Friedrich Daniel T, Scheithauer Marc O, Greve Jens, Duvvuri Uma, Sommer Fabian, Hoffmann Thomas K, Schuler Patrick J
Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany.
University of Pittsburgh Medical Center, Department of Otolaryngology, Pittsburgh, PA, USA.
Ann Otol Rhinol Laryngol. 2015 Aug;124(8):655-62. doi: 10.1177/0003489415575548. Epub 2015 Mar 10.
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.
喉部经口手术通常使用硬质喉镜、显微镜和激光进行。我们研究了一种灵活的、单端口、机器人辅助且由医生控制的内镜系统在实现经口轻松进入喉部进行手术方面的潜在效用。
使用Flex系统和兼容的柔性器械在人体尸体（n = 4）上进行经口喉部手术。识别解剖标志，并进行模拟手术操作。
在人体尸体模型中成功完成了标准的喉部手术操作。内置的高清数字摄像头能够对喉部进行高质量可视化。通过激光和射频切除术进行了会厌切除术以及后声带切除术。兼容工具的灵活设计实现了无创入路。
Flex系统有潜力改善喉部手术的入路，尤其是对于解剖结构复杂的患者。相关的柔性器械能够在人体尸体模型中完成喉部手术操作。建议进行进一步的临床研究以及开发补充技术和工具，以用于未来的临床应用。
