Abstract
Distal nasolacrimal duct stenosis is usually treated by head and neck surgeons with transnasal endoscopic dacryocystorhinostomy (DCR). The presented clinical study discusses advantages and drawbacks of a robot-assisted endoscope positioning system, which allows for hands-free visualization of the surgical field. Two patients were treated by surgical DCR. The endoscopic positioning system (Medineering® ) features a mechatronic holding arm with four segments and seven degrees of freedom. It is driven by using a foot pedal. Visualization and instrumentation of the surgical field including the relevant anatomical landmarks were feasible. The endoscope position could be controlled with sufficient precision. The surgeon was able to maintain bimanual instrumentation. The endoscope positioning system allows for two-handed surgery, which facilitates the essential steps of the surgical procedure. If the benefit of the system is sufficient for the use in clinical routine, it has to be evaluated in repeated applications.
Highlights
Nasolacrimal duct stenosis is a pathology, which usually presents with epiphora.[1,2] While it is not a life‐threatening disease, patients still suffer from functional issues and a reduced quality of life
While a proximal stenosis is commonly treated by ophthalmologists, head and neck surgeons typically focus on the treatment of the stenosis distal to the lacrimal sac
After manual adjustment of the endoscope to the positioning system, the endoscope position was controlled with sufficient precision by using the foot pedal
Summary
Nasolacrimal duct stenosis is a pathology, which usually presents with epiphora.[1,2] While it is not a life‐threatening disease, patients still suffer from functional issues and a reduced quality of life. The obstruction of the nasolacrimal duct is usually distinguished in subgroups, based on the location of the stenosis, for example, proximal, intra or distal to the lacrimal sac. While a proximal stenosis is commonly treated by ophthalmologists, head and neck surgeons typically focus on the treatment of the stenosis distal to the lacrimal sac. Distal nasolacrimal duct stenosis is usually treated by head and neck surgeons with transnasal endoscopic dacryocystorhinostomy (DCR). The presented clinical study discusses advantages and drawbacks of a robot‐assisted endoscope positioning system, which allows for hands‐free visualization of the surgical field. The endoscopic positioning system (Medineering®) features a mechatronic holding arm with four segments and seven degrees of freedom. It is driven by using a foot pedal. If the benefit of the system is sufficient for the use in clinical routine, it has to be evaluated in repeated applications
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