Abstract
Objective Advanced transnasal sinus and skull base surgery remains a challenging discipline
for head and neck surgeons. Restricted access and space for instrumentation can impede
advanced interventions. Thus, we present the combination of an innovative robotic
endoscope guidance system and a specific endoscope with adjustable viewing angle to
facilitate transnasal surgery in a human cadaver model.
Materials and Methods The applicability of the robotic endoscope guidance system with custom foot pedal
controller was tested for advanced transnasal surgery on a fresh frozen human cadaver
head. Visualization was enabled using a commercially available endoscope with adjustable
viewing angle (15–90 degrees).
Results Visualization and instrumentation of all paranasal sinuses, including the anterior
and middle skull base, were feasible with the presented setup. Controlling the robotic
endoscope guidance system was effectively precise, and the adjustable endoscope lens
extended the view in the surgical field without the common change of fixed viewing
angle endoscopes.
Conclusion The combination of a robotic endoscope guidance system and an advanced endoscope
with adjustable viewing angle enables bimanual surgery in transnasal interventions
of the paranasal sinuses and the anterior skull base in a human cadaver model. The
adjustable lens allows for the abandonment of fixed-angle endoscopes, saving time
and resources, without reducing the quality of imaging.
Keywords
robotic - surgery - sinus - endoscopic - skull base - FESS - RAS
