Robotic Surgery and Oncologic Outcomes
Menée aux Etats-Unis à partir des données de la "National Cancer Database" portant sur 9 745 patients atteints d'un carcinome épidermoïde oropharyngé de stade T1 ou T2 diagnostiqué entre 2010 et 2015 (âge moyen : 58,8 ans), cette étude compare, du point de vue de la survie, l'intérêt d'une chirurgie transorale robotisée et d'une chirurgie non robotisée
In the 20 years since the US Food and Drug Administration (FDA) approved the use of Intuitive Surgical’s da Vinci surgical system for general laparoscopic surgery, robotic surgery has become commonplace in nearly every surgical specialty. This shift is likely owing to the technical advantages of robotic surgery vs conventional laparoscopy, including improved ergonomics, superior visual depth and definition, expanded articulation, elimination of motor tremor, and finer movements, despite the limited haptic feedback and potentially prohibitive cost to smaller centers. Although initial strides in robotic surgery were taken in benign disease, such as coronary artery surgery and the Lindbergh cholecystectomy, it was not long before robotics became widely adopted in surgical oncology. This trend started in urologic and gynecologic surgery. By comparison, application to head and neck surgery came later, with transoral robotic surgery (TORS) gaining FDA approval in December 2009. By that time, pelvic robotic surgery was already pervasive; in 2010, adoption of robotic surgery for radical prostatectomy was more than 40% in the United States.
JAMA Oncology , éditorial, 2019