A Novel Instrument Holder to Improve Operative Efficiency in Endoscopic Laryngeal and Airway Surgery

• Published in: The Laryngoscope 2023-12, Vol.133 (12), p.3492-3498
• Main Authors: Jain, Aseem, Adams, Sarah M, Hale, Isaac, Voskoboynik, Anna, Sissoko, Cheick, Bugada, Matthew, Dion, Gregory R, Howell, Rebecca J, Friedman, Aaron D
• Format: Article
• Language: English
• Subjects: Endoscopy; Humans; Laryngoscopes; Larynx - surgery; Operating Rooms; Surgical Instruments
• ISSN: 0023-852X; 1531-4995
• DOI: 10.1002/lary.30835

Receiving instruments from surgical technicians during endoscopic laryngeal and airway microsurgery (ELAM) has challenges including repeated, expeditious handling of delicate instruments and passing them to the surgeon's hand opposite of where the surgical assistant is standing. Optimizing this interaction may reduce surgical errors and improve operative efficiency. A proprietary ELAM instrument holder was attached to both sides of the operating room bed. The device consisted of an articulating arm with custom silicone inserts mounted on a tray (storing up to three endoscopic instruments). ELAM cases were randomized to be performed either with (device) or without the holder (control). Using custom software, instrument pass time (IPT), instrument drop rate (IDR), and communication errors (eg handing incorrect instruments) were manually recorded. Qualitative use metrics relating to overall device satisfaction were also obtained. Data were collected from 25 device and 23 control cases among three different laryngologists. Average IPT was nearly three times quicker for the device (0.80 s, n = 1175 passes) compared with controls (2.09 s, n = 1208 passes) [p