Vivo Surgical had the pleasure of hosting our first Virtual Roundtable Discussion: Superior Illumination for Head & Neck Surgeries with Prof N Gopalakrishna Iyer, Head and Senior Consultant in the Department of Head and Neck Surgery at National Cancer Centre Singapore and Singapore General Hospital. Prof Gopal has extensive experience in the surgical management of head and neck cancers and performs complex resections and reconstructions of cancers.
As one of the inventors and users of KLARO™, Prof Gopal shared insights on various Head & Neck / Oral Maxillofacial surgical procedures such as marginal mandibulectomy, maxillectomy, partial glossectomy and neck surgery, where improved illumination and reduced shadows allowed for clearer visualisation of surgical margins and more precise incisions.
“The light is right in the cavity, so if you have instruments that are short or that are very close to the oral cavity (e.g piezoelectric saw), you don’t have an issue because you don’t block the light as the light is from the inside.”
During his presentation on KLARO™, he discussed the flexibility of choosing different retractors or moving KLARO™ to different positions for various procedures or surgical methodologies. For maxillectomy in particular, KLARO™ can be mounted onto a tongue depressor in a fixed position because the light can effectively illuminate the maxilla, with the margins clearly marked out, allowing clear visualisation of the saw blade during cutting. Having this lighting option available is useful in narrow surgical spaces, such as the oral cavity, where not much light penetrates in or when frequent light repositioning is required when using a conventional spotlight.
A key point that was shared was about how although good retraction alone can be effective for improving visualisation within the oral cavity, lighting from the outside when doing bone cuts is always an issue since light travels in a straight line and will not be able to illuminate regions that are behind flaps or are at a curved angle. In such cases, KLARO™ can be considered a superior alternative to both overhead operating theatre lights and headlights.
In neck surgery, the light from KLARO™ helps the surgeon to visualise and identify key anatomy structures and clearly distinguish between the fat and muscle layers. Prof Gopal highlighted that KLARO™ will be advantageous in level IA as well as deep cavity level IIB dissections, where he can visualise the areas under flaps using smaller incisions, especially in situations where there is minimal surgical assistance and insufficient retraction. He further discussed the possibility of also using KLARO™ for thyroid surgery, where small incisions are made to see around the corners of the cavity.
An interactive live Question and Answer (Q&A) session was also held where Prof Gopal addressed questions on which surgical margins were easier to visualise with KLARO™, which lighting setting he often used, the effectiveness of mounting the KLARO™ light strip onto different retractors, whether there is still a need to use headlights, how to angle the KLARO™ light strip optimally and which other surgical specialities will KLARO™ be beneficial in.
“There are certain locations where the headlights may still be important, but if you know how to angle the KLARO™ in the oral cavity especially, it is really good.”
Notably, Prof Gopal also mentioned the adaptability of KLARO™ for use In humanitarian missions such as in military and combat zones where access to good lighting is limited. KLARO™ could be a potential solution since it is a self-sustaining device which comes with its own battery pack and thus is not reliant on external power sources.
Attendees of this virtual discussion included Italian surgeons from a wide range of surgical specialties such as Otorhinolaryngology, ENT, Vascular and General Surgery.
Interested to watch the full video recording of this Virtual Roundtable Discussion? Head over to our YouTube page for access to this video and all our other related videos -
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