ビデオラリンゴスコープによる喉頭微細手術

抄録

Laryngomicrosurgery has been performed under an endoscopic video-monitoring system (“the endoscopic method”) since November 1996 at our department. This method using the Slimline type of Video-Laryngoscope (KARL STORZ, Model III) was compared with “the conventional method” using a microscope. The endoscope was connected to a TV-system to visualize the surgical field on a large monitor screen.
(1) Instruments and surgeon's position: An expensive and large microscope, which was required for surgery with the “the conventional method”, was unnecessary for surgery with “the endoscopic method”. As a result, the surgeon could easily insert, handle and fix the instruments in a comfortable position.
(2) Surgical field: “The endoscopic method” facilitated excellent visualization and recording of the entire surgical field including the instruments, while “the conventional method” suffers from two kinds of visual field defects and insufficient luminous energy resulted in poor recordings of the surgical field.
(3) Laryngeal extension: The vertical outer diameter of the Video-Laryngoscope is greater than that of the conventional smaller laryngoscope. Therefore, laryngeal extension may be more difficult during surgery using “the endoscopic method”.
“The endoscopic method” had advantages over “the conventional method” based on (1) and (2) above. I expect that the disadvantage mentioned in (3) will be easily overcome by reducing the vertical outer diameter of the Video-Laryngoscope.