Foot-controlled robotic-enabled endoscope holder for endoscopic sinus surgery: A cadaveric feasibility study

Area of Science:

• Robotic Surgery
• Endoscopic Sinus Surgery
• Medical Device Technology

Background:

• Traditional endoscopic sinus surgery often requires a three-handed technique.
• A dedicated assistant is typically needed to manipulate the endoscope.
• This can limit the surgeon's dexterity and potentially increase operative time.

Purpose of the Study:

• To evaluate the feasibility of a novel prototype foot-controlled robotic-enabled endoscope holder (FREE).
• To assess the advantages and disadvantages of the FREE system in functional endoscopic sinus surgery (FESS).
• To compare the two-handed technique with the FREE system to a traditional three-handed approach.

Main Methods:

• A cadaveric study was conducted using five human cadaver heads.
• The FREE robotic endoscope holder was utilized to mimic a single nostril three-handed technique.
• Feasibility, setup time, ease of use, and impact on surgeon's hands were assessed.

Main Results:

• The FREE robot demonstrated ease of use with a setup time under 3 minutes.
• A short learning curve was observed for the foot controls.
• Surgeons could effectively use both hands without hindrance, and tremor filtration ensured smooth endoscope movement with minimal collisions.

Conclusions:

• The ex-vivo cadaver tests confirmed the feasibility of the robotic prototype FREE endoscope holder.
• The system enables a two-handed surgical approach comparable to a three-handed technique, potentially reducing operating time.
• Further research is warranted to evaluate the safety profile and applicability in broader endoscopic surgery.