Learning Objectives:

Introduction: Recently, an endoscopic ear surgery is widely spreading. During the endoscopic surgery, the operator holds an endoscope with one hand and manipulates the instruments with another hand. The fixation of the endoscope could be unstable especially for operators who do not have enough experience of the endoscopic surgery. Unstableness of the endoscope can cause the surgical difficulty, furthermore, increases the complication by contacting to the surrounding important structures. Because the intraoperative monitor is 2-dimension, we could not measure how far the endoscope is displaced parallel to the visual axis. In this study, we objectively measured the 3-dimensional displacement of the endoscope in several situations and assessed the appropriate fixation.

Methods: The displacement of the endoscope tip was measured using the 3-dimensional motion capture software. The measurements were performed in several situations such as just holding the endoscope without any manipulation, during the manipulation, and while receiving the instrument from the scrub nurse. In each situation, the endoscope was fixed with or without operator's elbow.

Results: The displacement of the endoscope with elbow fixation tended to be smaller than that of without elbow fixation in each situation.

Conclusions: From our preliminary result, it seemed the most appropriate to fix the endoscope with elbow.