Active Endoscope Preserving Image Orientation for Endonasal Skull Base Surgery.

Area of Science:

• Neurosurgery
• Medical Robotics
• Surgical Instrumentation

Background:

• Conventional endoscopes in endonasal skull base surgery have limitations, including a fixed field of view and potential invasiveness during insertion.
• These limitations can complicate procedures and increase the risk of damaging critical tissues.

Purpose of the Study:

• To propose and design an active endoscope mechanism to address the challenges of conventional endoscopes in endonasal skull base surgery.
• To enhance surgical precision, safety, and maneuverability within confined surgical spaces.

Main Methods:

• Development of a 4 mm diameter active endoscope with a 2-degree-of-freedom (DOF) tilting and rotation mechanism.
• Implementation of kinematics control for intuitive operation and a fixed image sensor to maintain orientation relative to gravity.
• Design allows for directional changes within a 6.5 mm radius.

Main Results:

• The active endoscope provides a variable direction of view, covering wider ranges and enabling a forward-looking perspective during insertion.
• Intuitive control was demonstrated through experiments using a master device, allowing users to observe targets without needing to swap the endoscope.
• The device's small form factor and maneuverability are suitable for use in narrow cavities alongside other surgical tools.

Conclusions:

• The developed active endoscope mechanism offers significant advantages over traditional rigid endoscopes for endonasal skull base surgery.
• It enhances safety, improves visualization, and increases maneuverability, potentially leading to better surgical outcomes.
• Further clinical evaluation and studies on integration with surgical instruments are warranted.