The Endoscopic Sinus Simulator (ESS)

Endoscopic sinus surgery is a complex procedure requiring integration of radiographic findings with patient pathology.  It requires surgical experience much as otologic surgery does.  Temporal bone dissections have been found to be invaluable in the teaching of surgical procedures to the otolaryngology resident.  To date, because of limited availability of cadaveric specimens, similar teaching could not be performed for endoscopic sinus surgery.  The Department of Otolaryngology at AECOM has acquired an endoscopic sinus surgery simulator (ES3) designed and developed by Lockheed Martin, as a result of a grant for the US Army Medical Research and Material Command in conjunction with Dr. Charles Edmonds at Madigan Army Medical Center.  The first commercially available such device is at the Montefiore Medical Center campus, and is being used to train our residents at all levels of experience on the anatomy and techniques of sinus surgery.  A visual database creates smooth and accurate images in real time on a monitor as the surgeon positions the sinus endoscope and manipulates an array of instruments within a mannequin head.  As the surgeon moves the instruments, haptic feedback occurs (the push and pull of the instrument in relation to the procedure) with every motion.  The nasal passage image is correlated to the CT image on the monitor to show location of the instruments.  We are currently developing and undertaking an objective assessment of the use of this device for surgical training of our resident staff.