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Sheffield suction holder clips for endolaryngeal laser surgery

Published online by Cambridge University Press:  15 August 2013

J Manickavasagam  and
A Jebreel
J Manickavasagam*
Affiliation:
Department of Head and Neck Surgery, Royal Hallamshire Hospital, Sheffield, UK
A Jebreel
Affiliation:
Department of Head and Neck Surgery, Royal Hallamshire Hospital, Sheffield, UK Department of Paediatric ENT, Sheffield Children's Hospital, UK
*
Address for correspondence: Mr J Manickavasagam, 22 Sandygate Grange Drive, Sheffield S10 5NW, UK E-mail: jaiganeshkalpana@yahoo.co.uk
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Abstract

Background:

There has been a major evolution in laryngeal surgery, largely due to an improved understanding of disease pathogenesis and advances in technology, especially the introduction of lasers.

Method and results:

Continuous laser plume evacuation during endolaryngeal surgery improves visualisation of the surgical field. Hence, microlaryngoscopes are fitted with smoke evacuation channels on their sides. We have devised a new, simple and efficient suction holder clip for endolaryngeal surgery that has distinct advantages over other suction holders.

Keywords

LasersLarynxLaryngoscopySuction

Information

Type
Short Communications
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 9 , September 2013 , pp. 927 - 929
Copyright
Copyright © JLO (1984) Limited 2013 

Introduction

The success of laser surgery is reliant on the use of appropriate instruments which adhere to general safety precautions. Continuous evacuation of the smoke during endolaryngeal surgery improves visualisation of the surgical field. Microlaryngoscopes have been adapted for laser use by the addition of smoke evacuation channels on the sides of the laryngoscope. Although the addition of these channels enlarges the outer diameter of the laryngoscope, their presence greatly facilitates laser use.Reference Ossoff and Duncavage1, Reference Ossoff and Karlan2 However, there are drawbacks of handheld suction devices. For instance, they provide only intermittent laser plume evacuation, and because one hand of the surgeon is required to hold the suction device, their use slows the procedure. Nevertheless, continuous plume evacuation improves surgical finesse and accuracy, as particles within the smoke that can deflect or absorb the laser beam are avoided. In addition, continuous plume evacuation may lessen the likelihood of any viral particles contained within the laser plume spreading down the respiratory tract of the patient or to operating theatre personnel.Reference Courey and Ossoff3

Suction holder clip

The ideal fumes sucker for laser surgery should have the following features: it should be able to adequately suction the fumes; be readily attachable and detachable from the laryngoscope for suction in the event of bleeding; it should not obscure the view of the operating field; and it should be readily available and inexpensive.

Taking into account all of the above, the senior author devised a suction holder clip that has distinct advantages over other types of suction holders. These clips can hold various sucker sizes as they feature an expandable slit (Figures 1, 2 and 3).

Fig. 1

Views of the suction holder clip, with and without a laryngoscope, showing attachment to the sucker.

Fig. 2

(a) Aerial and (b) lateral views of the suction holder clip with a laryngoscope, showing attachment to the sucker.

Fig. 3

Sucker with suction holder clip attached.

Clip design

The clip is a strip of spring steel bent into the shape of a hair pin with a loop. A slot is present in one of the arms to hold the sucker. The clip is 4.5 cm in length. The inner and outer diameters of the suction holding slot are 3 mm and 5 mm respectively. Spring steel has a high yield strength which allows this clip to hold the laryngoscope and sucker together with grip. Further detail can be seen in the technical diagram (Figure 4).

Fig. 4

Technical diagram of the suction holder clip.

With this clip, the placement of the sucker at the proximal end of the laryngoscope and the position of the sucker tip at the distal end are both easily adjustable for optimal suction. The clip easily attaches onto any laryngoscope, without obscuring the visual field (Figure 1d). Furthermore, in the event of any bleeding, this sucker is easily detachable and can then be used for suction.

We routinely use these sucker clips in all endolaryngeal surgery. Overall, we feel that they are simple, easy to use and extremely efficient in the suctioning of fumes.

Footnotes

Presented as a poster at the 14th British Academic Conference in Otolaryngology, 4–6 July 2012, Glasgow, Scotland, UK, and at the American Academy of Otolaryngology–Head and Neck Surgery, and OTO Expo, 9–12 September 2012, Washington, DC, USA.

References

1Ossoff, RH, Duncavage, JA. Adult subglottiscope for laser surgery. Ann Otol Rhinol Laryngol 1988;97:552–3Google Scholar
2Ossoff, RH, Karlan, MS. Safe instrumentation in laser surgery. Otolaryngol Head Neck Surg 1984;92:644–8Google Scholar
3Courey, MS, Ossoff, RH. Laser applications in adult laryngeal surgery. Otolaryngol Clin North Am 1996;29:973–86Google Scholar
Figure 0

Fig. 1 Views of the suction holder clip, with and without a laryngoscope, showing attachment to the sucker.

Figure 1

Fig. 2 (a) Aerial and (b) lateral views of the suction holder clip with a laryngoscope, showing attachment to the sucker.

Figure 2

Fig. 3 Sucker with suction holder clip attached.

Figure 3

Fig. 4 Technical diagram of the suction holder clip.