# A Comparative Evaluation of Three Different Attachment Methods for a Video Laryngoscope in a Surgical Setting

## TL;DR

This paper compares three methods for attaching a video laryngoscope in surgery, finding that an articulated stand offers the best stability under force.

## Contribution

The study introduces and evaluates novel attachment methods for curved video laryngoscopes in surgical settings.

## Key findings

- The metal bracket showed significantly higher resistance to lateral forces than the articulated stand and 3D-printed clamp.
- The articulated stand exhibited greater torque resistance compared to the metal bracket and 3D-printed clamp.
- The articulated stand outperformed other methods in terms of both lateral force resistance and rotational stability.

## Abstract

The prerequisite for transoral microsurgery of laryngeal lesions is an uninterrupted line of sight to the operative field. Patients with cervical stiffness or anatomical variations that prevent adequate laryngeal exposure are typically unsuitable for this procedure. In such cases, a curved video laryngoscope may facilitate improved access to the larynx. However, conventional suspension laryngoscopy setups are incompatible with standard video laryngoscopes.

This study evaluates three attachment methods for integrating a curved video laryngoscope into a surgical setup, focusing on their resistance to external forces.

This study assessed three different attachment methods (3D‐printed clamp vs. metal bracket vs. articulated stand) for a video laryngoscope in a surgical setup. External forces, both lateral and rotational (torque), were applied and continuously measured until laryngeal visualization was compromised by displacement of the video laryngoscope.

The metal bracket demonstrated significantly (p < 0.001) higher resistance to lateral forces (median 184.49 N, 95% CI [181.59–189.61 N]) compared to the articulated stand (median 88.16 N, 95% CI [76.73–88.98 N]) and the 3D‐printed clamp (median 55.59 N, 95% CI [54.74–57.58 N]). The articulated stand exhibited significantly (p < 0.005) greater torque resistance (median 9.57 N m, 95% CI [5.65–9.87 N m]) compared to the metal bracket (median 1.58 N m, 95% CI [1.57–2.13 N m]) and the 3D‐printed clamp (median 2.46 N m, 95% CI [2.24–2.79 N m]).

Overall, the articulated stand outperformed the other attachment methods, displaying robust resistance to lateral forces and superior rotational stability.

Level 4.

The study presents a systematic evaluation of innovative attachment methods for integrating a curved video laryngoscope into surgical setups, addressing a significant clinical need for improving laryngeal exposure in patients with complex anatomical or mobility challenges. In this work, we assessed the performance of three attachment systems—3D‐printed clamp, metal bracket, and articulated stand—under conditions simulating external surgical forces.