Modified Larssen solution (MLS)-fixed cadaver model for transoral endoscopic thyroidectomy vestibular approach (TOETVA) education: a feasibility study

Çelik, Servet; Bilge, Okan; Özdemir, Murat; Dionigi, Gianlorenzo; Anuwong, Angkoon; Makay, Özer

doi:10.1007/s00464-022-09224-8

Cited by 4 publications

(3 citation statements)

References 39 publications

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“…The study showed that this solution has suitable organoleptic properties, flexible tissue preservation, and better efficacy for TOETVA. 11 Moreover, a median port seems to be safer than lateral ports in both cadavers; it should be taken into account that the measurements were performed under traction (Fig. 5).…”

Section: Discussionmentioning

confidence: 97%

“…In addition, ethical approval was obtained from our Institutional Review Board (approval number 22-3T/8). Three modified Larssen solution (MLS)-embalmed human cadavers suitable for surgical training and research were used 10,11 and 2 soft embalmed human cadavers without prior neck surgery were used for SP application. To compare a single port with standard TOETVA, a conventional TOETVA operation was performed on another cadaver by surgeons G.D., O.M., and M.O.…”

Section: Methodsmentioning

confidence: 99%

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A Feasible Technique for Transoral Endoscopic Thyroidectomy Through Vestibular Access Using a Single-port Technique

Karimov

Türk

Özdemir

et al. 2023

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Background: The aim of this study was to evaluate the safety and feasibility of a single-port system for transoral endoscopic thyroidectomy with vestibular access (TOETVA). Materials and Methods: Two embalmed human cadavers were used to test the single-port technique. After positioning, a median vestibular incision was made. Adipose tissue was dissected through the mentum with a Kelly clamp to reach the subplatysmal level. The Keyport Single Port System (Richard Wolf) was then inserted. After port placement, flexible endoscopic dissectors and a 5-mm endoscope were advanced. After removing the dissectors, we inserted the ArtiSential laparoscopic instruments. We also used a 3-port TOETVA on another human cadaver to compare the results with those of the single-port surgery. Results: In the first cadaver, skin tension was observed during trocar insertion and dissection. Trocar insertion resulted in skin perforation in the submental area. In the second cadaver, the single-port trocar was successfully inserted despite the significant skin tension. However, the trocar did not allow the necessary surgical maneuvers to proceed with subsequent surgical steps and create a working space. Postprocedural anatomic dissection revealed that the distal branches of the mental nerve were related to the trocar passage. Conclusions: Our cadaver study demonstrated that single-port TOETVA is unsafe and not feasible with the current technology of the Keyport single-port system. This approach needs to be improved to perform this technique without injury to distal branches of the mental nerve, skin perforation, and other complications.

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Section: Discussionmentioning

confidence: 97%

Section: Methodsmentioning

confidence: 99%

A Feasible Technique for Transoral Endoscopic Thyroidectomy Through Vestibular Access Using a Single-port Technique

Karimov

Türk

Özdemir

et al. 2023

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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“…This solution consists of phenol, glycerol, ethanol, and sodium chloride, which offer a different approach to cadaveric preservation. 9 The modified Larssen solution has been reported to provide satisfactory tissue preservation while using lower concentrations of formaldehyde than traditional formalin-based methods. This reduction in formaldehyde concentration can help to mitigate the health risks associated with formaldehyde exposure, making the modified Larssen solution a safer alternative for students and faculty involved in dissection activities.…”

Section: Modified Larssen Solutionmentioning

confidence: 99%

Alternative natural and chemical substances to traditional formalin-based embalming fluid for cadaveric dissection: A review

Satapathy

Kar

2023

IJCAP

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Formalin, a widely used embalming fluid in the preservation of cadavers, poses significant health risks to anatomists, medical students, and the environment. This review article evaluates alternative natural and chemical substances for embalming fluid in cadaveric dissection. We conducted a comprehensive literature search on PubMed, Scopus, and Web of Science, focusing on alternative embalming fluids in the past 20 years. The main outcome of interest was the effectiveness of alternative fluids in preserving cadavers for dissection. The review identified several alternatives, including Thiel's solution, modified Larssen solution, Genelyn, and natural alternatives such as honey and essential oils. Thiel's solution has emerged as a popular alternative, providing excellent preservation and flexibility of cadavers. However, the high costs and the need for specialized equipment limit its widespread adoption. Essential oils and honey have also shown potential as effective, environmentally friendly alternatives to formalin. Future research should optimise the composition and application of these alternatives to improve their cost-effectiveness, feasibility, and environmental impact.

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Transoral Endoscopic Thyroidectomy Vestibular Approach: Lessons from a Five Years’ Experience

Zhang,

Dionigi,

Frattini

et al. 2023

Updates in Surgery

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Modified Larssen solution (MLS)-fixed cadaver model for transoral endoscopic thyroidectomy vestibular approach (TOETVA) education: a feasibility study

Cited by 4 publications

References 39 publications

A Feasible Technique for Transoral Endoscopic Thyroidectomy Through Vestibular Access Using a Single-port Technique

A Feasible Technique for Transoral Endoscopic Thyroidectomy Through Vestibular Access Using a Single-port Technique

Alternative natural and chemical substances to traditional formalin-based embalming fluid for cadaveric dissection: A review

Transoral Endoscopic Thyroidectomy Vestibular Approach: Lessons from a Five Years’ Experience

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