Adopting Chopsticks Technique in Endoscopic Ear Surgery - An Alternative to Single-handed Operations
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AbstractEndoscopic Ear Surgery (EES) is gaining increased attention in the field of otology operations. Being highly successful in the surgical management of middle ear pathologies through various techniques with otological outcomes comparable to traditional methods. Even lateralskull base approaches for the management of acoustic
neuromas can be performed safely with EES. Although EES is becoming more common, the single-handed operation continues tohinder the adoption of ESS. With the conventional training in microscopic surgery using both hands, single-handed ESS imposes a psychological and a training barrier. The narrow external auditory canal limits the number of instruments and the movement of the instruments and theendoscope. EES requires one hand to hold
the endoscope, leaving only one hand available for theoperation. The challenge of a single-handed operation is especially obvious with bleeding, wherethere is a frequent need to switch and clean instruments resulting in a more cumbersome andpotentially longer operation time while the learning curve is being traversed. In light of the benefits brought by ESS in otology, a technique mimicking the use of chopsticks provides a solution to single handed
EES. Chopsticks are shaped as a pair of equal-length sticks, and have been used as kitchen and eating utensils in the Orient for over six centuries. Thistechnique was first described in laparoscopic surgery [1,2]. Similarly, in the field of otorhinolaryngology, the chopsticks technique with an endoscope and suction for functional endoscopic sinus surgery was also described to reduce time for suction and improve operative field visualization [3]. During tonsillectomy, the chopsticks technique allows simultaneous use of two instruments held in one hand [4]. During EES,
the narrow ear canal severely limits the use of multiple instruments and requires frequent changeover of instruments. The chopsticks technique allows surgeons to hold and operate two instruments in one hand. It can conveniently perform various surgical operations in a timely fashion without the need of conversion between two instruments.
The operation duration can be shortened as the two instruments can perform various surgical operations, leading to less swapping of instruments, easier control of bleeding and manipulated tissue. Here we depict the chopsticks technique in EES to address the challenges faced by a single-handed operation during EES and to allow the operation to progress efficiently by switching between various types of instruments during EES.
Acceptance Date08/09/2020
All Author(s) ListWai Tsz Chang, Michael CF Tong
Journal nameHSOA Journal of Otolaryngology, Head & Neck Surgery
Volume Number6
Issue Number2
PublisherHerald Scholarly Open Access
Place of PublicationUSA
Article number100046
LanguagesEnglish-United Kingdom
Keywordschospstick technique, endoscopic ear surgery, new surgical technique, single hand operation

Last updated on 2021-11-09 at 00:01