KEY POINTS
- This is the first study to use a qualitative methodology to assess the
potential advantages and disadvantages of the application of 3D
endoscopes in pediatric otolaryngology surgery.
- Open-ended, structured interviews were conducted with six pediatric
Otolaryngologist operating at a tertiary pediatric centre, with a
minimum one year of experience using a 3D endoscopy system.
- Thematic analysis of the surgeon’s responses identified 3D endoscopy
to provide improved surgical field visualization which thus served as
a valuable teaching tool.
- The surgeons interviewed found 3D endoscopy to improve surgical
outcomes in pediatric airway surgery, particularly in surgeries
involving the larynx.
- Further quantitative evaluation of patient outcomes could delineate
the precise clinical role 3D endoscopy may hold in future pediatric
Otolaryngology practice.
INTRODUCTION
Three-dimensional (3D) endoscopy has emerged as a surgical tool to
improve visualization and stereoscopic vision in Otolaryngologic
surgery. The diameter of 3D endoscopes has been reduced to 4 mm, thereby
allowing surgeons to better navigate narrow anatomy while continuing to
reliably provide images of high quality and resolution. Early
peer-reviewed evaluations of the novel surgical technique have not
yielded a definitive consensus on 3D endoscopy’s utility in
Otolaryngology. Three-dimensional endoscopy was found to provide
enhanced visualization of the laryngeal structures which improved
surgical excision1. In contrast, other reports have
found no difference in clinical outcomes when using 3D over 2D endoscopy
in sinus or middle ear surgeries, although 3D endoscopy provided notably
improved anatomic visualization2,3. Despite the
discordance, such quantitative research has been confined to
experimental settings or specific clinical presentations, and has
largely failed to evaluate 3D endoscopy use in regular clinical
practice. This is the first study to use a qualitative methodology to
assess the potential advantages and disadvantages of 3D endoscope use in
pediatric Otolaryngology surgery as experienced by surgeons with regular
access to 3D endoscopic technology.
METHODS
A qualitative study design was employed to obtain an in-depth and broad
understanding of Otolaryngologists’ experiences with 3D endoscopy,
focussing on clinical advantages and challenges that they faced when
using the novel surgical equipment. A Karl Storz TipCam™ (Karl Storz
GmbH & Co, Tuttlingen, Germany) second generation 3D-high-definition,
4mm endoscopy system (0 degree, 30 degree, 45 degree) was used by all
participants with 3D glasses and appropriate personal protective
equipment. The study was approved by the Research Ethic Board at British
Columbia Children’s Hospital (BCCH). Written informed consent was
obtained from all interview participants prior to their study
participation. The study followed Standards for Reporting Qualitative
Research (SRGR) guidelines.