Foot-Controlled Robot-Enabled EnDOscope Manipulator (FREEDOM) for Sinus Surgery: Design, Control, and Evaluation

Area of Science:

• Robotics in Medicine
• Surgical Technology
• Minimally Invasive Surgery

Background:

• Teleoperated robotic systems have limitations in functional endoscopic sinus surgery (FESS), including instrument size and setup complexity.
• Current FESS practices often require an assistant to manually handle the endoscope during bimanual procedures.

Purpose of the Study:

• To develop the Foot-controlled Robot-Enabled EnDOscope Manipulator (FREEDOM) system for FESS.
• To provide reliable, safe, and surgeon-centered endoscope positioning with minimal disruption to surgical workflow.

Main Methods:

• Designed a modular, compact robot with coaxial instrument manipulation and a compliant endoscope holder for patient safety.
• Developed a foot-wearable interface for hands-free endoscope control, reducing assistant workload.
• Evaluated the system through cadaver and clinical studies, assessing safety (IEC-60601-1) and setup time.

Main Results:

• The FREEDOM system demonstrated a short learning curve (3.4 mins) for foot control, promoting ergonomic and surgeon-centered procedures.
• Setup time was minimal (3.6 mins), and the system was validated as safe.
• Surgeons could perform three-handed procedures independently in FESS without altering routine practice.

Conclusions:

• The FREEDOM system offers a safe, efficient, and user-friendly solution for hands-free endoscope manipulation in FESS.
• This technology empowers surgeons to perform complex procedures autonomously, improving surgical ergonomics and patient care.