L R Schild1,2, F Boehm1,2, L Kienle1,2, A Seitz3, L A Kahrs4, T M Boeckers5, J Greve1,2, T K Hoffmann1,2, P J Schuler6,7. 1. Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Centre, Frauensteige 12, 89075, Ulm, Germany. 2. Surgical Oncology Ulm, i2SOUL Consortium, Ulm, Germany. 3. Institute of Orthopaedic Research and Biomechanics, Centre for Trauma Research Ulm, Ulm University Medical Centre, Ulm, Germany. 4. Department of Mathematical and Computational Sciences, University of Toronto Mississauga, Mississauga, Canada. 5. Institute of Anatomy, Ulm University Medical Centre, Ulm, Germany. 6. Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Centre, Frauensteige 12, 89075, Ulm, Germany. patrick.schuler@uniklinik-ulm.de. 7. Surgical Oncology Ulm, i2SOUL Consortium, Ulm, Germany. patrick.schuler@uniklinik-ulm.de.
Abstract
PURPOSE: It is not always possible to create linear access to the larynx using a rigid operating laryngoscope for microlaryngoscopy. In this study, we evaluate the usability of a novel curved surgical prototype with flexible instruments for the larynx (sMAC) in a simulation dummy and human body donor. METHODS: In a user study (n = 6), head and neck surgeons as well as medical students tested the system for visualization quality and accessibility of laryngeal landmarks on an intubation dummy and human cadaver. A biopsy of the epiglottis was taken from the body donor. Photographic and time documentation was carried out. RESULTS: The sMAC system demonstrated general feasibility for laryngeal surgery. Unlike conventional microlaryngoscopy, all landmarks could be visualized and manipulated in both setups. Biopsy removal was possible. Visibility of the surgical field remained largely unobstructed even with an endotracheal tube in place. Overall handling of the sMAC prototype was satisfactorily feasible at all times. CONCLUSION: The sMAC system could offer an alternative for patients, where microlaryngoscopy is not applicable. A clinical trial has to clarify if the system benefits in clinical routine.
PURPOSE: It is not always possible to create linear access to the larynx using a rigid operating laryngoscope for microlaryngoscopy. In this study, we evaluate the usability of a novel curved surgical prototype with flexible instruments for the larynx (sMAC) in a simulation dummy and human body donor. METHODS: In a user study (n = 6), head and neck surgeons as well as medical students tested the system for visualization quality and accessibility of laryngeal landmarks on an intubation dummy and human cadaver. A biopsy of the epiglottis was taken from the body donor. Photographic and time documentation was carried out. RESULTS: The sMAC system demonstrated general feasibility for laryngeal surgery. Unlike conventional microlaryngoscopy, all landmarks could be visualized and manipulated in both setups. Biopsy removal was possible. Visibility of the surgical field remained largely unobstructed even with an endotracheal tube in place. Overall handling of the sMAC prototype was satisfactorily feasible at all times. CONCLUSION: The sMAC system could offer an alternative for patients, where microlaryngoscopy is not applicable. A clinical trial has to clarify if the system benefits in clinical routine.
Entities:
Keywords:
Curved; Flexible instruments; Laryngeal surgery; TORS; Video laryngoscope
Authors: Leon R Schild; Felix Böhm; Marco Boos; Lüder A Kahrs; Jan Coburger; Jens Greve; Lutz Dürselen; Thomas K Hoffmann; Patrick J Schuler Journal: Laryngoscope Date: 2020-06-25 Impact factor: 3.325
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