Adding Flexible Instrumentation to a Curved Videolaryngoscope: A Novel Tool for Laryngeal Surgery
Open Access
- 25 June 2020
- journal article
- research article
- Published by Wiley in The Laryngoscope
- Vol. 131 (2), E561-E568
- https://doi.org/10.1002/lary.28868
Abstract
Objectives Transoral surgery of the larynx with rigid instruments is not always possible. This may result in insufficient therapy or in an increased need for open surgery. For these patients, alternative surgical systems are needed. Here, we demonstrate a curved prototype for laryngeal surgery equipped with flexible instruments. Study Design Pre‐clinical user study in an ex vivo porcine laryngeal model. Methods The prototype was built from established medical devices, namely a hyperangulated videolaryngoscope and modified flexible instruments as well as three‐dimensional printed parts. Feasibility of laryngeal manipulation was evaluated in a user study (n = 19) with a porcine ex vivo laryngeal model. Using three different visualization technologies, the participants performed various fine motor skills tasks and rated the usability of the system on a 5‐point Likert scale. Results Exposure, accessibility, and manipulation of important laryngeal structures were always possible using the new prototype. The participants needed considerably less time (mean, 96.4 seconds ± 6.4 seconds vs. 111.5 seconds ± 4.5 seconds, P = .18), reported significantly better general impression (mean score 3.0 vs. 3.8, P = .041) and significantly lower user head and neck strain (2.6 vs. 1.7, P = .022) using a 40‐inch television screen as compared to a standard videolaryngoscope monitor. Conclusion The results indicate that our curved prototype and large monitor visualization may provide a cost‐effective minimally invasive alternative for difficult laryngeal exposure. Its special advantages include avoiding the need for a straight line of sight and a simple and cost‐effective construction. The system could be further improved through advances in camera chip technology and smaller instruments. Laryngoscope , 2020Keywords
This publication has 34 references indexed in Scilit:
- Comparison of the C-MAC D-Blade, Conventional C-MAC, and Macintosh Laryngoscopes in Simulated Easy and Difficult AirwaysJournal of the Turkish Anaesthesiology and Intensive Care Society, 2014
- Preoperative clinical predictors of difficult laryngeal exposure for microlaryngoscopy: The laryngoscoreThe Laryngoscope, 2014
- Cost comparison of open approach, transoral laser microsurgery and transoral robotic surgery for partial and total laryngectomiesEuropean Archives of Oto-Rhino-Laryngology, 2014
- Functional outcomes after TORS for oropharyngeal cancer: a systematic reviewEuropean Archives of Oto-Rhino-Laryngology, 2014
- Evaluation of a 3D system based on a high-quality flat screen and polarized glasses for use by surgical assistants during robotic surgeryIndian Journal of Urology, 2014
- Transoral robotic surgery vs transoral laser microsurgery for resection of supraglottic cancer: a pilot surgeryInternational Journal of Medical Robotics and Computer Assisted Surgery, 2013
- Transoral robotic surgery for the treatment of T1–T2 carcinoma of the larynx: Preliminary studyThe Laryngoscope, 2013
- Prinzipielle Unterschiede am Stimmapparat von Mensch und Schwein: Einige wesentliche morphologische KriterienPneumologie, 2010
- Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008International Journal of Cancer, 2010
- Transoral Robotic Surgery (TORS) in Laryngeal and Hypopharyngeal CancerJournal of Laparoendoscopic & Advanced Surgical Techniques, 2009