E.N.T. Hack: Southampton Panendoscopy Kit Organiser. How We Do It?

E.N.T. Hack: Southampton Panendoscopy Kit Organiser. How We Do It? | Authorea try { document.documentElement.classList.add('js'); } catch (e) { } var _gaq = _gaq || []; _gaq.push(['_setAccount', 'G-8VDV14Y67G']); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js'; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s); })(); Skip to main content Preprints Collections Wiley Open Research IET Open Research Ecological Society of Japan All Collections About About Authorea FAQs Contact Us Quick Search anywhere Search for preprint articles, keywords, etc. Search Search ADVANCED SEARCH SCROLL This is a preprint and has not been peer reviewed. Data may be preliminary. 11 February 2025 V1 Latest version Share on E.N.T. Hack: Southampton Panendoscopy Kit Organiser. How We Do It? Author : Ahmed Saleh Authors Info & Affiliations https://doi.org/10.22541/au.173925200.05370539/v1 115 views 63 downloads Contents Abstract Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract NO abstract as per the author guidlines for clinical experience articles E.N.T. Hack: Southampton Panendoscopy Kit Organiser. How We Do It? Key points: • Panendoscopy instruments consist of long light cables for rigid and direct endoscopes and long suction tubing. • Such long instruments and tubing’s impede smooth and efficient operations. • We propose Our system which uses a 15 cm plastic ruler, and two 9 cm metal towel clips betwixt which kit management can be streamlined intra-operatively. • Our system is a simple, inexpensive, robust and reusable measure to optimise organisation of instruments. • Our organiser improves ergonomics (reduced resistance, enhanced control of active cable lengths). Introduction: Panendoscopy refers to endoscopic evaluation of the upper aerodigestive tract for the purpose of diagnostic biopsy, tumour staging and assessment of surgical resectability. This is unique to Ear, Nose & Throat surgical specialty.[1] This is generally under general anaesthesia. In patients with suspicious neck nodes, it is of paramount importance for the primary site to be identified during this process. This will ensure appropriate treatment such as radiotherapy is targeted and focused, which will minimise side effects.[2] Long instruments and their associated cables are essential for the procedure. These usually consist of light cables for Hopkin’s rod and various direct endoscopes for pharyngoscopy, laryngoscopy and oesophagoscopy. [3] This also includes suction tubing and its associated long metal suction tip. Such apparatus may impede smooth and efficient operations when lying mobile and in close proximity to each other. Standard panendoscopy sets do not routinely include corresponding organisational system and literature search yields no existence of reported methods. Method: We propose a simple, inexpensive, robust and reusable measure to optimise organisation of instruments. Our system uses a 15 cm plastic ruler, and two 9 cm metal towel clips betwixt which kit management can be streamlined intra-operatively (figure 1). Result: Primary advantages include ergonomic improvements (reduced resistance, enhanced control of active cable lengths) and reduced unintended instrument displacement via secure attachment to the scrub table. This also stops the covering drape on the table from moving in case of accidental tug. The materials may be sterilised and repeatedly used for innumerable cases. Discussion: The recommended panendoscopy kit organiser represents a significant improvement to reduce challenges encountered during panendoscopy procedures. Prior to this method, cables and tubings frequently get tangled and affect the efficiency of the procedure. By offering a standardised approach to intra-operative organisation, our system aims to enhance procedural efficiency and ergonomic comfort. The inherent bendability of the ruler allows sufficient flex underneath it which applies just enough pressure to hold light cables in place and yet, it does not squash down the suction tubing. The long metal suction tip can appear to have a life of its own when left free on the scrub table. This system allows for it to be securely inserted underneath the ruler until it is needed again. One of the primary advantages of our system lies in its ergonomic enhancements. The reduction in resistance/drag during instrument manipulation, facilitated by the streamlined kit arrangement, can alleviate physical strain on the operator and promote smoother action. Efficient instrument organisation is critical for optimising workflow and minimising delays in clinical settings. Our system addresses this need by reducing cable entanglement and unintended instrument displacement, thereby promoting procedural stability, efficiency and safety. For example, this set-up can prevent whipping movement of suction tip which can splash bodily fluid left in the tip to surrounding staff member. In addition, our system is extremely low-cost, sustainable and easily available. The 15 cm plastic ruler was purchased via an online marketplace for £3.99 for 6 and 10 towel clips for £6.99. Therefore, the effective cost of each panendoscopy organiser is less than £2.05 i.e. 1 plastic ruler (£0.67) + 2 towel clips (£0.69 x 2). The use of these materials ensures affordability and accessibility, particularly in resource-constrained healthcare settings. Moreover, the easy-to-clean property and reusability of the components contribute to its longevity and environmental sustainability. The equipment do not require formal sterilisation as panendoscopy is not a sterile procedure. The Southampton panendoscopy kit organiser has been tried and vigorously tested. We have been utilising this method in all our panendoscopy procedures at our hospital since 2023. In conclusion, the panendoscopy kit organiser offers a simple, inexpensive, effective and pragmatic solution for optimising instrument organisation and operational efficiency. By addressing the need for standardised intra-operative organisation, this method has enhanced safety, ergonomic comfort and streamline workflow in our panendoscopy settings. Figure 1: Plastic ruler and towel clips on the left. On the right, how they are applied. Note the different light cables, suction tubing and suction tip underneath the ruler. References: 1. Valentin A, Goetz M, Hetzel J, Reinert S, Hoefert S. Routine panendoscopy in oral squamous cell cancer patients: mandatory or facultative?. Clin Oral Investig . 2021;25(3):1245-1254. doi:10.1007/s00784-020-03429-8 2. Jordan, K., Ritschl, L., Fichter, A. et al. The Role of Panendoscopy in Primary Diagnostics of Patients with Oral Cavity Cancer. J. Maxillofac. Oral Surg. (2024). https://doi.org/10.1007/s12663-024-02363-6 3. Kawaida M, Fukuda H, Kohno N. Video-assisted endoscopic laryngosurgery using a direct laryngoscope and a long rigid endoscope. Diagn Ther Endosc . 2000;6(2):51-57. doi:10.1155/DTE.6.51 Information & Authors Information Version history V1 Version 1 11 February 2025 Copyright This work is licensed under a Non Exclusive No Reuse License. Authors Affiliations Ahmed Saleh University Hospital Southampton NHS Foundation Trust View all articles by this author Metrics & Citations Metrics Article Usage 115 views 63 downloads .FvxKWukQNSOunydq8rnd { width: 100px; } Citations Download citation Ahmed Saleh. E.N.T. 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