2017 年 19 巻 1 号 p. 17-26
A high level of surgical skill is required for endoscopic sinus surgery (ESS), a procedure that involves the nasal sinus, which is adjacent to important organs, without injury. However, it is difficult to assess such surgery quantitatively in a clinical environment. Thus, we employed a surgical navigation system that is currently used in ESS, and have developed a method to assess surgical tasks by utilizing the navigation system as a recording medium. Previously, we had developed a method for analyzing the manipulation of an endoscope, which is an important aspect of ESS, using this navigation system, based on simulated surgeries. Here, we established a method for measuring and analyzing endoscope manipulation during clinical image-guided ESS. In this study, we analyzed 8 clinical cases, in which expert surgeons treated one nasal cavity, and resident surgeons treated the contralateral cavity, by ESS. In order to clarify the features of endoscopic manipulation by experts and residents in detail, we performed principal component analysis as well as time-series analysis using the analytical parameters derived from information stored on the navigation system. Our proposed method enabled quantitative evaluation of the performance of endoscopic manipulation during ESS in a clinical environment.