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In this paper the first active surgical robot system (OTTO) in a clinical environment for maxillofacial surgery is presented. The medical application is described from a technical point of view and the requirements for a robot in this specialty are defined. The paper describes the system architecture of the robotics environment and the need for research and development. The robot's hardware is based o n a delta-kinematics robot system. At the current state of development, the robot can be used for inserting non-flexible catheters and for i mplanting bone fixtures in the skull.

In a patient with progressive ophthalmological problems, including uncontrolled intraocular pressure related to a cavernous sinus dural arteriovenous fistula, urgent intervention may be necessary to prevent permanent visual loss. We report a case in which inadequate transarterial embolisation and lack of access for transvenous catheterisation, including a direct approach through the superior ophthalmic vein, preceded percutaneous puncture of the superior ophthalmic vein deep within the orbit, permitting venous occlusion without complications. This case demonstrates that deep orbital puncture of the vein is feasible for occlusion of a cavernous sinus dural arteriovenous fistula.