A handheld flexible manipulator system for frontal sinus surgery

Bibliographic Details
Title: A handheld flexible manipulator system for frontal sinus surgery
Authors: Suat Coemert, Robert Roth, Gero Strauss, Pia M. Schmitz, Tim C. Lueth
Source: Int J Comput Assist Radiol Surg
Publisher Information: Springer Science and Business Media LLC, 2020.
Publication Year: 2020
Subject Terms: Adult, Endoscopes, 0209 industrial biotechnology, Phantoms, Imaging, 0206 medical engineering, Video Recording, Endoscopy, Equipment Design, 02 engineering and technology, ddc, Surgery, Computer-Assisted, Frontal Sinus/pathology [MeSH], Endoscopes [MeSH], Adult [MeSH], Handheld, Humans [MeSH], Prospective Studies [MeSH], Frontal Sinus/surgery [MeSH], Endoscopy/economics [MeSH], Original Article, Surgery, Computer-Assisted/economics [MeSH], Surgery, Computer-Assisted/instrumentation [MeSH], Phantoms, Imaging [MeSH], Equipment Design [MeSH], Frontal sinus surgery, Video Recording [MeSH], Endoscopic surgery, Endoscopy/instrumentation [MeSH], Flexible manipulator, Frontal Sinus, Humans, Prospective Studies
Description: Purpose Draf drainage is the standard treatment procedure for frontal sinus diseases. In this procedure, rigid angled endoscopes and rigid curved instruments are used. However, laterally located pathologies in the frontal sinus cannot be reached with rigid instrumentation. In order to assist surgeons with such complicated cases, we propose a novel handheld flexible manipulator system. Methods A cross section of 3 mm × 4.6 mm enables transnasal guiding of a flexible endoscope with 1.4 mm diameter and a standard flexible surgical instrument with up to 1.8 mm diameter into the frontal sinus with increased reachability. The developed system consists of an electrical discharge-machined flexure hinge-based nitinol manipulator arm and a purely mechanical handheld control unit. The corresponding control unit enables upward and left–right bending of the manipulator arm, translation, rolling, actuation and also quick exchange of the surgical instrument. In order to verify the fulfillment of performance requirements, tests regarding reachability and payload capacity were conducted. Results Reachability tests showed that the manipulator arm can be inserted into the frontal sinus and reach its lateral regions following a Draf IIa procedure. The system can exert forces of at least 2 N in the vertical direction and 1 N in the lateral direction which is sufficient for manipulation of frontal sinus pathologies. Conclusion Considering the fact that the anatomical requirements of the frontal sinus are not addressed satisfactorily in the development of prospective flexible instruments, the proposed system shows great potential in terms of therapeutic use owing to its small cross section and dexterity.
Document Type: Article
Other literature type
File Description: application/pdf
Language: English
ISSN: 1861-6429
1861-6410
DOI: 10.1007/s11548-020-02220-0
Access URL: https://link.springer.com/content/pdf/10.1007/s11548-020-02220-0.pdf
https://pubmed.ncbi.nlm.nih.gov/32613601
https://link.springer.com/content/pdf/10.1007/s11548-020-02220-0.pdf
https://dblp.uni-trier.de/db/journals/cars/cars15.html#CoemertRSSL20
https://link.springer.com/article/10.1007/s11548-020-02220-0
https://pubmed.ncbi.nlm.nih.gov/32613601/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7419368
http://europepmc.org/article/MED/32613601
https://repository.publisso.de/resource/frl:6468864
https://mediatum.ub.tum.de/1578062
Rights: CC BY
Accession Number: edsair.doi.dedup.....d50c8488c194b24d0ce8041d1a18fe08
Database: OpenAIRE
Description
ISSN:18616429
18616410
DOI:10.1007/s11548-020-02220-0