[Mechatronic in functional endoscopic sinus surgery. First experiences with the daVinci Telemanipulatory System].

BACKGROUND

This study examines the advantages and disadvantages of a commercial telemanipulator system (daVinci, Intuitive Surgical, USA) with computer-guided instruments in functional endoscopic sinus surgery (FESS).

METHODS

We performed five different surgical FESS steps on 14 anatomical preparation and compared them with conventional FESS. A total of 140 procedures were examined taking into account the following parameters: degrees of freedom (DOF), duration , learning curve, force feedback, human-machine-interface.

RESULTS

Telemanipulatory instruments have more DOF available then conventional instrumentation in FESS. The average time consumed by configuration of the telemanipulator is around 9+/-2 min. Missing force feedback is evaluated mainly as a disadvantage of the telemanipulator. Scaling was evaluated as helpful. The ergonomic concept seems to be better than the conventional solution.

DISCUSSION

Computer guided instruments showed better results for the available DOF of the instruments. The human-machine-interface is more adaptable and variable then in conventional instrumentation. Motion scaling and indexing are characteristics of the telemanipulator concept which are helpful for FESS in our study.