Development of an active robot system for multi-modal paranasal sinus surgery

Abstract

Background. Severe complications in endoscopic paranasal sinus surgery are rare, however, when they occur they are often fatal. Injuries to the optic nerve or the internal carotid artery mostly occur after penetration of the sphenoid sinus' anterior wall. Methods. We present the robot system "A 73" with its newly designed 4-canal-microendoscope and special instruments that meets the demands of endoscopic paranasal sinus surgery. A fully automated perforation of the sphenoid sinus' anterior wall was performed in five cadaveric specimens. Results. The sphenoid sinus' anterior wall could be perforated without damaging the surrounding structures in all cases. Subsequently, the approach was enlarged to the desired diameter using telemanipulation mode. The analysis of both the transformation error and intraopertive accuracy showed values in the submillimeter range. Conclusions. Using a newly developed robotic system, a fully automated perforation of the sphenoid sinus' anterior wall was performed precisely and reproducibly. This approach can be enlarged in a telemanipulation mode. © Springer Medizin Verlag 2004.