Endoscopic Middle Ear Surgery Using a Robotic Endoscope Holder

By June 7, 2019

Mattheis, Stefan1; Lang, Stephan1
1 Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, Germany.

To evaluate the application of a robotic endoscope holder in endoscopic middle ear surgery.

-Study Design: In a prospective clinical study we evaluated the use of the Medineering Robotic System in combination with an Olympus 4K-endoscope in endoscopic middle ear surgery. A 30° or 0° endoscope was attached to a robotic arm which was controlled via foot paddle.
-In 6 patients (4 male, 2 female) with chronic otitis media we performed an endoscopic tympanoplasty. Three patients suffered from choleteatoma, which was treated with a combined approach in two patients and a trans-attic approach in one patient.
-Interventions: In two patients we performed a type 1 tympanoplasty and in 3 patients we performed a type 3 tympanoplasty. The procedures were performed endoscopically via a 55″” 4K-monitor.

-Main outcome measures: Feasibility of the use of an robotic arm during endoscopic middle ear surgery, set-up time, adverse events.
-All surgeries were completed successfully. Set-up time for the robotic arm was less than ten minutes. The 4K endoscope provided a good visualization of the middle ear and mastoid with high resolution and contrast. Using a robotic endoscope holder allows a “”two-hand surgery””. No severe adverse events occurred.

The application of a robotic endoscope holder in endoscopic middle ear surgery is feasible and a promising development. The technique allows bi-manual surgery and provides, in combination with a 4K-endoscope, a good visualization of all relevant anatomic regions of the middle ear.