Maximizing efficiency with exoscopic surgery: a versatile approach for transoral procedures| ACTA Otorhinolaryngologica Italica

Abstract

Objective

Several devices have been developed to improve head and neck surgery. 3D exoscopes provide surgeons a viable alternative to microscopes. We propose our exoscopic setting for oropharyngeal (TOEOS) and laryngeal transoral (TOELS) surgery.

Methods

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.

Results

Among 40 patients undergoing TOELS for glottic tumor, negative superficial and deep margins were achieved in 79.2% and 75.0% of patients, respectively. The mean operative time was 73.7 ± 35.9 minutes. 14 patients were treated by TOEOS and, in only one case, a positive deep margin required a re-resection. The mean operative time for TOEOS was 140.3 ± 82.1 minutes and the average hospitalization was 10.3 ± 3.8 days.

Conclusions

3D exoscopes improve visualization of the surgical site in different environments and allows the use of multiple surgical instruments and lasers, easing transoral surgery. In addition, as the first surgeon’s view is shared between the OR staff, the exoscopic setup plays a crucial role in the collaboration between the OR crew members and for teaching purposes.