Robotic-Assisted Transoral Cleft Palate Surgery (TORCS)

Abstract

The goals for treating the patient with a cleft palate are to achieve normal speech, hearing, and maxillofacial growth and to avoid fistulas. Palatal muscle reconstruction in cleft palate patients confers better functional results with respect to velopharyngeal competence and eustachian tube function. Although most children with cleft palates eventually recover normal eustachian tube function after palatoplasty, for the majority of children, this recovery does not occur for many years. The author does strongly believe that proper palatal muscle repair is of paramount importance for a good surgical outcome after cleft palate repair. We hypothesized that the preservation of the innervation and vascularization of the palatal muscles during their dissection, reorientation, and suturing might optimize eustachian tube function. Surgical robots provide three-dimensional endoscopic vision, which gives the surgeon true depth perception. This vision provides increased freedom of motion for the micro-endoscopic instruments, including simulated flexion, extension, pronation, and supination of the instruments. The aforementioned advantages facilitate more delicate handling of soft tissues and increased surgical precision.