Potential Advantages of a Single-Port, Operator-Controlled Flexible Endoscope System for Transoral Surgery of the Larynx

The Annals of Otology, Rhinology, and Laryngology
Daniel T FriedrichPatrick J Schuler

Abstract

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. 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. 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. 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.

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Citations

Aug 13, 2015·Journal of Surgical Oncology·Peter T DziegielewskiEnver Ozer
Mar 19, 2016·The International Journal of Medical Robotics + Computer Assisted Surgery : MRCAS·Daniel T FriedrichPatrick J Schuler
May 20, 2016·The International Journal of Medical Robotics + Computer Assisted Surgery : MRCAS·Patrick J SchulerMarc O Scheithauer
Aug 12, 2016·HNO·T K HoffmannP J Schuler
Jun 21, 2018·The International Journal of Medical Robotics + Computer Assisted Surgery : MRCAS·D T FriedrichJ Burgner-Kahrs
Feb 24, 2019·Japanese Journal of Clinical Oncology·Meijin NakayamaRyan K Orosco
Nov 3, 2016·Current Opinion in Otolaryngology & Head and Neck Surgery·Steven Dirven, Jacqui E Allen
Oct 22, 2019·International Forum of Allergy & Rhinology·Raewyn G Campbell
Feb 27, 2017·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·Daniel T FriedrichP J Schuler
May 5, 2017·Journal of Robotic Surgery·Daniel T FriedrichJ Greve
May 20, 2020·Robotic Surgery : Research and Reviews·Talisa RossZaid Awad
Jan 17, 2019·International Journal of Computer Assisted Radiology and Surgery·Max-Heinrich LavesTobias Ortmaier
Dec 19, 2020·Current Opinion in Otolaryngology & Head and Neck Surgery·Raewyn G Campbell, Richard J Harvey

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Methods Mentioned

BETA
dissector
dissection

Software Mentioned

Flex System
Flex
TORS

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