{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T15:32:12Z","timestamp":1747150332127,"version":"3.40.5"},"reference-count":9,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,6,19]],"date-time":"2023-06-19T00:00:00Z","timestamp":1687132800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2023,12]]},"abstract":"Objective<\/jats:title>Receiving instruments from surgical technicians during endoscopic laryngeal and airway microsurgery (ELAM) has challenges including repeated, expeditious handling of delicate instruments and passing them to the surgeon's hand opposite of where the surgical assistant is standing. Optimizing this interaction may reduce surgical errors and improve operative efficiency.<\/jats:p><\/jats:sec>Methods<\/jats:title>A proprietary ELAM instrument holder was attached to both sides of the operating room bed. The device consisted of an articulating arm with custom silicone inserts mounted on a tray (storing up to three endoscopic instruments). ELAM cases were randomized to be performed either with (device) or without the holder (control). Using custom software, instrument pass time (IPT), instrument drop rate (IDR), and communication errors (eg handing incorrect instruments) were manually recorded. Qualitative use metrics relating to overall device satisfaction were also obtained.<\/jats:p><\/jats:sec>Results<\/jats:title>Data were collected from 25 device and 23 control cases among three different laryngologists. Average IPT was nearly three times quicker for the device (0.80\u2009s, n<\/jats:italic>\u2009=\u20091175 passes) compared with controls (2.09\u2009s, n<\/jats:italic>\u2009=\u20091208 passes) [p<\/jats:italic>\u2009<\u20090.001]. IPT interquartile range was five times higher for control (1.65\u2009s) versus device cases (0.42\u2009s). IDR was not significantly different [p<\/jats:italic>\u2009=\u20090.48]; however, device cases had significantly lower communication errors compared to control cases [p<\/jats:italic>\u2009=\u20090.01]. Surgeons and surgical assistants were similarly satisfied with the device on a 5\u2010point Likert scale (mean: 4.2\/5, standard deviation: 0.92).<\/jats:p><\/jats:sec>Conclusion<\/jats:title>The proposed endoscopic instrument holder can improve ELAM operative workflow by reducing instrument passing time and variability without increasing IDR.<\/jats:p><\/jats:sec>Level of Evidence<\/jats:title>2 Laryngoscope<\/jats:italic>, 133:3492\u20133498, 2023<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.30835","type":"journal-article","created":{"date-parts":[[2023,6,19]],"date-time":"2023-06-19T09:45:10Z","timestamp":1687167910000},"page":"3492-3498","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Novel Instrument Holder to Improve Operative Efficiency in Endoscopic Laryngeal and Airway Surgery"],"prefix":"10.1002","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2105-4940","authenticated-orcid":false,"given":"Aseem","family":"Jain","sequence":"first","affiliation":[{"name":"College of Medicine University of Cincinnati Cincinnati Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6790-9492","authenticated-orcid":false,"given":"Sarah M.","family":"Adams","sequence":"additional","affiliation":[{"name":"College of Medicine University of Cincinnati Cincinnati Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isaac","family":"Hale","sequence":"additional","affiliation":[{"name":"College of Medicine University of Cincinnati Cincinnati Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Voskoboynik","sequence":"additional","affiliation":[{"name":"Department of Communication Sciences and Disorders University of Cincinnati Cincinnati Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheick","family":"Sissoko","sequence":"additional","affiliation":[{"name":"Division of Laryngology, Department of Otolaryngology\u2010Head and Neck Surgery University of Cincinnati Medical Center Cincinnati Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Bugada","sequence":"additional","affiliation":[{"name":"College of Medicine University of Cincinnati Cincinnati Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory R.","family":"Dion","sequence":"additional","affiliation":[{"name":"Division of Laryngology, Department of Otolaryngology\u2010Head and Neck Surgery University of Cincinnati Medical Center Cincinnati Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5503-0325","authenticated-orcid":false,"given":"Rebecca J.","family":"Howell","sequence":"additional","affiliation":[{"name":"Division of Laryngology, Department of Otolaryngology\u2010Head and Neck Surgery University of Cincinnati Medical Center Cincinnati Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5615-3442","authenticated-orcid":false,"given":"Aaron D.","family":"Friedman","sequence":"additional","affiliation":[{"name":"Division of Laryngology, Department of Otolaryngology\u2010Head and Neck Surgery University of Cincinnati Medical Center Cincinnati Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,6,19]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21877"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.aco.0000192796.02797.82"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2273.2003.00745.x"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11701-011-0325-0"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamahealthforum.2022.0371"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/1553350611413611"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599819885635"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2021.02.049"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1117\/1.JBO.26.1.010901"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.30835","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,14]],"date-time":"2023-11-14T11:37:47Z","timestamp":1699961867000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.30835"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,19]]},"references-count":9,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2023,12]]}},"alternative-id":["10.1002\/lary.30835"],"URL":"https:\/\/doi.org\/10.1002\/lary.30835","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"type":"print","value":"0023-852X"},{"type":"electronic","value":"1531-4995"}],"subject":[],"published":{"date-parts":[[2023,6,19]]},"assertion":[{"value":"2023-03-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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