Endoscopic Transoral Hybrid Supracricoid Partial Laryngectomy with Cricohyoidoepiglottopexy

Meijin Nakayama, Ryan K Orosco, F Christopher Holsinger, Giuseppe Spriano, Giovanni Succo, Armando De Virgilio, Nobuhiko Oridate

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVES: The 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.

METHODS: Preclinical 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).

RESULTS: EndoT 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.

CONCLUSIONS: EndoT 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.

Original languageEnglish
Pages (from-to)273-279
Number of pages7
JournalAnnals of Otology, Rhinology and Laryngology
Volume129
Issue number3
DOIs
Publication statusPublished - Mar 2020

Keywords

  • Aged, 80 and over
  • Cadaver
  • Cricoid Cartilage/surgery
  • Epiglottis/surgery
  • Feasibility Studies
  • Humans
  • Hyoid Bone/surgery
  • Laryngeal Neoplasms/surgery
  • Laryngectomy/methods
  • Male
  • Natural Orifice Endoscopic Surgery/instrumentation
  • Neck Muscles/surgery

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