title: Specification Analysis, Design, and Prototyping of a Burr Hole Endoscope Stabilization Device.
abstract: OBJECTIVE
  Aim of this study was to develop a prototype for an innovative, burr-hole mounted device, for stabilizing endoscopes during intracranial surgery. The objective was an easily maneuverable device, freeing one hand without compromising flexibility and safety. This could avoid the need for a second surgeon or a bulky holder, thus improving coordination.
  
  
  METHODS
  The initial concept arose from the observation that intraventricular endoscopy is often performed by 2 surgeons, 1 navigating the endoscope and 1 inserting/handling instruments through the working channel. A specification analysis was performed. Desired properties were specified through a literature review, as well as informal interviews with surgeons and engineers. Tools used for the design included blueprints, 3-dimensional computer aided-design and cooperating with engineers. The final prototype was 3D-printed and the toruses were produced with molding.
  
  
  RESULTS
  A prototype named BuESta (Burr hole Endoscope Stabililizer) was produced. This consists of 2 half hollow sphere parts and interchangeable toruses and has the following features: easy to produce, inexpensive, not prolonging surgical time, semirigid, variable fixation, easy to fix/release, safe, no bulky articulated arms, mimicking basic concepts of second hand fixation (index finger/thumb fixation, hand resting/stabilizing on skull).
  
  
  CONCLUSIONS
  This work represents a feasibility study including specification analysis, design and prototyping of a novel Burr hole endoscope stabilizing device. The device offers variable support for the endoscope, from complete free-hand to semirigid to rigid, thus freeing one hand which is often used to stabilize the endoscope. It can potentially help achieve solo surgery.
authors.affiliation: Barts Health NHS Trust, St Bartholomew's and The Royal London Hospital, London, UK dimitris.paraskevopoulos@bartshealth.nhs.uk.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Paraskevopoulos
mesh_terms: D002552:Cerebral Ventricles / Q000601:surgery*; D017076:Computer-Aided Design; D004724:Endoscopy / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design; D004869:Equipment Safety; D006801:Humans; D021621:Imaging, Three-Dimensional; D044582:Neuroendoscopes / Q000145:classification; D044583:Neuroendoscopy / Q000295:instrumentation*; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000379:methods
keywords: device innovation; endoscope holder; endoscopy; minimally invasive surgery; neuroendoscopy; ventricular surgery