Daniel T Friedrich1, Marc O Scheithauer1, Jens Greve1, Uma Duvvuri2, Fabian Sommer1, Thomas K Hoffmann1, Patrick J Schuler3. 1. Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany. 2. University of Pittsburgh Medical Center, Department of Otolaryngology, Pittsburgh, PA, USA. 3. Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany patrick.schuler@uniklinik-ulm.de.
Abstract
INTRODUCTION: Transoral surgery of the larynx is commonly performed with a rigid laryngoscope, a microscope, and a laser. We investigated the potential utility of a flexible, single-port, robot-assisted and physician-controlled endoscopic system to enable easy, transoral surgical access to the larynx. METHODS: Transoral laryngeal surgery was performed in human cadavers (n = 4) using the Flex System and compatible flexible instruments. Anatomical landmarks were identified, and mock surgical procedures were performed. RESULTS: Standard laryngeal surgical procedures were completed successfully in a human cadaver model. The built-in HD digital camera enabled high-quality visualization of the larynx. Epiglottectomy, as well as posterior cordectomy, were performed by laser and radio-frequency resection. The flexible design of the compatible tools enabled a nontraumatic approach. CONCLUSION: The Flex System has the potential to improve surgical access to the larynx, especially in patients with challenging anatomy. The associated flexible instruments enabled completion of surgical procedures in the larynx in a human cadaveric model. Further clinical studies, as well as the development of supplemental technology and tools, are recommended for future clinical applications.
INTRODUCTION: Transoral surgery of the larynx is commonly performed with a rigid laryngoscope, a microscope, and a laser. We investigated the potential utility of a flexible, single-port, robot-assisted and physician-controlled endoscopic system to enable easy, transoral surgical access to the larynx. METHODS: Transoral laryngeal surgery was performed in human cadavers (n = 4) using the Flex System and compatible flexible instruments. Anatomical landmarks were identified, and mock surgical procedures were performed. RESULTS: Standard laryngeal surgical procedures were completed successfully in a human cadaver model. The built-in HD digital camera enabled high-quality visualization of the larynx. Epiglottectomy, as well as posterior cordectomy, were performed by laser and radio-frequency resection. The flexible design of the compatible tools enabled a nontraumatic approach. CONCLUSION: The Flex System has the potential to improve surgical access to the larynx, especially in patients with challenging anatomy. The associated flexible instruments enabled completion of surgical procedures in the larynx in a human cadaveric model. Further clinical studies, as well as the development of supplemental technology and tools, are recommended for future clinical applications.
Authors: Daniel T Friedrich; L Dürselen; B Mayer; S Hacker; F Schall; J Hahn; T K Hoffmann; P J Schuler; J Greve Journal: J Robot Surg Date: 2017-05-03
Authors: Daniel T Friedrich; M O Scheithauer; J Greve; N Rotter; J Doescher; T K Hoffmann; P J Schuler Journal: Eur Arch Otorhinolaryngol Date: 2017-02-24 Impact factor: 2.503