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Journal of Education, Health and Sport

Robotic Surgery in Obstructive Sleep Apnea-Hypopnoea Syndrome
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  • Robotic Surgery in Obstructive Sleep Apnea-Hypopnoea Syndrome
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Robotic Surgery in Obstructive Sleep Apnea-Hypopnoea Syndrome

Authors

  • Arkadiusz Standyło Medical University of Lublin https://orcid.org/0000-0002-5154-4759
  • Aleksandra Obuchowska Medical University of Lublin https://orcid.org/0000-0003-0464-2695
  • Justyna Wójcik Medical University of Lublin https://orcid.org/0000-0001-7163-6784
  • Alicja Ozga Medical University of Lublin https://orcid.org/0000-0003-1291-905X
  • Karolina Obuchowska Medical University of Lublin https://orcid.org/0000-0003-4519-8236
  • Piotr Trojanowski Medical University of Lublin https://orcid.org/0000-0001-9160-291X

DOI:

https://doi.org/10.12775/JEHS.2020.10.09.064

Keywords

robotic surgery, obstructive sleep apnoea, da Vinci system, obesity

Abstract

Obstructive sleep apnoea-hypopnoea (OSAH) syndrome is a sleep disorder characterised by pauses in breathing (apnoea) or periods of reduced breathing (hypopnoea) during sleep. It  results in cerebral hypoxia and a disturbed sleep pattern. The gold standard treatment for OSA is continuous positive airway pressure (CPAP). However, significant number of patients are not able to tolerate this device and approximately 50% of patients report inability to achieve long term usage to CPAP.

Robotic surgery is an emerging technique for sleep surgery. TORS is an alternative treatment for OSA for patients who have failed CPAP treatment or conventional non-robotic sleep surgery. This technology is assisted by remote-controlled miniaturized surgical instruments and magnified visualization with a high-definition three-dimensional camera. Tongue base reduction (TBR) refers to the primary focus of this targeted surgery for obstructive sleep apnea (OSA).

TORS approach for OSA may include 2 different surgical steps frequently combined in the same procedures according to the patient’s features: tongue base reduction and supraglottoplasty (SGP).

In the light of the present results and of the literature, TORS tongue-base reduction appears to be effective. With the improved visualization and precise tissue removal provided by robotic surgery, TORS may become more widespread in the treatment of OSA in the coming years. There was an improvement in objective and subjective sleep measures. The comparison among pre-operative and post-operative parameters showed a significant decreasing in post-operative AHI, ESS and an increasing of the lowest SpO2 value.

References

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Vauterin T, Garas G, Arora A. Transoral Robotic Surgery for Obstructive Sleep Apnoea-Hypopnoea Syndrome. ORL J Otorhinolaryngol Relat Spec. 2018;80(3-4):134-147. doi:10.1159/000489465

Lee JA, Byun YJ, Nguyen SA, Lentsch EJ, Gillespie MB. Transoral Robotic Surgery versus Plasma Ablation for Tongue Base Reduction in Obstructive Sleep Apnea: Meta-analysis. Otolaryngol Head Neck Surg. 2020;162(6):839-852. doi:10.1177/0194599820913533

Garas G, Kythreotou A, Georgalas C, et al. Is transoral robotic surgery a safe and effective multilevel treatment for obstructive sleep apnoea in obese patients following failure of conventional treatment(s)? Ann Med Surg (Lond). 2017;19:55-61. doi:10.1016/j.amsu.2017.06.014

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Aynacı E, Karaman M, Kerşin B, Fındık MO. Comparison of radiofrequency and transoral robotic surgery in obstructive sleep apnea syndrome treatment. Acta Otolaryngol. 2018;138(5):502-506. doi:10.1080/00016489.2017.1417635

Folk D, D’Agostino M. Transoral robotic surgery vs. endoscopic partial midline glossectomy for obstructive sleep apnea. World Journal of Otorhinolaryngology - Head and Neck Surgery. 2017;3(2):101-105. doi:10.1016/j.wjorl.2017.05.004

Cammaroto G, Montevecchi F, D’Agostino G, et al. Tongue reduction for OSAHS: TORSs vs coblations, technologies vs techniques, apples vs oranges. Eur Arch Otorhinolaryngol. 2017;274(2):637-645. doi:10.1007/s00405-016-4112-4 [camaroto2016]

Hwang CS, Kim JW, Kim JW, et al. Comparison of robotic and coblation tongue base resection for obstructive sleep apnoea. Clinical Otolaryngology. 2018;43(1):249-255. doi:10.1111/coa.12951

Miller SC, Nguyen SA, Ong AA, Gillespie MB. Transoral robotic base of tongue reduction for obstructive sleep apnea: A systematic review and meta-analysis. Laryngoscope. 2017;127(1):258-265. doi:10.1002/lary.26060

Vicini C, Dallan I, Canzi P, et al. Transoral robotic surgery of the tongue base in obstructive sleep Apnea-Hypopnea syndrome: anatomic considerations and clinical experience. Head Neck. 2012;34(1):15-22. doi:10.1002/hed.21691

Vicini C, Montevecchi F. Transoral Robotic Surgery for Obstructive Sleep Apnea: Past, Present, and Future. Sleep Med Clin. 2019;14(1):67-72. doi:10.1016/j.jsmc.2018.10.008 [vicini2018]

Babademez MA, Gul F, Sancak M, Kale H. Prospective randomized comparison of tongue base resection techniques: Robotic vs coblation. Clinical Otolaryngology. 2019;44(6):989-996. doi:10.1111/coa.13424

Cammaroto G, Meccariello G, Costantini M, et al. Trans-Oral Robotic Tongue Reduction for OSA: Does Lingual Anatomy Influence the Surgical Outcome? J Clin Sleep Med. 2018;14(8):1347-1351. doi:10.5664/jcsm.7270 [camaroto2018]

Meccariello G, Cammaroto G, Montevecchi F, et al. Transoral robotic surgery for the management of obstructive sleep apnea: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol. 2017;274(2):647-653. doi:10.1007/s00405-016-4113-3

de Bonnecaze G, Vairel B, Dupret-Bories A, Serrano E, Vergez S. Transoral robotic surgery of the tongue base for obstructive sleep apnea: Preliminary results. European Annals of Otorhinolaryngology, Head and Neck Diseases. 2018;135(6):411-415. doi:10.1016/j.anorl.2018.09.001

Vicini C, Montevecchi F, Gobbi R, De Vito A, Meccariello G. Transoral robotic surgery for obstructive sleep apnea syndrome: Principles and technique. World J Otorhinolaryngol Head Neck Surg. 2017;3(2):97-100. doi:10.1016/j.wjorl.2017.05.003

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Published

2020-09-22

How to Cite

1.
STANDYŁO, Arkadiusz, OBUCHOWSKA, Aleksandra, WÓJCIK, Justyna, OZGA, Alicja, OBUCHOWSKA, Karolina and TROJANOWSKI, Piotr. Robotic Surgery in Obstructive Sleep Apnea-Hypopnoea Syndrome. Journal of Education, Health and Sport. Online. 22 September 2020. Vol. 10, no. 9, pp. 525-534. [Accessed 3 July 2025]. DOI 10.12775/JEHS.2020.10.09.064.
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Vol. 10 No. 9 (2020)

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Review Articles

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