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Robot-Assisted Transcanal Endoscopic Ear Surgery for Congenital Cholesteatoma
Published on: December 15, 2023
Feasibility and User Experience of a Passive Robotic Endoscope Holding Arm in Various Ear, Nose, and Throat Surgical
Anke Daser1, Kerstin Stähr1, Friederike Kaster1
1Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital Essen, University of Duisburg-Essen, Germany.
Objective:
Evaluation of the feasibility and surgical applicability of the ENDOFIXexo robotic endoscope holder (AKTORmed) in various ear, nose, and throat (ENT) procedures.
Methods:
This study was conducted as a prospective single-center feasibility study involving 26 patients who underwent endoscopic ENT surgery between September 2022 and May 2025. The ENDOFIXexo system was used as a passive robotic assistant. The study assessed surgical performance, intraoperative handling, system limitations, and safety outcomes.
Results:
The device provides stable endoscopic visualization and allows truly bimanual operation in multiple procedures. It is particularly beneficial for orbital decompression, dacryocystorhinostomy, eustachian tube balloon dilation, and endoscopic ear and laryngeal surgeries. Nonetheless, its application is limited to narrow nasal cavities and highly hemorrhagic procedures. No adverse events were observed, and the setup time remained below 10 minutes.
Conclusions:
The ENDOFIXexo is a safe and practical tool with the potential to enhance the quality of endoscopic ENT surgery by strongly facilitating bimanual techniques. Its utility is highly valuable in complex or assistant-limited procedures. However, further studies are necessary to strengthen these findings.
