J Appl Biomed 23:138-143, 2025 | DOI: 10.32725/jab.2025.010

Applying the technology ORBEYE^TM exoscope in transoral exoscopic laryngeal surgery: single centre prospective study

Richard Holý^{1, 2, *}, Tomáš Filipovský^{1, 2}, Eva Lukavcová¹, David Kalfeřt^{3, 4}, Pavol Praženica⁵, Petra Dytrych^{6, 7}, Jiří Hložek^{1, 2}, Jan Rotnágl^{1, 2}, Daniel Kovář^{1, 2}, Jaromír Astl^{1, 2}

1 Military University Hospital Prague, Department of Otorhinolaryngology and Maxillofacial Surgery, Prague, Czech Republic

2 Charles University, Third Faculty of Medicine, Prague, Czech Republic

3 University Hospital Motol, Department of Otorhinolaryngology and Head and Neck Surgery, Prague, Czech Republic

4 Charles University, First Faculty of Medicine, Prague, Czech Republic

5 University Hospital Limerick, Department of Otolaryngology Head & Neck Surgery, Limerick, Ireland

6 University Hospital Motol, Department of Ear, Nose and Throat, Prague, Czech Republic

7 Charles University, Second Faculty of Medicine, Prague, Czech Republic

Introduction: ORBEYE^TM exoscope offers superior visualization with clearer imaging compared to standard methods and supports narrow band imaging (NBI). ORBEYE^TM provides better visualization of tissue structures, thus increasing the accuracy of the surgical procedure. The systematic use of ORBEYE^TM in transoral exoscopic laryngeal surgery (TOLES) is rarely documented. This study evaluates the sensitivity and specificity of TOLES using ORBEYE^TM with white light and NBI modalities.

Methods: Between 8/2021 and 8/2024, 84 patients underwent TOLES using ORBEYE^TM with white light and NBI modes. All surgeries were performed in a specialized setting with consistent preoperative and intraoperative imaging protocols.

Results: TOLES using ORBEYE^TM was successfully performed in all 84 patients. A statistically significant dependence (p < 0.001) was observed between preoperative/perioperative (TOLES) findings and definitive histology for both white light and NBI modalities. ORBEYE^TM facilitated detailed imaging of tissue structures and allowed targeted biopsies.

Conclusion: TOLES with perioperative NBI/white light endoscopy achieved a high correlation between pre-histopathological diagnoses and final histopathological results. ORBEYE^TM exoscope provides three-dimensional 4K resolution, superior imaging, and improved ergonomics for the surgeon, reducing workload and increasing efficiency. It delivered more efficient surgical team collaboration and experience sharing. The integration of NBI into the TOLES system facilitated accurate navigation and targeting of the biopsy, helping to establish correct definitive diagnosis. TOLES showed more accurate scoring of perioperative NBI findings.

Keywords: Endoscopy; Histopathological results; Laryngeal tumor; Narrow band imaging; Orbeye; Transoral exoscopic laryngeal surgery

Grants and funding:

Our prospective study was approved by the Ethics Committee of the Military University Hospital Prague - Reference Number 108/17-29/2022. All patients signed an informed consent form. This research was funded by Project MO 1012 of the Ministry of Defence of the Czech Republic and by the Cooperation Program, research area SURG., Charles University, Czech Republic.

Conflicts of interest:

The authors have no conflict of interest to declare.

Received: May 18, 2025; Revised: July 2, 2025; Accepted: August 12, 2025; Prepublished online: August 21, 2025; Published: September 30, 2025  Show citation