Taihei Fujii1, Yasuomi Kunimoto1, Tomohiko Kisaka2, Shivani Gupta3, Hiroaki Yazama1, Junko Kuya4, Kazunori Fujiwara1, Hiromi Takeuchi1. 1. Division of Otolaryngology, Head and Neck Surgery, Department of Sensory and Motor Organs, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan. 2. †Division of Biodesign, Translational Research Center, Hiroshima University, Hiroshima 734-8551 Japan. 3. ‡School of International Biodesign, All India Institute of Medical Sciences, New Delhi 110029, India. 4. §Nippon Medical School Chiba Hokusoh Hospital, Inzai 270-1694, Japan.
Abstract
BACKGROUND: Endoscopic surgery is developing in various clinical specialties. During ear endoscopic surgery, a surgeon has to hold an endoscope with one hand and operate the surgical instruments with another hand. Therefore, the stability of the surgeon's hand affects the field of surgical view and quality of the surgery considerably. There are few techniques which are used during surgery to stabilize the endoscope. However, no study has evaluated the efficacy of such techniques in detail. This study examined the three dimensional movement of an endoscope to compare and evaluate the effect of various stabilization techniques to reduce the hand tremor while using the endoscope. METHODS: A non-randomized controlled trial involving 15 medical students was conducted in Tottori University, Japan. Subjects held an endoscope with their non-dominant hand and manipulated it using three different stabilization techniques i.e. with resting the elbow on the table, resting the endoscope on the ear canal, both with the elbow on the table and endoscope on the ear canal. For the control, subjects were made to use the endoscope without any stabilization technique. The endoscopic movement was measured with and without using the stabilization techniques. RESULTS: The results obtained in this study indicated that manipulating the endoscope with resting the elbow on the table restrains both vertical (Y-axis) and optical axis (Z-axis) direction of tremor, and manipulating the endoscope by resting it on the ear canal restrains both vertical (Y-axis) and horizontal axis (X-axis) direction while the combined use of both the techniques reduces the endoscope movement in all the three X, Y and Z axes. CONCLUSION: In conclusion, concomitant use of both techniques appears to be clinically beneficial in endoscopic ear surgery.
BACKGROUND: Endoscopic surgery is developing in various clinical specialties. During ear endoscopic surgery, a surgeon has to hold an endoscope with one hand and operate the surgical instruments with another hand. Therefore, the stability of the surgeon's hand affects the field of surgical view and quality of the surgery considerably. There are few techniques which are used during surgery to stabilize the endoscope. However, no study has evaluated the efficacy of such techniques in detail. This study examined the three dimensional movement of an endoscope to compare and evaluate the effect of various stabilization techniques to reduce the hand tremor while using the endoscope. METHODS: A non-randomized controlled trial involving 15 medical students was conducted in Tottori University, Japan. Subjects held an endoscope with their non-dominant hand and manipulated it using three different stabilization techniques i.e. with resting the elbow on the table, resting the endoscope on the ear canal, both with the elbow on the table and endoscope on the ear canal. For the control, subjects were made to use the endoscope without any stabilization technique. The endoscopic movement was measured with and without using the stabilization techniques. RESULTS: The results obtained in this study indicated that manipulating the endoscope with resting the elbow on the table restrains both vertical (Y-axis) and optical axis (Z-axis) direction of tremor, and manipulating the endoscope by resting it on the ear canal restrains both vertical (Y-axis) and horizontal axis (X-axis) direction while the combined use of both the techniques reduces the endoscope movement in all the three X, Y and Z axes. CONCLUSION: In conclusion, concomitant use of both techniques appears to be clinically beneficial in endoscopic ear surgery.
Authors: Elliott D Kozin; Ashton Lehmann; Margaret Carter; Ed Hight; Michael Cohen; Hideko H Nakajima; Daniel J Lee Journal: Laryngoscope Date: 2014-04-10 Impact factor: 3.325
Authors: Attila Óvári; Dóra Neményi; Tino Just; Tobias Schuldt; Anne Buhr; Robert Mlynski; András Csókay; Hans-Wilhelm Pau; István Valálik Journal: PLoS One Date: 2016-03-30 Impact factor: 3.240