A novel assistant system for transoral surgery of the larynx

Introduction

Transoral laser surgery is the standard procedure in the treatment of larynx cancer. However, the compulsory overstretching of the cervical spine to establish a straight line of sight is not feasible for all patients. A non-linear assistance system could provide better access to the larynx in these patients.

Methods

We present the prototype of a self-designed assistance system for transoral larynx surgery. The 3D-printed prototype is a non-linear laryngoscope with three channels for a flexible video laryngoscope and two flexible instruments. Access and visualization of the larynx were evaluated in a user study (n = 19) in an animal model and on an intubation dummy. In addition, sham surgical procedures were carried out on a human donor body.

Results

In the animal model, the time to reach all anatomical landmarks in the larynx correlated with the experience of the participants (49s vs. 91s). Bringing the surgical instruments into the optimal position for a simulated cordectomy, the time was 128s ± 32s. In the intubation dummy, access to the larynx was still possible even after the cervical spine reclination was restricted. In the case of human donors, the prototype was superior to a standard laryngoscope for displaying the larynx.

Summary

In preclinical tests, the surgical assistance system offers the possibility of manipulating larynx structures non-linearly. In the future, this may represent a cost-effective, minimally invasive alternative in the case of insufficient larynx exposure. A clinical pilot study will be initiated based on these results.

Lumendi Ltd. und Karl Storz SE & Co. KG

Conflict of InterestDer Erstautor weist auf folgenden Interessenkonflikt hin: Materielle Unterstützung durch Lumendi Ltd. und Karl Storz SE & Co. KG

Publication History

Article published online:
24 May 2022