Beth Israle Deconess Medical Center and Cambridge Health Alliance
Harvard Medical School, Boston, MA, USA
Despite several endoscope holders exist for other types of surgery, they are not adequate for specific functional requirement for EES. The purpose of this study is to review the shortcomings of the existing scope holders and to suggest design features for future ESS scope holders.
3 existing surgical scope holders were found to be representative in scope designs.
YiKY laparoscopic device is attached to operating table rail. In ear surgeries, the scope holder is suspended in the air through an attachment arm. If a camera is mounted, unsteady vision can be perceived if the device or the operating table is accidentally bumped.
MITAKA arm has 12 degrees of freedom that can be released through a pneumatic switch that is ideal for coarse but not micro-positioning for the scope. The device drifts 3 mm when it is unlocked or locked.
MIT scope holder has a novel magnetic ball transfer, albeit bulky, that allows scope micro positioning along the ear canal. It also uses an attachment arm that has several degrees of freedom. Unlike the MITAKA arm, multiple locks need to be individually switched to allow scope macro adjustments.
A scope holder for ESS requires unique design that most existing scopes for other surgical specialties do not offer. For stability it might be best to eliminate the long attachment arm. The scope holder can then be attached to surgical clamps at the operated ear. Certain complex features such as multiple degree of freedom may have to be sacrificed in order to reduce device bulk.