Artikel
Analysis of Endoscopic Guidance during FESS for Path Planning of an Assisting Surgery Robot
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Autoren
Veröffentlicht: | 8. Juli 2008 |
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Gliederung
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Background: In order to relieve the surgeon during functional endoscopic endonasal sinus surgery (FESS), the endoscope guidance should be performed by an autonomic assisting robot. A step to this is the in vivo evaluation of endoscope movements with help of navigation tools, endoscopic images, and force sensors during conventional FESS.
Methods: We used a novel customised software to record more than 20,000 positions and orientations of the endoscope with the help of a navigation system as well as endoscopic images and forces occurring at the endoscope. The software provides a synchronous view of the recorded data and tools for statistical analysis. It also allows to show the 3D working space of the endoscope as well as the pivot area located at the nasal entrance.
Results: Besides the visualisation of the endoscope working space, we determined cuboids that describe likely positions of the endoscope tip: At 99.99% of the time the endoscope tip is located within a cuboid of the size 49.54 mm x 40.94 mm x 12.01 mm. At 50% of the time the tip is within the much smaller cuboid of 16.59 mm x 11.38 mm x 6.30 mm. The pivot area can be described by a 2D Gaussian distribution with standard deviations of 3.45 mm in the direction of the principal axis and 2.02 mm for the minor axis. For example 50% of the intersection points between the pivot area and the endoscope axis are within an ellipsoid of 3.93 mm x 2.31 mm. Therefore, robots that use a pivot point to simplify the kinematics are not sufficient for this task.
Conclusion: With the help of navigation and sensor data of the endoscope we are able to determine the spatial probability distribution of the endoscope to develop a save and intuitive robotic assistance for endoscope guidance in the nasal cavity during FESS.