Development and testing of a surgical assistant for transoral laryngeal surgery

• Applicant: Professor Dr. Patrick Johannes Schuler
• Subject Area: Otolaryngology, Phoniatrics and Audiology ; Medical Physics, Biomedical Technology
• Term: since 2022
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 491516763

In laryngeal carcinoma, standard therapy often involves surgical intervention, depending on the stage of the tumor. In the operation, a transoral approach should be preferred. However, in about 10-15% of the current cases, the opening of the neck from the outside is necessary as no suitable instruments or technologies are available. In about 15% of cases with laryngeal cancer, the results of the operation are suboptimal because transoral visualization of the larynx is inadequate. In these patients, complications or limitations in the operational process are unavoidable. Due to the suboptimal therapy, pronounced follow-up operations including the complete laryngectomy are necessary. In addition, there is currently a significant deficit in the early diagnosis of precancerous lesions and tumors of the upper airway. Patients are therefore treated too late, often resulting in total resection of the affected area with significant loss of function.Transoral robot-assisted surgery (TORS) aims to improve the treatment of patients with pathologies in the cervical region. Two clinically approved systems are currently available for this purpose (DaVinci®, Flex®). It should be noted, however, that both robotic systems unfortunately do not meet all surgical requirements, and we still see an urgent need for improvement in order to carry out the various surgical interventions in the larynx optimally. The requirements include secure access to the glottic and subglottic levels, compatibility with various assistance systems and fine mechanical manipulation of tissue structures.The proposed project investigates and integrates new assistive technologies for the treatment of laryngeal carcinoma in order to provide each patient with the best possible care. In a modular mode of operation, aspects of an experimental system for transoral surgery will be evaluated. Fundamental examination of an ideal non-linear approach will be performed to provide access to the larynx. Further research questions on optimized laryngeal treatment are subdivided into the integration of a laser instrument for atraumatic tissue resection, the identification of potential surgical risks and the introduction of virtual reality. Finally, the implementation of a clinical study will be prepared.

• DFG Programme: Research Grants