Exolaryngoscopy: a new technique for laryngeal surgery

Area of Science:

• Otolaryngology
• Surgical Technology
• Endoscopic Procedures

Background:

• Traditional operating microscopes are standard in endoscopic laryngeal surgery.
• Limitations include surgeon ergonomics and visualization constraints.
• Novel visualization systems are needed to improve surgical outcomes and comfort.

Purpose of the Study:

• To evaluate a high-definition endoscopic video system (exoscope) as an alternative to the operating microscope in endoscopic laryngeal surgery.
• To assess the system's economic viability, visualization capabilities, and impact on surgeon comfort.
• To explore its utility with various surgical instruments and imaging techniques.

Main Methods:

• An extracorporeal optical system (exoscope) was positioned 25 cm from the surgical field, replacing the operating microscope.
• Standard microsurgical instruments and CO2 laser were utilized with the exoscope.
• Narrow Band Imaging (NBI) for auto-fluorescence was employed for lesion visualization.
• 12 patients with benign and malignant vocal cord pathologies were treated.

Main Results:

• The exoscope system provided optimal vision and enhanced surgeon comfort and ease.
• All 12 patients with vocal cord pathologies achieved the predicted surgical results.
• The system demonstrated potential advantages in surgical workflow and patient outcomes.
• Narrow Band Imaging facilitated visualization of precancerous and cancerous lesions.

Conclusions:

• The high-definition endoscopic video system is a cost-effective and effective alternative to the operating microscope for endoscopic laryngeal surgery.
• It offers significant improvements in surgeon ergonomics and visualization.
• The system shows promise for treating a range of vocal cord pathologies, including cancerous lesions.