Endoscopic Transoral Hybrid Supracricoid Partial Laryngectomy with Cricohyoidoepiglottopexy
Endoscopic Transoral Hybrid Supracricoid Partial Laryngectomy with Cricohyoidoepiglottopexy
复制标题
内镜经口混合式环上喉部分切除术联合环舌骨会厌固定术
DOI：
10.1177/0003489419885139
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
Oridate Nobuhiko
中科院分区：
文献类型：
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作者：
Nakayama Meijin;Orosco Ryan K.;Holsinger F. Christopher;Spriano Giuseppe;Succo Giovanni;De Virgilio Armando;Oridate Nobuhiko
目的已描述了使用灵活的下一代机器人手术平台进行操作的混合环上喉部分切除术联合环舌骨会厌固定术（SCPL-CHEP，即开放部分水平喉切除术OPHL IIa型）。我们试图评估使用内窥镜经口（EndoT）手术技术，没有roboticsMethodsPreclinical尸体研究，使用两个人的尸体进行此程序的可行性。Hybrid SCPL-CHEP采用柔性内窥镜进行可视化，手持器械进行操作（锡尔斯钩单极和解剖，HAVAS LaryngoFIT可延展直钳口器械和Stratafix 4-0螺旋无结倒刺缝线）。手动操作的刚性器械允许经口切口和粘膜剥离。我们提供的程序步骤的EndoT混合technology.ConclusionsEndoT混合SCPL-CHEP在临床前尸体实验室设置技术上是可行的，并出现可比的混合SCPL-CHEP通过transoral机器人手术（TORS）。选定的手持仪器和灵活的内窥镜似乎有利于喉微创手术。考虑到可行性、适用性和患者受益，这种新型手术和技术需要进一步的临床研究。
ObjectivesThe hybrid supracricoid partial laryngectomy with cricohyoidoepiglottopexy (SCPL-CHEP, that is, open partial horizontal laryngectomies OPHL Type IIa) has been described using a flexible next generation robotic surgical platform for manipulation. We sought to evaluate the feasibility of performing this procedure using endoscopic transoral (EndoT) surgical techniques without robotics.MethodsPreclinical cadaveric study using two human cadavers. Hybrid SCPL-CHEP was performed with a flexible endoscope for visualization and hand-held instruments for manipulation (SILS Hook monopolar and Dissect, HAVAS LaryngoFIT malleable straight jaw instruments, and Stratafix 4-0 spiral knotless barbed suture).ResultsEndoT hybrid SCPL-CHEP was successfully performed. The hand-manipulated rigid instruments allowed for transoral incisions and mucosal suturing. We provide the procedural steps of EndoT hybrid techniques.ConclusionsEndoT hybrid SCPL-CHEP was technically feasible in the preclinical cadaveric laboratory setting and appeared comparable to the hybrid SCPL-CHEP via transoral robotic surgery (TORS). Selected handheld instruments and flexible endoscopy appear to facilitate minimally invasive surgery of the larynx. This novel procedure and technique warrant further clinical study for consideration of feasibility, applicability, and patient benefit.