Design and use of assistant robotic arm in endoscopic transnasal surgery.

Objective: This study aimed to develop a robotic system with autonomous functionality for holding and manipulating the endoscope in endoscopic endonasal surgery. A cost-effective prototype was created with the goal of using robotic assistance and achieving a more efficient learning curve for endoscopic surgery.

Methods: A Stewart platform-based endoscope holder and positioner robotic system, developed by the Mechatronics Engineering Department of Kocaeli University, was used in conjunction with 3D Slicer and Plus Toolkit open-source health technology software. Following initial configuration on a 3D skull model, the system was applied to a fresh-frozen cadaver.

Results: The robotic system and its registration process proved feasible, allowing the robot to autonomously reach predetermined anatomical points during the nasal step of the surgery. Compared with a previous study by the same authors, the surgery duration was successfully shortened. The experiment yielded positive outcomes in both the artificial skull model and the cadaver. The robotic system effectively performed the nasal stage of the surgery. The integration of a robotic surgical arm in the endoscopic endonasal approach holds the potential to enhance the learning curve through shared experiences. The robot offers assistance to surgeons during the learning phase of the endoscopic endonasal approach, aiding in the identification of anatomical landmarks through preoperative planning.

Conclusions: This system may present advantages such as improved visualization, enhanced maneuverability, and reduced user fatigue compared with conventional methods. These findings show the potential of robotic assistance in endoscopic surgical techniques.