Evaluation and application of CO₂ laser fiber delivery for single port transoral robotic surgery

Abstract

Abstract Background Transoral robotic surgery (TORS) using the Single‐Port system (SPS) relies on electrocautery, limiting its applications in the upper aerodigestive tract. We evaluated the feasibility of a CO 2 delivery system for the SPS. Methods Otolaryngology residents performed a cutting exercise using a handheld CO 2 laser and participated in a cadaveric oropharyngeal dissection using the SPS with monopolar cautery (SP + EC) and CO 2 laser (SP + CO 2 ). Residents completed the System Usability Scale (SUS) questionnaire to evaluate these techniques. Results The same laser fiber was used for all combined dissections. The handheld CO 2 laser, SP + EC, and SP + CO 2 demonstrated similar SUS scores. On individual domain scores, SP + CO 2 received less favorable ratings compared to the handheld CO 2 laser for complexity, integration, and cumbersome experience ( p < 0.05). On subgroup stratification, less TORS experience was associated with worse SUS scores. Conclusion SP‐guided CO 2 laser delivery is a viable alternative to electrocautery in robotic surgery, and should be considered when performing TORS.