[Evaluation of force data with a force/torque sensor during FESS. A step towards robot-assisted surgery].
BACKGROUND
To relieve the surgeon during functional endoscopic endonasal sinus surgery (FESS), the endoscope should be guided by autonomous robot assistance. The surgeon will thus have two hands free for suctioning and manipulation during FESS.


METHODS
With a force/torque sensor mounted on the endoscope, we measured forces in six degrees of freedom in five cadaver heads and in 20 actual endoscopic sinus procedures. On the cadaver heads we performed complete endoscopic endonasal dissection of all paranasal sinuses. All forces at the endoscope were monitored continuously.


RESULTS
The mean forces occurring at the endoscope were 3.2 N. There were only slight differences between the in vivo and ex vivo data. We measured peak forces up to 25.2 N. In 95% of all cases, forces were lower than 7 N.


CONCLUSIONS
Forces up to 7 N are sufficient for endoscopic guidance during FESS. Peak forces are distinctive for endoscopic guidance by humans and could be optimised by sensor-based intraoperative robot guidance. Higher forces are required for surgical endoscopy of the frontal and maxillary sinuses compared with the ethmoid sinuses.
Eichhorn
K W G
KW
Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde/Chirurgie, Universitätsklinikum Bonn, Sigmund-Freud-Strasse 25, 53105 Bonn. klaus.eichhorn@ukb.uni-bonn.de
Tingelhoff
K
K
Wagner
I
I
Westphal
R
R
Rilk
M
M
Kunkel
M E
ME
Wahl
F M
FM
Bootz
F
F
D002102:Cadaver; D019723:Endoscopes; D004867:Equipment Design; D019544:Equipment Failure Analysis; D006801:Humans; D010256:Paranasal Sinuses / Q000601:surgery*; D010865:Pilot Projects; D015203:Reproducibility of Results; D012371:Robotics / Q000295:instrumentation* / Q000379:methods; D012680:Sensitivity and Specificity; D013312:Stress, Physiological; D025321:Surgery, Computer-Assisted / Q000295:instrumentation* / Q000379:methods; D019415:Torque; D014159:Transducers