Dan Karakla, M.D., provides an overview of the Medrobotics Flex® Robot and demonstrates its effectiveness is completing a diagnostic biopsy of a tumor situated at the aryepiglottic fold and the pharyngeus.
Hi, I'm Dan Caracalla. I'm at Eastern Virginia Medical School. I'm a professor of otolaryngology had neck surgery, Norfolk, Virginia. And I'm here to talk a little bit more about thesis. Entra FMS comprehensive head neck cancer program, specifically the med Robotics flex robot and what it can help us to do for our patients. E yeah, the Flexeril but allows us to access the tongue based super clinic larynx the oral pharynx, um, areas that we have a little bit more trouble getting to with standard equipment, whether it be micro directly. Endoscopy, laser devices, three divinci, rigid armed robot. The retractor systems in place, teeth that guarded. Now we're bringing the flex robot arm in place way have a side stand. Male stand is especially clamped onto the or bed. It moves up and down with the bed, which is an important safety teacher. I think for these sorts of cases, those are the working channels there. Those metal devices, those side arms. Once we're happy, we have adequate exposure, will bring the robot in farther again, taking care of for access. Mm. And we'll drive the robot in with fine movements. Just it's visualization positioning, and we're at the head of the bed, which is different than the DaVinci robot where your remote It's something that's Mawr comfortable with head, neck and otolaryngology surgeons. And so we're starting to see this tumor at the right area. Pavletic Full media wall of pure form. You can see the pulsations from the corroded artery and a poster lateral right side introducing the instruments Have bovie have Maryland dissector retractor. And this is the Maryland dissector retractor on the left side. Endotracheal tube obviously right there in the larynx. Yeah, introducing the boby. Now this is a needle tip Boby. So it's quite find The tip is really delicate and we have to be careful with the f i o to we have to be careful with boby sparks to that tube. But because the movements air pretty precise waken stay away from the tube. We're asking the tumor. There are different blades for different exposure Different access to the tongue base Oral pharynx poster pharynx, sympathetic lyrics type of pharynx. This is really a diagnostic biopsy. If we retract the endotracheal tube to the left side Contra lateral the tumor, you get better exposure. You can see the initial cuts here. You can use a cut mode or Kateri mode with the movie as you can with most babies less Qaderi, the better for a pathologist we consume in with the robot, we can adjust the intensity of the light. Certainly we can adjust the end of the unit and bring it closer or farther as well. On his terms, extending along the right area, you gotta pull to the media wall of the pure form. If there's any significant bleeding, we can use Steiner clip a pliers or sexual bovie or pressure cotton noise with basil. Constructors air also helpful along with a variety of from biotic agents flow sealed, etcetera. Since the time of this surge, we've done more advanced procedures we've done to superglue declaring Japanese trans orally. Yeah, rotate instrument there, bring different exposure, different angles for the excision. Okay. Yeah. Okay. Okay. Okay. Yeah. I'm going through the lateral border of this excision. And depending on the specimen in the intent of the surgery, you'll need to maintain orientation of the specimen for the pathologists margin assessment. This'll patient actually had to synchronous timmers. He also had a t one glaad IQ larynx cancer. and this is an area pig. Logic pools the pure form tumors. So to tumors, totally separate the galactic larynx. Cancer is on the left side. This is the right side of leading. There are also micro or angel original instruments made for more delicate surgeries. Within the Lauren Jalin Troy Tous, it could be used. The anesthesia team also has the monitor so they can monitor the and watch the progress of the tumor excision. In the procedures, the special will be withdrawn oriented, submitted depending on the intent of the biopsy. Okay, so the flex robot is essentially a single arm unit allows me to get access to the back of the throat with a single arm, deploy the working instruments of Bovi and Maryland dissector retractor and in place that I can't get to quite a Z easily with the DaVinci.