Abstract
Background: Coblation based bipolar plasma devices are designed to operate at a relatively low temperature to gently dissolve and/or shrink target tissue with minimal thermal damage to surrounding healthy tissue. Coblation technology provides ablation, resection, coagulation of soft tissue and hemostasis of blood vessels in one convenient surgical device. Coblation technology can be used in the larynx and trachea for removing or debulking sessile polyps, lesions or tumors. Minimally invasive coblation technology can offer less invasive treatment with quicker recovery and shorter hospitalization. Aim: This case study aims to explore the advantages of coblation combined with microscopy to treat benign laryngeal lesions. Case report: We report the case of laryngeal papilloma treated with minimally invasive coblation resection. Fiberoptic laryngoscopy was done pre-operatively and that showed papillomatous mass at anterior half of right vocal cord involving inferior surface and also extending upto anterior commissure. Mobility of both vocal cords was normal. On the basis of the above findings with normal vocal cords mobility, the microlaryngeal surgery with coblation was planned. After complete pre-op work up, the patient underwent trans-oral microscopic coblation excision of mass under general anaesthesia. Power level was set to 7 for ablation and 3 for coagulation. The PROciseTM LW Plasma Wand system was chosen such that it was malleable to reach the papillomatous mass without obstructing the vision. It was totally excised and sent for histopathology examination. Post-operatively after four hours, he was able to take normal diet comfortably. He was followed up after 10 days. Histopathological report confirmed the diagnosis of papilloma. Check laryngoscopy was performed after 3 weeks. Laryngeal examination was absolutely normal with almost normal vocal cords and normal voice post-operatively. Conclusion: Microscopic surgery with coblation has the advantages of less bleeding, short procedure duration, increased completion rate and few complications.
Highlights
Benign neoplasms of the larynx constitute an interesting array of lesions that produces symptoms which can vary from mild hoarseness to life threatening stridor
Coblation technology can be used in the larynx and trachea for removing or debulking sessile polyps, lesions or tumors
The PROciseTM LW Plasma Wand is designed for controlled removal of bulky, and sessile laryngeal lesions
Summary
Benign neoplasms of the larynx constitute an interesting array of lesions that produces symptoms which can vary from mild hoarseness to life threatening stridor. These lesions can create a lot of mental and emotional tension in the patient and the family [1]. In the last few years, different techniques have been proposed to reduce morbidity and surgical risk. The PROciseTM LW Plasma Wand is designed for controlled removal of bulky, and sessile laryngeal lesions. It provides ablation, coagulation, irrigation, and suction capabilities in one versatile single-use device [6]
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