Giotakis Aris I, Giotakis Evangelos I, Kyrodimos Efthymios
First Department of Otorhinolaryngology, Hippocrateion General Hospital, 115 27 Athens, Greece.
J Clin Med. 2024 Jan 16;13(2):507. doi: 10.3390/jcm13020507.
Transoral pharyngeal surgery is mainly feasible with the use of a microscope or robotic systems. Data about alternative methods, with lower costs and easier availability, are sparse. We intended to examine to what extent the endoscope-holding arm is a suitable alternative to the microscope or robotic systems.
We retrospectively reviewed subjects who underwent pharyngeal tumor resection with the endoscope-holding arm in our university department.
We identified 13 subjects who underwent transoral pharyngeal surgery between November 2020 and November 2023. Most subjects presented with an oropharyngeal tumor (6/11 in the lateral wall or tonsil; 4/11 in the tongue base). The oropharyngeal lateral wall or tonsillar tumors were exposed with a standard mouth gag. The tongue-base tumors or hypopharyngeal tumors were exposed with an operating laryngoscope. Advantages over the microscope included an angled view. Advantages over robotic systems included haptic feedback and a faster setup. Advantages over both the microscope and robotic systems included lower costs and easier availability. Visualization with the endoscope was sufficient and similar to that of the microscope. Bimanual action was possible with surgical forceps and a monopolar electrode.
Transoral pharyngeal surgery was feasible with the endoscope-holding arm. The endoscope-holding arm could be a cost-efficient alternative to the microscope or robotic systems.
经口咽手术主要借助显微镜或机器人系统来实施。关于成本更低且更易获取的替代方法的数据较为匮乏。我们旨在探究持内镜臂在多大程度上可作为显微镜或机器人系统的合适替代方案。
我们回顾性分析了在我校科室接受持内镜臂下咽肿瘤切除术的患者。
我们确定了13例在2020年11月至2023年11月期间接受经口咽手术的患者。大多数患者患有口咽肿瘤（侧壁或扁桃体肿瘤6例/11例；舌根肿瘤4例/11例）。口咽侧壁或扁桃体肿瘤通过标准口咽通气道暴露。舌根肿瘤或下咽肿瘤通过手术喉镜暴露。相对于显微镜的优势包括视角呈一定角度。相对于机器人系统的优势包括触觉反馈和更快的设备设置。相对于显微镜和机器人系统两者的优势包括成本更低且更易获取。内镜的视野足够，与显微镜的视野相似。使用手术钳和单极电极可进行双手操作。
持内镜臂下经口咽手术是可行的。持内镜臂可作为显微镜或机器人系统的一种经济高效的替代方案。
