Workspace and pivot point for robot-assisted endoscope guidance in functional endonasal sinus surgery (FESS)

Area of Science:

• Robotics in Medicine
• Surgical Navigation
• Medical Imaging

Background:

• Development of robot-assisted endoscope guidance for functional endoscopic sinus surgery (FESS) requires data on conventional FESS workspaces and endoscope movements.
• Understanding instrument dynamics is crucial for advancing surgical robotics.

Purpose of the Study:

• To collect and analyze endoscope and instrument movement data during conventional FESS procedures.
• To identify key movement patterns and pivot points for robot-assisted guidance development.

Main Methods:

• A self-developed marker-based tracking system was used to record pose data (position and orientation) of the endoscope and instruments.
• Data was collected from five real functional endoscopic sinus surgeries.

Main Results:

• Automated segmentation of endoscope poses revealed an hourglass shape.
• A distinct pivot region, or pivot point, was identified at the 'waistline' of the hourglass, near the nasal entrance.
• The pivot point size correlated with the 4mm endoscope diameter.

Conclusions:

• A consistent pivot point was identified in endoscopic sinus surgery, simplifying endoscope motion analysis.
• Reducing endoscope motion to four degrees of freedom (three rotations, one translation) facilitates easier and safer robot-assisted guidance.
• This research provides foundational data for enhanced robotic surgical systems in FESS.