First Experience of ARTip Cruise VITOM-assisted OPF Removal of Frontal Fibro-osseous Lesion: Operative Video.

Abstract

INTRODUCTION The ever-expanding use of the endoscopes, coupled with dedicated instrumentation, has reshaped the panorama of surgical approaches to the frontal sinus, reducing indications for craniofacial procedures to be performed. Nonetheless, external approaches, such as the osteoplastic flap (OPF), must be part of the otorhinolaryngologist’s armamentarium. In this regard, exoscopeswere recently introduced as analternative or support to operating microscopes (OMs), with the intent of improving the surgeon’s field of vision and ergonomics. In this article, we present, to the best of our knowledge, the first case of in vivo application of VITOM 3D-4K (KARL STORZ GmbH & Co, Tuttlingen, Germany) coupled with a dedicated robotic arm (ARTip CruiseTM) to remove an extensive left frontal sinus fibrous dysplasia via a combined OPFendonasal approach. Advantages and disadvantages of the exoscope’s assistance will be discussed and a surgical step-bystep video of the procedurewill be provided.