New approaches in endoscopically assisted laryngeal surgery – A multimedia contribution.

Introduction Laryngeal exposure in direct laryngoscopy when using a Kleinsasser laryngoscope and the operating microscope may prove to be complicated at times. The use of angled endoscopes is a way to gain insight into laryngeal areas that are difficult to expose directly, especially in the anterior commissure. To allow the use both of hands during microlaryngoscopy, we use a semi-robotic endoscope-holding- system, which enables high maneuverability as well as precise positioning of the endoscope. In this multimedia presentation we aim to demonstrate our clinical experience with endoscopically assisted microlaryngoscopic surgery.

Material and Methods The semi-robotic holding system used weighs 12.4 kg, can be attached to the rail of the operating table and holds a weight of up to 1kg. It can therefore hold a commercially available 30° endoscope and an attached camera. In our video we demonstrate endoscopically assisted microlaryngeal surgery using the semi-robotic endoscope support arm for oncological and functional microlaryngoscopic procedures.

Results Our video explains the respective advantages of the endoscopically assisted procedure during the individual operations. Duration and preparation effort of microlaryngoscopy with the endoscope holding arm did not differ from that when using the operating microscope.

Discussion Endoscopically assisted surgery with angled endoscopes may offer an advantage regarding overview over the glottis in patients with difficult laryngeal exposure. The use of endoscope holding systems allows two-handed surgery. The camera connected to the endoscope also allows the use of visualization technologies, e.g. contrast enhancement or hue shifting, which may be advantageous in tissue differentiation.

Conflict of Interest

The author declares that there is no conflict of interest.

Publication History

Article published online:
24 May 2022