatric population with excellent success. It should be considered a feasible option for implementation at an institution-based level.