Transoral laser microsurgery for the treatment of laryngeal cancer using a 3D-exoscope

Introduction: In the last decades, new technological devices and instruments have been developed to overcome the technical limits of transoral laser microsurgery (TOLS). The recent introduction of 3D-exoscopy (3Dex) seems to be a promising tool in the field of diagnostic and operative laryngology as an alternative to the traditional microlaryngoscopy applying an operating microscope (OM).

Materials & Methods: We gathered first experiences combining a 3Dex (VITOM® 3D, Karl Storz) with a CO2 laser for the treatment of glottic neoplasms two years ago and recently aquired semi-robotic holding and steering element (ARTip Cruise®, Karl Storz) for the exoscope and an attached CO2-Laser micromanipulator. A series of 3 patients with T1a glottic carcinoma was operated using a 3Dex and key parameters were compared to cases where an OM was applied.

Results: Comparison of operation time and oncological results between the 3Dex and OM groups did not reveal significant differences.

Conlcusion: The smaller viewing system, better ergonomics for the primary surgeon and the assistant and a direct view for the entire surgical team make a 3Dex an interesting alternative for visualization in TOLS.

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