Viola Hahn (Ulm), Patrick J. Schuler (Ulm), Gabriel Gschwend (Ulm), Linus Kienle (Ulm), Leon Schild (Ulm), Jens Greve (Ulm), Thomas Hoffmann (Ulm), Felix Böhm (Ulm)
Introduction: This study presents a hybrid model for preclinical testing and surgical training of the novel hyperangulated laryngoscope for surgery (sMAC). In cases where transoral laser microsurgery (TLM) using the conventional Kleinsasser operating laryngoscope faces challenges, such as limited cervical spine mobility or post-radiation changes, the sMAC offers a potential solution. This study aims to create a suitable preclinical model for testing the sMAC instrument, focusing on surgical training.
Methods: A hybrid model was developed by integrating a porcine larynx into a plastic airway manikin. Then the sMAC, which design is based on a hyperangulated videolaryngoscope with additional working channels, was used by trained surgeons and residents to perform endolaryngeal cordectomies on the model. Additionally, vocal folds were marked blue to simulate a laryngeal lesion or tumor, and the resection of the blue marked areas were performed.
Results: The assembly of the setup was efficient and provided clear visual exposure of the glottic plane. The model allowed the straightforward exchange of porcine larynges. The sMAC system enabled precise surgical interventions, and trained surgeons as well as untrained residents successfully performed cordectomies and biopsies of blue marked areas in the larynx-manikin model.
Conclusion: The hybrid model offers a realistic and cost-effective solution for training and testing endolaryngeal surgical procedures, especially with the sMAC laryngoscope. Although there are minor anatomical differences between porcine and human larynges, the model's affordability and similarity to human tissue make it a valuable tool for training and development. Further studies are needed to assess its utility for training inexperienced surgeons.
The authors thank Lumendi Ltd. for providing flexible instruments. The study was supported by the German Research Foundation (DFG, #491516763).