Development of a new endoscope holder for head and neck surgery—from the technical design concept to implementation

Abstract

Endoscope holders are utilized by a variety of surgeons but are not commonplace in head and neck surgery. The SOLOASSIST active camera holder, which is currently used for abdominal surgery, will soon be adapted for head and neck surgery in collaboration with AKTORmed GmbH SOLO SURGERY (Barbing, Germany). In our pre-feasibility study, we analyzed the use of the existing endoscope holder on anatomical specimens during head and neck surgery. Based on these results, we are proceeding towards the development of a new endoscope holder for head and neck surgery. First, we drafted the technical concepts and discussed the advantages and disadvantages of the system. Then, we used anatomic specimens to measure the forces that occur intraoperatively during sinus surgery. Next, we designed a computer-aided design (CAD) model. Finally, we developed the first production prototype and used it for a frontal skull base procedure on an anatomical specimen. We present the three most promising concepts for a new holder. The resulting total force (F res = √(X (2) + Y (2) + Z (2))) was calculated to be 3.2 N during sinus surgery. We could observe all necessary intraoperative landmarks with the endoscope and its holder in a sinus and frontal skull base surgery. We developed a production prototype of a new endoscope holder and demonstrate satisfactory results in the use of anatomic specimens for skull base surgery.

Robotische Chirurgie – operiert der Roboter?

“…The SOLOASSIST endoscope support (ACTORmed, Regensburg, Germany) has originally been developed for abdominal surgery and is currently adapted in cadaver studies for the requirements of lateral paranasal sinus and skull base surgery ( Fig. 5a ) 86 . The endoscope holder can be controlled directly via a small joystick, which is mounted to the rigid standard instruments.…”

“…Der SOLOASSIST Endoskop-Halter (AKTORmed, Regensburg) ist ursprünglich für die Abdominalchirurgie entwickelt worden und wird nun in Kadaverstudien für die Anforderungen der lateralen Nasennebenhöhlen- und Schädelbasischirurgie adaptiert ( Abb. 5a ) 86 . Der Endoskop-Halter kann direkt über einen kleinen Joystick gesteuert werden, welcher an die starren Standard-Instrumente montiert wird.…”

Recent advances in robot‐assisted head and neck surgery

“…Adopting an established system for abdominal surgery, Kristin et al . adapted the SOLOASSIST endoscope holder (AKTORmed, Barbing, Germany) to the special needs of head and neck surgery (Figure ) . The desired instruments are equipped with an integrated joystick to maneuver the scope holder without additional controlling devices.…”

An Innovate Robotic Endoscope Guidance System for Transnasal Sinus and Skull Base Surgery: Proof of Concept

“…21 Wurm et al presented a robot for sinus surgery, which was capable of performing sphenoidotomy and sphenoidectomy. 22 The SoloAssist endoscope holder (AK-TORmed ROBOTIC Surgery, Barbing, Germany), purposely created for abdominal surgery, was adopted for sinus surgery by Kristin et al 23 The automated endoscopic system for optimal positioning (AESOP) scope holding system has been equipped with voice-controlled movement enabling bimanual manipulation to optimize workflow and applicability in endoscopic sinus surgery. 24 In our department, the Flex system (Medrobotics, Raynham, MA, United States) has been successfully adopted for visualization of the maxillary sinus, sphenoid, and even brain stem via transnasal approach in a cadaver model.…”