Laser-assisted surgery of the upper aero-digestive tract: a clarification of nomenclature. A consensus statement of the European Laryngological Society

Abstract

Acronyms and abbreviations are frequently used in otorhinolaryngology and other medical specialties. CO2 laser-assisted transoral surgery of the pharynx, the larynx and the upper airway is a family of commonly performed surgical procedures termed transoral laser microsurgery (TLM). The abbreviation TLM can be confusing because of alternative modes of delivery. Classification and definition of the different types of procedures, performed transorally or transnasally, are proposed by the Working Committee for Nomenclature of the European Laryngological Society, emphasizing the type of laser used and the way this laser is transmitted. What is usually called TLM, would more clearly be defined as CO2 laser transoral microsurgery or CO2 TOLMS or CO2 laser transoral surgery only (with a handpiece) would be defined as CO2 TOLS. KTP transnasal flexible laser surgery would be KTP TNFLS. Transoral use of the flexible CO2 wave-guide with a handpiece would be a CO2 TOFLS. One can argue that these clarifications are not necessary and that the abbreviation TLM for transoral laser microsurgery is more than sufficient. But this is not the case. Laser surgery, office-based laser surgery and microsurgery are frequently and erroneously interchanged for one another. These classifications allow for a clear understanding of what was performed and what the results meant.

Teleoperated tubular continuum robots for transoral surgery – feasibility in a porcine larynx model

“…Methods for patient‐ or application‐specific optimization of the tube shape could be used to determine dedicated tube designs for future studies in the larynx . Transoral laser microsurgery is an established technique, especially in Europe, and it is broadly adopted in the surgical therapy of laryngeal neoplasms of a certain size . This generates a high demand for competing techniques, and patient selection has always been crucial to exploit the benefits of robotic approaches .…”

“…[40][41][42] Transoral laser microsurgery is an established technique, especially in Europe, and it is broadly adopted in the surgical therapy of laryngeal neoplasms of a certain size. 43 This generates a high demand for competing techniques, and patient selection has always been crucial to exploit the benefits of robotic approaches. 44 Therefore, patients with challenging anatomy and impeded access caused by trismus or spine rigidity could benefit from flexible techniques, and direct visualization facilitates orientation in the surgical field, compared to the linear perspective through the microscope.…”

Laryngeal Mid-Cord Erythroleukoplakias: How to Modulate the Transoral CO2 Laser Excisional Biopsy

“…A retrospective study was carried out, enrolling 147 previously untreated patients (male/female ratio, 5/1; mean age, 66 years; age range, 25-88 years), 139 (94.5%) of whom were affected by unilateral mid-cord erythroleukoplakias, and 8 (5.5%), by bilateral mid-cord lesions without involvement of the anterior commissure, who underwent a total of 155 excisional biopsies by transoral CO 2 laser microsurgery (CO 2 TOLMS according to the ELS nomenclature [14]). The procedures were performed between January 2012 and December 2016 at the Departments of Otorhinolaryngology-Head and Neck Surgery at the Universities of Genoa (N = 111) and Cagliari (N = 44), Italy.…”

Intraoperative Surgical Complications in Transoral Laser CO2 Microsurgery of the Larynx: An Observational, Prospective, Single-Center Study

“…11 Technique report was done according to the consensus nomenclature of ELSOC. 12 In the case of small tumors (T1a, T1b), if possible, en bloc resection was attempted, and after resection, the piece was pinned and oriented in a corkboard.…”