A handheld flexible manipulator system for frontal sinus surgery
Autor: | Suat Coemert, Tim C. Lueth, Gero Strauss, Robert Roth, Pia M. Schmitz |
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Rok vydání: | 2020 |
Předmět: |
Adult
0209 industrial biotechnology Computer science Instrumentation Video Recording Biomedical Engineering Control unit Hinge Health Informatics 02 engineering and technology 03 medical and health sciences Cross section (physics) 020901 industrial engineering & automation 0302 clinical medicine Vertical direction medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies 030223 otorhinolaryngology Simulation Endoscopes Frontal sinus Handheld Phantoms Imaging Payload Endoscopy Equipment Design General Medicine Frontal sinus surgery Endoscopic surgery Computer Graphics and Computer-Aided Design Flexible manipulator ddc Computer Science Applications medicine.anatomical_structure Surgery Computer-Assisted Surgical instrument Frontal Sinus Original Article Surgery Computer Vision and Pattern Recognition |
Zdroj: | International Journal of Computer Assisted Radiology and Surgery |
ISSN: | 1861-6429 1861-6410 |
Popis: | 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. |
Databáze: | OpenAIRE |
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