Transoral Robotic Surgery for retropharyngeal Space Lymph Node Recurrence Following Irradiation Failure in Nasopharyngeal Carcinoma
09-12, 12:15–12:45 (Europe/Istanbul), Head & Neck Surgery 3

Eighty-five percent of nasopharyngeal carcinoma (NPC) cases present with lymphadenopathy, most commonly involving level II cervical lymph nodes and the retropharyngeal space. The surgical management of recurrent lymph node (LN) metastases in the retropharyngeal space is particularly challenging due to the complexity of the anatomy and the destructive nature of traditional open surgical approaches, such as maxillary or mandibular swing techniques. With the advent of the da Vinci surgical robot, transoral robotic surgery (TORS) has been adopted as a minimally invasive approach to remove retropharyngeal LN metastases. In this program, we will demonstrate the use of the da Vinci Xi system to excise retropharyngeal lymph nodes using three instruments: Maryland Bipolar Forceps, Monopolar Curved Scissors, and ProGrasp Forceps. Enhanced traction and countertraction provided by the ProGrasp Forceps, combined with the assistance of a bedside surgeon, enable safe and precise dissection of the retropharyngeal LN. The procedure ensures effective hemostasis and benefits from high-magnification, interchangeable 30-degree upward or downward 3D endoscopy. Additionally, the tremor reduction and motion filtration features of the da Vinci Xi system allow a robotic surgeon with 15 years of experience to perform complex two-surgeon, four-handed procedures in a confined space with greater dexterity and precision. (Video link https://zenodo.org/records/15537792 )


This program aims to demonstrate the safe and effective use of transoral robotic surgery (TORS) with the da Vinci Xi system for resecting recurrent retropharyngeal lymph node metastases in nasopharyngeal carcinoma. Using three robotic instruments, this minimally invasive approach enhances precision, traction, and hemostasis in a complex anatomical area, minimizing surgical morbidity and improving outcomes.(Video link https://zenodo.org/records/15537792 )

Prof. Chen-Chi Wang is a full professor at National Yang-Ming Chiao Tung University in Taipei and National Chung Hsing University in Taichung, Taiwan. He received his M.D. from National Yang-Ming University in 1994 and completed residency training in Otorhinolaryngology – Head and Neck Surgery at Taichung Veterans General Hospital (TCVGH) in 2000. He furthered his training in phonosurgery under Prof. Hiroyuki Fukuda in Tokyo and in head and neck oncology under Prof. Eugene N. Myers at the University of Pittsburgh Medical Center. He also studied under Prof. Steven M. Zeitels in 2004.

Prof. Wang served as Director of the Department of Otorhinolaryngology – Head and Neck Surgery at TCVGH from 2017 to 2023 and leaded the International Medical Service Center from 2022 to early 2025. He is actively involved in global academic communities, having served as Secretary General (2015–2019), Executive Board Member (2019–2023), and Advisor (2023–present) of the Asia-Oceania Association of Otorhinolaryngological Societies. He is President of the Taiwan Voice Society and a board member of multiple international organizations in voice, thyroid, and robotic surgery.

His research focuses on laryngopharyngeal reflux, laryngology, and robotic head and neck surgery. He has published numerous innovative studies, including a book chapter on “EMG-Guided Injection Laryngoplasty” in Vocal Fold Injection. Prof. Wang has received numerous national honors, including the Symbol of National Quality (2016, 2021), National Innovation Award (2022), and the NHQA Diamond Prize (2024). In 2018, he was elected a member of the Collegium Oto-Rhino-Laryngologicum Amicitiae Sacrum (CORLAS).

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