A Technique with Manipulator‐Assisted Endoscope Guidance for Functional Endoscopic Sinus Surgery

• Published in: Otolaryngology-head and neck surgery Vol. 145; no. 5; pp. 833 - 839
• Main Authors: Fischer, Miloš, Gröbner, Christina, Dietz, Andreas, Krinninger, Maximillian, Lüth, Tim C., Strauß, Gero
• Format: Journal Article
• Language: English
• Published: Sage CA: Los Angeles, CA SAGE Publications 01-11-2011
• Subjects: bimanual manipulation; endoscope guidance; functional endoscopic sinus surgery; manipulator assistance
• ISSN: 0194-5998; 1097-6817
• DOI: 10.1177/0194599811412726

Objective
The goal of this study was to examine the theoretical feasibility of a new manipulator system for endoscope guidance in functional endoscopic sinus surgery.
Study Design
The accuracy of endoscope positioning and time of endoscope movement with an endoscope manipulator system were determined with an artificial sinus model.
Setting
A laboratory trial was performed. The time for 60 repetitions of manual compared to manipulator‐assisted endoscope movements directed at 3 different target positions was evaluated. In addition, the alignment of the position vector for each endoscope movement was examined.
Subjects and Methods
A zero‐degree Hopkins II telescope with a camera was used to head for the target positions. First, the endoscope movements were done manually, and afterward the endoscope manipulator system was used for endoscope guidance. The alignment of the position vector of the endoscope was measured with a portable measuring arm.
Results
There was no statistical difference between the time for manual and manipulator‐assisted endoscope movements for all target positions. The alignment of the position vector of the endoscope was statistically different at 2 target positions: anterior ethmoid left side and ostium of maxillary sinus left side. There was no statistical difference at all other positions.
Conclusion
The endoscope manipulator system has the potential to be integrated into the operating workflow without extending the time for endoscope guidance. The surgeon will be able to use both hands for the manipulation of the instruments. Less frequent endoscope movements and instrument changes may be expected after technical modification.