Specification Analysis,Design,and Prototyping of a Burr Hole Endoscope Stabilization Device

Objective. Aim of this study was to develop a prototype for an innovative, burr-hole mounted device, for stabilizing endoscopes during intracranial surgery. The objective was an easily maneuverable device, freeing one hand without compromising flexibility and safety. This could avoid the need for a second surgeon or a bulky holder, thus improving coordination. Methods. The initial concept arose from the observation that intraventricular endoscopy is often performed by 2 surgeons, 1 navigating the endoscope and 1 inserting/handling instruments through the working channel. A specification analysis was performed. Desired properties were specified through a literature review, as well as informal interviews with surgeons and engineers. Tools used for the design included blueprints, 3-dimensional computer aided-design and cooperating with engineers. The final prototype was 3D-printed and the toruses were produced with molding. Results. A prototype named BuESta (Burr hole Endoscope Stabililizer) was produced. This consists of 2 half hollow sphere parts and interchangeable toruses and has the following features: easy to produce, inexpensive, not prolonging surgical time, semirigid, variable fixation, easy to fix/release, safe, no bulky articulated arms, mimicking basic concepts of second hand fixation (index finger/thumb fixation, hand resting/stabilizing on skull). Conclusions. This work represents a feasibility study including specification analysis, design and prototyping of a novel Burr hole endoscope stabilizing device. The device offers variable support for the endoscope, from complete free-hand to semirigid to rigid, thus freeing one hand which is often used to stabilize the endoscope. It can potentially help achieve solo surgery.