A Method Based on 3D Shape Analysis Towards the Design of Flexible Instruments for Endoscopic Maxillary Sinus Surgery

Area of Science:

• Medical Devices
• Surgical Innovation
• Otolaryngology

Background:

• Minimally invasive surgery (MIS) adoption is increasing due to steerable flexible instruments.
• Flexible instruments offer potential for accessing difficult anatomical regions in sinus surgery.
• Specific design metrics for flexible instruments in maxillary sinus surgery are currently lacking.

Purpose of the Study:

• To propose a measurement processing method for developing steerable flexible instruments for limited access surgery.
• To provide essential design information for adapting flexible instruments for maxillary sinus surgery.
• To assess the reachability of maxillary sinus areas using a flexible instrument through a standard antrostomy.

Main Methods:

• Development of a method to process anatomical measurements for instrument design.
• Application of the method to maxillary sinus surgery data.
• Statistical analysis of instrument diameter and bending capabilities for surgical access.
• Validation through cadaver experiments.

Main Results:

• An instrument diameter < 2.4 mm is suitable for > 72.5% of subjects.
• A flexible instrument with a specific bending capability can reach 94.9% of maxillary sinus areas via a standard antrostomy.
• No additional incisions or tissue removal are needed for comprehensive access in most cases.

Conclusions:

• The proposed method provides crucial data for designing effective steerable flexible instruments for maxillary sinus surgery.
• A flexible instrument with a diameter < 2.4 mm and adequate bending can achieve near-complete access to the maxillary sinus.
• This approach supports the advancement of MIS techniques in sinus surgery, potentially improving patient outcomes.