Demonstration of nasopharyngeal surgery with a single port operator-controlled flexible endoscope system.

BACKGROUND Nasopharyngeal surgery is commonly performed with a rigid endoscope using a transnasal or transoral approach. Here, we demonstrate a flexible single port computer-assisted endoscopic system enabling easy transoral access to the nasopharynx. METHODS Transoral nasopharyngeal surgery was performed in human cadavers (n = 8) using the Flex System (Medrobotics, Raynham, MA). Learning curves were evaluated based on the time necessary for reaching the Eustachian tube. Mock surgical procedures were performed with compatible flexible instruments. RESULTS Nasopharyngeal surgery is feasible with the Flex System with a nontraumatic approach. The inbuilt HD digital camera enables high-quality visualization of the nasopharynx. The design of the flexible compatible tools adequately meets the requirements for surgical procedures in the nasopharynx. CONCLUSION The single port operator-controlled flexible endoscope system is a feasible way to approach the nasopharynx for surgical manipulation. Further clinical studies as well as development of supplemental tools are in progress.