Other necessary instruments for TOUSS
An articulated arm to secure and stabilize the video-endoscope will be needed. This way the frame will be easily adjusted during the intervention.
A suction device will be also important to use in this procedure, to remove the aerosol substance generated by the ultrasounds and to keep the tissue clean.
To manouver the tissue we use the regular instruments used in a laparoscopy (mosquito forceps, needle holders…)
The new FLEXDEX articulated instruments allow the stitching of the neopharynx and cervical fistulas in a much easier way.
The patient is placed in supine position. Cervical extension will be avoided so the pharynx is as surgically available as possible
The ventilator and the anaesthesiologist will be in the left side of the patient. After the general anaesthesia is applied, the articulated arm will also be stationed on the left side. This is meant to not disturb the interaction between the theatre nurse (placed on the right side) and the surgeon (at the head of the station).
At the beginning the assistant will go right or left of the surgeon.
The ultrasound/bipolar energy generator will be positioned at the foot of the table and, to its right, the endoscopic tower. This way, the access to both will be best. The tower’s monitor has an articulated arm that can be used to station everything on the table in a more accessible place for the surgeon.
The instrument table will also be at the foot of the table and oriented to the monitor, so that the theatre nurse can follow along the procedure