The iArmS Robotic Armrest Prolongs Endoscope Lens–Wiping Intervals in Endoscopic Sinus Surgery

Objective. Fouling of the endoscope lens is a major problem in endoscopic sinus surgery (ESS). We examined whether the use of the intelligent arm support system (iArmS), a robotic armrest, could prolong endoscope lens–wiping intervals in ESS and thus allow for continuously clear endoscopic images. Study Design. This study is a prospective, nonrandomized crossover study. Methods. Three surgeons who performed ESS at 2 centers each conducted 3 operations with the iArmS and 3 operations without the iArmS; thus, 18 operations were assessed. To blind the assessments, we performed them prospectively without informing subjects of the endpoints. We recorded the operations and observed the recordings at a later date; endoscope lens–wiping times were noted in seconds to determine the endoscope lens–wiping intervals. Our examination was based on the null hypothesis that endoscope lens–wiping intervals would not differ according to the use or nonuse of the iArmS. Results. The median endoscope lens–wiping intervals with and without using the iArmS were 361 seconds and 135 seconds, respectively. Based on the Wilcoxon rank-sum test, this difference was significant ( P = 0.001); thus, the null hypothesis was rejected. This result indicated that endoscope lens–wiping intervals are greatly prolonged by the use of the iArmS. Conclusion. The iArmS robotic armrest is suitable for ESS, prolongs endoscope lens–wiping intervals, and facilitates obtaining continuous clear endoscopic images.