Microlaryngoscopy

Setting

 

  • WIPER  (wash hands, introduce yourself, permission, expose patient, reposition)

  • Ask if the patient is happy to see you

 

Perception

 

  • Check what the patient understands so far

  • What symptoms are they having and what treatments have they tried so far

  • Offer options including surgery and alternatives

 

Invitation 
 
  • Ask if they would like to know more about the operation

  • Ask permission to take consent

  • Explain you will outline the procedure, alternatives, risks and benefits, recovery time.

  • ‘If at any point you have any questions feel free to interrupt me, but I’ll also ask you afterwards if you have any questions’

 

Knowledge

 

  • Explain procedure

  • Draw diagram

  • Explain alternatives

  • Intended benefits

  • Potential risks and complications

    • With any operation, risk of bleeding, infection, pain, risk of GA – anaesthetist will be able to go through in more detail. See General Risks below

    • Also specific risks associated with this operation.

      • Hoarse voice

      • Sore throat

      • Damage to lips, teeth and gums

      • Perforation

      • Ignition burns if laser surgery

    • Individual risks to patient

 

Post op

 

  • Most likely to be day case procedure/overnight stay

  • Avoid voice use if phonosurgery performed

  • Time off work – give sick note

  • Contact department/attend A&E if: Increasing difficulty breathing, neck swelling, fever, pain not responding to analgesics

 

Follow up advice

 

  • See back in clinic in X weeks/months

 

Summary

 

  • Summarise consultation

  • Offer opportunity to ask questions

  • Offer patient information leaflet

  • Thank patient, wash hands and close

 

General Risks

 

 

  • Bleeding and bruising

  • Infection

  • Pain

  • Scar

  • Risk of general anaesthesia

  • Further surgery

  • Return to theatre

  • Recurrence

  • Suboptimal outcome

  • Numbness

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