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Related Concept Videos

Sutures of the Skull01:22

Sutures of the Skull

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The human skull is composed of several bones that come together to protect the brain and support the structures of the face. The junctions where these bones meet are called sutures.
Sutures are immobile joints between adjacent bones of the skull. The narrow gap between the bones is filled with dense, fibrous connective tissue that unites the bones. The long sutures located between the skull bones are not straight but instead follow irregular, tightly twisting paths. These twisting lines tightly...
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Related Experiment Video

Updated: Mar 29, 2026

Real-Time Dynamic Navigation System for the Precise Quad-Zygomatic Implant Placement in a Patient with a Severely Atrophic Maxilla
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HelixFlex: bioinspired maneuverable instrument for skull base surgery.

Giada Gerboni1, Paul W J Henselmans, Ewout A Arkenbout

  • 1The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy.

Bioinspiration & Biomimetics
|December 2, 2015
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Summary

Developing new surgical instruments for endoscopic endonasal surgery, this study introduces a multi-actuation technique to improve maneuverability for skull base lesions. The HelixFlex prototype shows promising results for enhanced surgical access and control.

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Area of Science:

  • Neurosurgery
  • Medical Device Engineering
  • Minimally Invasive Surgery

Background:

  • Endoscopic endonasal surgery is the standard for pituitary tumors and increasingly used for skull base lesions.
  • Current endoscopic instruments lack maneuverability, hindering access to complex anatomical areas.
  • Existing highly maneuverable instruments are often mechanically complex and difficult to mass-produce.

Purpose of the Study:

  • To develop a novel actuation technique for endoscopic surgical instruments.
  • To enhance instrument maneuverability and reduce construction complexity for skull base surgery.
  • To create instruments with independent control over end-effector orientation and position.

Main Methods:

  • Development of a multi-actuation technique integrating multiple cable routings into a single steerable structure.
  • Integration and testing of the multi-actuation technique into a handheld prototype instrument named HelixFlex.
  • Evaluation of the prototype's maneuverability and rigidity.

Main Results:

  • Successful integration of the multi-actuation technique into the HelixFlex prototype.
  • The HelixFlex instrument features a 4 degrees of freedom, 5.8 mm diameter steerable tip.
  • Promising results demonstrated regarding HelixFlex's maneuverability and potential rigidity.

Conclusions:

  • The multi-actuation technique offers a solution to the limited maneuverability of current endoscopic surgical instruments.
  • The HelixFlex prototype demonstrates the feasibility of achieving enhanced maneuverability with reduced mechanical complexity.
  • This innovation has the potential to improve surgical outcomes for challenging skull base pathologies.