title: A technique with manipulator-assisted endoscope guidance for functional endoscopic sinus surgery: proof of concept.
abstract: OBJECTIVE
  The goal of this study was to examine the theoretical feasibility of a new manipulator system for endoscope guidance in functional endoscopic sinus surgery.
  
  
  METHODS
  The accuracy of endoscope positioning and time of endoscope movement with an endoscope manipulator system were determined with an artificial sinus model.
  
  
  METHODS
  A laboratory trial was performed. The time for 60 repetitions of manual compared to manipulator-assisted endoscope movements directed at 3 different target positions was evaluated. In addition, the alignment of the position vector for each endoscope movement was examined.
  
  
  METHODS
  A zero-degree Hopkins II telescope with a camera was used to head for the target positions. First, the endoscope movements were done manually, and afterward the endoscope manipulator system was used for endoscope guidance. The alignment of the position vector of the endoscope was measured with a portable measuring arm.
  
  
  RESULTS
  There was no statistical difference between the time for manual and manipulator-assisted endoscope movements for all target positions. The alignment of the position vector of the endoscope was statistically different at 2 target positions: anterior ethmoid left side and ostium of maxillary sinus left side. There was no statistical difference at all other positions.
  
  
  CONCLUSIONS
  The endoscope manipulator system has the potential to be integrated into the operating workflow without extending the time for endoscope guidance. The surgeon will be able to use both hands for the manipulation of the instruments. Less frequent endoscope movements and instrument changes may be expected after technical modification.
authors.affiliation: Department of ORL-HNS, University Hospital Leipzig, Leipzig, Germany. milos.fischer@medizin.uni-leipzig.de
authors.forename: Milos
authors.initials: M
authors.lastname: Fischer
authors.forename: Christina
authors.initials: C
authors.lastname: Gröbner
authors.forename: Andreas
authors.initials: A
authors.lastname: Dietz
authors.forename: Maximillian
authors.initials: M
authors.lastname: Krinninger
authors.forename: Tim C
authors.initials: TC
authors.lastname: Lüth
authors.forename: Gero
authors.initials: G
authors.lastname: Strauss
mesh_terms: D004724:Endoscopy / Q000295:instrumentation* / Q000379:methods; D005240:Feasibility Studies; D008953:Models, Anatomic; D010256:Paranasal Sinuses / Q000601:surgery*; D013525:Surgical Instruments