Closed linear stapling in total laryngectomy- personal preferences and checklists to optimize outcomes

• Published in: Oral oncology reports Vol. 6; p. 100044
• Main Authors: Varghese, Bipin T., Vishwani, Ankit
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01.06.2023; Elsevier
• Subjects: Linear stapling; Optimised technique; Total laryngectomy; Linear stapling; Total laryngectomy; Optimised technique
• ISSN: 2772-9060; 2772-9060
• DOI: 10.1016/j.oor.2023.100044

Use of linear staplers for pharyngeal closure after total laryngectomy is yet to gain its due acceptance among head and neck surgeons because of a lack of experience sharing among those already well versed in it. Presented here are some nuances and the checklist that would enhance the safety and results of closed stapling in a total laryngectomy for advanced endolaryngeal cancers comprising meticulous separation of the tumour-free pharynx, the uninvolved vascularity maintained thyroid gland and the infrahyoid muscles [1] from the tumour involved larynx based on an angiosome concept. •The closed stapling technique has the potential to reduce the onset of early pharyngeal leaks and formation of late pharyngocutaneous fistula in primary and salvage laryngectomies, besides saving operating time.•Evading Epiglottis, Nasogastric tube, Instrumentation used to retract the epiglottis, Hyoid bone and thyroid horns with ligaments and the posterior pharyngeal wall is the technical key to successful stapling.•Careful preservation of blood supply to uninvolved extrinsic laryngeal musculature and thyroid glandular tissue enhances outcomes of stapling.