Assessment of the necessary conditions for robot-assisted surgery in the nasal cavity

Objectives - to determine the necessary conditions for performing robot-assisted operations in the nasal cavity.

Material and methods. We have investigated the movement of an endoscope in space by measurements based on high-resolution computed tomography (CT) data. A total of 50 CT scans of the paranasal sinuses were used for this purpose. The tomograms were randomly selected from among the patients of the ENT clinic of the Saratov State Medical University. The main parameters characterizing the movement of the endoscope in the nasal cavity under the conditions set by us are the magnitude of its linear displacement from the entry point and the angle of its deviation, measured in three planes - frontal, sagittal and horizontal, provided that the planes of these sections pass through the entry point during various operations. To control these measurements, we detected the displacements of the endoscope in space using an optical tracking system we made, as well as specialized software designed specifically for the purpose of optical tracking. With the help of this device, measurements were carried out on the skulls and their models, the silicone model for endoscopic examination K. Storz 723128, as well as during real endoscopic operations on the paranasal sinuses. All studies were combined into groups according to the standard protocols of endoscopic operations performed endonasally: “Anterior ethmoidotomy”, “Posterior ethmoidotomy”, “Frontotomy”, “Sinusotomy”, “Sphenotomy”, “Adenotomy”.

Results. The main characteristics of the movement of the endoscope in the nasal cavity at a given entry point in the nostril area were established - its maximum linear and angular displacement during various types of FESS interventions for adults.

The results obtained by us can serve as the main criteria for the development of a specialized robot assistant that holds and moves the endoscope in space during FESS.