Lai Chih-Sheng

Taichung Veterans General Hospital, Taiwan, R.O.C

Title: Functional outcome and complications of robot-assisted free flap oropharyngeal reconstruction


He is an attending plastic surgeon at Taichung Veterans General Hospital, Taiwan. He has more than 10 years of experience as plastic surgeon and specializes in wound treatment and reconstructive surgery. He obtained medical degree from Chung Shan Medical University. He has also authored many research publications and is an active member of many surgery societies as Taiwan Society of Plastic Surgery, Member of Taiwan Society for Surgery of the Hand, Member of Taiwan Society for Reconstructive Microsurgery


Purpose: The purpose of this study was to assess the outcomes of robotic-assisted oropharyngeal reconstruction comparison with conventional free flap reconstruction. The robotic surgical system provides a clear, magnified, 3-dimensional (3D) view as well as a precise and stable instrumental movement, which minimizes many technical difficulties that may be encountered in the surgical treatment of oropharyngeal tumors.

Materials and Methods:A retrospective review of consecutive patients who underwent reconstructive operations using free radial forearm fasciocutaneous flap for oropharyngeal defects over a 20-month period (May 2013 to December 2014). The primary predictor variable was method of reconstruction (conventional versus robot-assisted). Outcome measures were postoperative complication rates, revision rates, and postoperative functional outcomes.

Results:The study sample consisted of 47 subjects who underwent reconstructive operations using free radial forearm fasciocutaneous flap for oropharyngeal defects (33 conventional and 14 robot-assisted reconstructions). Complication rates between the conventional and robot-assisted groups were similar for flap failure, partial necrosis, wound infections, hematoma or seroma formation, wound dehiscence, and fistula formatiom. The revision requiring additional operation was comparable between the two cohorts. The functional outcomes postoperatively of robot-assisted reconstructions are better than conventional reconstructions as demonstrated by the Functional Intraoral Glasgow Scale scores.

Conclusion: There is no significant difference in complication and revision rates between conventional versus robot-assisted oropharyngeal reconstructions. The application of a robotic surgical system seems to be a safe option with better oral function postoperatively in the free flap reconstruction of oropharyngeal defects without lip or mandible splitting.