[Development of an active robot system for multi-modal paranasal sinus surgery].
BACKGROUND
Severe complications in endoscopic paranasal sinus surgery are rare, however, when they occur they are often fatal. Injuries to the optic nerve or the internal carotid artery mostly occur after penetration of the sphenoid sinus' anterior wall.


METHODS
We present the robot system "A 73" with its newly designed 4-canal-microendoscope and special instruments that meets the demands of endoscopic paranasal sinus surgery. A fully automated perforation of the sphenoid sinus' anterior wall was performed in five cadaveric specimens.


RESULTS
The sphenoid sinus' anterior wall could be perforated without damaging the surrounding structures in all cases. Subsequently, the approach was enlarged to the desired diameter using telemanipulation mode. The analysis of both the transformation error and intraopertive accuracy showed values in the submillimeter range.


CONCLUSIONS
Using a newly developed robotic system, a fully automated perforation of the sphenoid sinus' anterior wall was performed precisely and reproducibly. This approach can be enlarged in a telemanipulation mode.
Wurm
J
J
Klinik und Poliklinik für Hals-Nasen-Ohren-Kranke der Universität Erlangen-Nürnberg. jochen.wurm@hno.imed.uni-erlangen.de
Bumm
K
K
Steinhart
H
H
Vogele
M
M
Schaaf
H G
HG
Nimsky
C
C
Bale
R
R
Zenk
J
J
Iro
H
H
D002102:Cadaver; D004867:Equipment Design; D019544:Equipment Failure Analysis; D006801:Humans; D066298:In Vitro Techniques; D010254:Paranasal Sinus Diseases / Q000473:pathology / Q000601:surgery*; D010256:Paranasal Sinuses / Q000473:pathology / Q000601:surgery*; D012371:Robotics / Q000295:instrumentation* / Q000379:methods; D013525:Surgical Instruments; D017216:Telemedicine / Q000295:instrumentation* / Q000379:methods; D014584:User-Computer Interface; D020535:Video-Assisted Surgery / Q000295:instrumentation* / Q000379:methods