ABSTRACT
The bimanual technique has expanded the range of surgery and it allows more precise surgery to be carried out with better visibility. In classical endoscopic sinus surgery, the endoscopic surgeon holds the endoscope with one hand while carrying out the surgical procedure with the other hand. The surgeon will spend a lot of time sucking blood out, removing the sucker, inserting the surgical instrument and then they have to repeat the process when blood has recollected. From the ergonomic viewpoint this way of working is inefficient. With only one free hand for surgery, as the other has to hold the endoscope, it is also difficult to retract any structure out of the way, or for tension to be placed on any tissue that needs to be cut (Fig. 4.1).
