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Updated: Jul 16, 2026

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
A new force-based objective assessment of technical skills in endoscopic sinus surgery
Toru Kumagai1, Juli Yamashita, Osamu Morikawa
1National Institute of Advanced Industrial Science and Technology, Tsukuba, Ibaraki, Japan. kumagai.toru@aist.go.jp
Abstract:
We propose objectively assessing endoscopic sinus surgery (ESS) skills by measuring the force applied to a patient model. We collected data on 16 subjects performing gauze packing task using a precise human nasal model with a six-degree-of-freedom force/torque sensor. Mann-Whitney's U test was used to analyze their performance. Intermediates (ESS: 10-50 cases) used significantly greater force than students or experts (ESS: over 150 cases) at the 5 % level. Maximum force improved only among experts. These results imply that young surgeons pay too little attention to force applied to patients or tissues.
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