Zero-touch laryngoscopy: a six-DOF robotic platform for remote ENT examination

This study aims to design and evaluate a six-degree-of-freedom (6-DOF) master-slave robotic system for remote, contact-free ENT examination, focusing on safety, efficiency, and user workload. A three-axis Cartesian stage with a three-axis spherical wrist was designed for precise, non-contact laryngoscopy. Six participants (3 experts, 3 novices) performed eight phantom and eight in-vivo trials each. Primary outcomes included task-completion time and subjective workload (NASA-TLX), analysed using mixed-effects ANOVA (α = 0.05). In vivo, experts completed tasks in 300 ± 12 s, compared to 481 ± 18 s for novices (p < 0.001); phantom trials showed similar trends (experts = 125 ± 9 s; novices = 212 ± 15 s, p < 0.001). Experts reported lower NASA-TLX scores (34 ± 7) than novices (47 ± 6, p = 0.02). Learning-curve analysis showed a per-trial time improvement of 2.24 s for experts and 1.13 s for novices. This novel 6-DOF robotic platform enables safe, efficient, and contact-free ENT inspection while reducing the skill barrier for novice users. Its ergonomic master interface and stable spherical-link architecture make it suitable for both clinical deployment and training. Ongoing work includes integration of haptic feedback and multi-centre clinical validation.