The iArmS Robotic Armrest Prolongs Endoscope Lens-Wiping Intervals in Endoscopic Sinus Surgery

Objective. Fouling of the endoscope lens is a major problem in endoscopic sinus surgery (ESS). We examined whether the use of the intelligent arm support system (iArmS), a robotic armrest, could prolong endoscope lens-wiping intervals in ESS and thus allow for continuously clear endoscopic images. Study Design. This study is a prospective, nonrandomized crossover study. Methods. Three surgeons who performed ESS at 2 centers each conducted 3 operations with the iArmS and 3 operations without the iArmS; thus, 18 operations were assessed. To blind the assessments, we performed them prospectively without informing subjects of the endpoints. We recorded the operations and observed the recordings at a later date; endoscope lens-wiping times were noted in seconds to determine the endoscope lens-wiping intervals. Our examination was based on the null hypothesis that endoscope lens-wiping intervals would not differ according to the use or nonuse of the iArmS. Results. The median endoscope lens-wiping intervals with and without using the iArmS were 361 seconds and 135 seconds, respectively. Based on the Wilcoxon rank-sum test, this difference was significant (P = 0.001); thus, the null hypothesis was rejected. This result indicated that endoscope lens-wiping intervals are greatly prolonged by the use of the iArmS. Conclusion. The iArmS robotic armrest is suitable for ESS, prolongs endoscope lens-wiping intervals, and facilitates obtaining continuous clear endoscopic images.