Marchi Filippo, Bellini Elisa, Ioppi Alessandro, Iandelli Andrea, Filauro Marta, Sampieri Claudio, Parrinello Giampiero, Laborai Andrea, Mora Francesco, Castello Eolo, Peretti Giorgio
IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy.
Acta Otorhinolaryngol Ital. 2024 Dec;44(6):368-376. doi: 10.14639/0392-100X-N2958.
Several devices have been developed to improve head and neck surgery. 3D exoscopes provide surgeons a viable alternative to microscopes. We propose our setting for transoral exoscopic oropharyngeal (TOEOS) and transoral exoscopic laryngeal surgery (TOELS).
A case series of patients treated with the exoscopic setup at the Otolaryngology Unit of IRCCS San Martino Hospital, Genoa, is presented. Our surgical setup and surgical and oncological outcomes are described.
Among 40 patients undergoing TOELS for glottic and supraglottic tumours, negative superficial and deep margins were achieved in 79.2% and 75% of patients, respectively. The mean operative time was 73.7 ± 35.9 minutes. Fourteen patients were treated by TOEOS and in only one case was re-resection required due to a positive deep margin. The mean operative time for TOEOS was 140.3 ± 82.1 minutes and the average duration of hospitalisation was 10.3 ± 3.8 days.
3D exoscopes improve visualisation of the surgical site in different environments and allow the use of multiple surgical instruments and lasers, easing transoral surgery. In addition, as the first surgeon's view is shared between the operatory room (OR) staff, the exoscopic setup plays a crucial role in the collaboration between the OR team and for teaching purposes.
已开发出多种设备以改善头颈外科手术。3D 外视镜为外科医生提供了一种可行的显微镜替代方案。我们介绍我们进行经口外视镜下口咽手术（TOEOS）和经口外视镜下喉手术（TOELS）的情况。
介绍了在热那亚 IRCCS 圣马蒂诺医院耳鼻喉科使用外视镜设备治疗的一系列病例。描述了我们的手术设置以及手术和肿瘤学结果。
在 40 例接受 TOELS 治疗声门和声门上肿瘤的患者中，分别有 79.2%和 75%的患者实现了切缘浅部和深部阴性。平均手术时间为 73.7±35.9 分钟。14 例患者接受了 TOEOS 治疗，仅 1 例因深部切缘阳性需要再次切除。TOEOS 的平均手术时间为 140.3±82.1 分钟，平均住院时间为 10.3±3.8 天。
3D 外视镜可改善不同环境下手术部位的可视化，并允许使用多种手术器械和激光，简化了经口手术。此外，由于手术室（OR）工作人员可以共享主刀医生的第一视角，外视镜设置在手术室团队协作和教学方面发挥着关键作用。
