title: In vitro experiments with the triangular flap cutter applied to functional tracheoesophageal shunt for voice rehabilitation after total laryngectomy.
abstract: BACKGROUND
  Since the introduction and practice of functional tracheoesophageal shunt (FTES) for voice rehabilitation after total laryngectomy, patients have often suffered from fistula-related complications such as aspiration, tract stenosis and infection partly as a result of nonstandardized or incorrectly made flap operation. In striving to solve these problems as far as possible, a triangular flap cutter (TFC) was developed to perform the flap operation.
  
  
  METHODS
  Flap operations were performed using a TFC on 10 tracheoesophageal models (pigs) and 10 fresh esophageal models (esophageal cancer patients, with their informed consent) and incision parameters and incision effects were detected.
  
  
  RESULTS
  Perfect triangular flaps were achieved in 18 out of 20 cases using the TFC with minimal peripheral tissue injury (average time, 2-3 min). Of the 2 unsuccessful cases, 1 case exhibited insertion failure and the other experienced flap creation failure due to clinical contraindication for TFC use and insufficient operational skills, respectively.
  
  
  CONCLUSIONS
  The TFC is a new device, which offers the unique advantage of precise incision for the creation of a flap, with the potential to resolve fistula-related problems and improve operation efficiency.
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Head and Neck Surgery, Peking University School of Oncology, Beijing Cancer Hospital and Institute, Beijing, China.
authors.forename: P
authors.initials: P
authors.lastname: Wang
authors.forename: J
authors.initials: J
authors.lastname: Guo
authors.forename: P
authors.initials: P
authors.lastname: Shen
authors.forename: B
authors.initials: B
authors.lastname: Liu
mesh_terms: D000818:Animals; D001044:Aphonia / Q000601:surgery; D004944:Esophagoplasty / Q000295:instrumentation*; D004947:Esophagus / Q000601:surgery*; D006801:Humans; D007825:Laryngectomy / Q000534:rehabilitation*; D013071:Speech, Alaryngeal; D013552:Swine; D014132:Trachea / Q000601:surgery*