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Mechanical Reinforcement towards Fully Soft Magnetic Endoscopic Endonasal Surgical Manipulators

Endoscopic Endonasal Surgery (EES) targets the sinuses or base of the skull for treatment of lesions, tumors or polyps. The endonasal approach for these procedures is much safer than a craniotomy approach, involving removing part of the skull to access the operating site. Even though current EES is highly beneficial, technolog- ical limitations are still present [1]. EES is performed by inserting a rigid endoscope and accompanying tools through the nostrils. The coupled constraints of narrow, curved anatomy with straight and rigid tools present a significant challenge in EES, limiting visibility and maneuverability within the workspace. Enhancing the flexibility and controllable Degrees of Freedom (DoF) of the tools could make procedures safer and easier to perform. Most of the proposed robotic solutions for EES are mechanically driven with sizes close to standard and do not address the issue of miniaturisation or delicate tissue interaction [2], [3]. The field of soft robotics may offer solutions to the issues faced in EES, allowing small compliant manipulators with increased DoF for superior maneuverability and safer tissue interactions. Of these robotic designs, the relatively new field of Soft Magnetic Manipulators (SMMs) presents some notable advantages when designing for small scales. SMMs can be entirely soft and can be magnetically pre-programmed to pro- duce desired deformations under exposure to specific and controlled external magnetic fields [4]. External, remote actuation of this type thus enables extreme miniaturization without loss of controllable DoFs, which is often impossible to achieve with other approaches due to the accommodation of onboard actuation. Due to these advantages magnetically actuated devices can be very beneficial in medical environment ‚Äì specifically for improving navigation through tortuous anatomical pathways and difficult to access surgical sites, such as in EESs. In this paper we investigate the application of soft continuum magnetic manipulators to EES procedures. In combination, the presented approach aims to enable del- icate interaction with tissue, and higher maneuverability with respect to current EES tools; overcoming issues associated with torsion.