A smart micro-drill for cochleostomy formation: A comparison of cochlear disturbances with manual drilling and a human trial

Coulson, Chris; Assadi, Masoud Zoka; Taylor, R.; Du, Xinli; Brett, PN; Reid, Andrew; Proops, David W.

doi:10.1179/1754762811y.0000000018

Cited by 16 publications

(17 citation statements)

References 17 publications

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“…A recent preliminary study on the use of a handheld micromanipulator for robot‐assisted stapes footplate surgery was also published, which indicated a significant reduction in position errors and mean duration time spent in dangerous zones . Moreover, most experimental surgical robots in otology have been developed for direct cochlear access in cochlear implantation procedures, as mentioned above . However, these are totally automated robot systems and have few other clinical applications, as they can only be used for cochlear implantation, which accounts for a small portion of various surgeries requiring mastoidectomy.…”

Section: Discussionmentioning

confidence: 99%

“…Following this, several types of robots were developed and tested for otologic surgery, but most remain in an experimental stage. Among these robots, the most frequently reported on were developed for cochlear implantation, which drills along a predetermined trajectory line from the bone surface to the cochlea …”

Section: Introductionmentioning

confidence: 99%

“…Among these robots, the most frequently reported on were developed for cochlear implantation, which drills along a predetermined trajectory line from the bone surface to the cochlea. [4][5][6][7][8][9][10][11] As mastoidectomy is one of the most basic and important otologic surgical procedures, and robot systems for this procedure can have broad clinical applications. Several robotic devices for mastoidectomy have been developed, although most include automated robots that drill through the mastoid bone as programmed.…”

Section: Introductionmentioning

confidence: 99%

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A cadaver study of mastoidectomy using an image‐guided human–robot collaborative control system

Yoo

Lee

Yang

et al. 2017

Laryngoscope Investig Oto

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ObjectiveSurgical precision would be better achieved with the development of an anatomical monitoring and controlling robot system than by traditional surgery techniques alone. We evaluated the feasibility of robot‐assisted mastoidectomy in terms of duration, precision, and safety.Study DesignHuman cadaveric study.Materials and MethodsWe developed a multi‐degree‐of‐freedom robot system for a surgical drill with a balancing arm. The drill system is manipulated by the surgeon, the motion of the drill burr is monitored by the image‐guided system, and the brake is controlled by the robotic system. The system also includes an alarm as well as the brake to help avoid unexpected damage to vital structures. Experimental mastoidectomy was performed in 11 temporal bones of six cadavers. Parameters including duration and safety were assessed, as well as intraoperative damage, which was judged via pre‐ and post‐operative computed tomography.ResultsThe duration of mastoidectomy in our study was comparable with that required for chronic otitis media patients. Although minor damage, such as dura exposure without tearing, was noted, no critical damage to the facial nerve or other important structures was observed. When the brake system was set to 1 mm from the facial nerve, the postoperative average bone thicknesses of the facial nerve was 1.39, 1.41, 1.22, 1.41, and 1.55 mm in the lateral, posterior pyramidal and anterior, lateral, and posterior mastoid portions, respectively.ConclusionMastoidectomy can be successfully performed using our robot‐assisted system while maintaining a pre‐set limit of 1 mm in most cases. This system may thus be useful for more inexperienced surgeons.Level of EvidenceNA.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A cadaver study of mastoidectomy using an image‐guided human–robot collaborative control system

Yoo

Lee

Yang

et al. 2017

Laryngoscope Investig Oto

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“…If penetration is allowed to take place, then in reality the tip of the drill bit will have penetrated much further beyond the tissue interface than is necessary to complete the removal of bone tissue of the cochlea as the tissues are flexible and will have deflected significantly in response to tool forces prior to penetration. Avoiding penetration is important in the process to minimise trauma of the hearing organ, as is the amplitude of disturbances induced during the drilling process [13]. …”

Section: Drilling Processmentioning

confidence: 99%

“…Feedback is by observation of behaviour under the binocular microscope [12, 13]. Standard surgical drilling burrs are used.…”

Section: Drilling Processmentioning

confidence: 99%

Feasibility Study of a Hand Guided Robotic Drill for Cochleostomy

Brett

Zoka-Assadi

et al. 2014

BioMed Research International

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The concept of a hand guided robotic drill has been inspired by an automated, arm supported robotic drill recently applied in clinical practice to produce cochleostomies without penetrating the endosteum ready for inserting cochlear electrodes. The smart tactile sensing scheme within the drill enables precise control of the state of interaction between tissues and tools in real-time. This paper reports development studies of the hand guided robotic drill where the same consistent outcomes, augmentation of surgeon control and skill, and similar reduction of induced disturbances on the hearing organ are achieved. The device operates with differing presentation of tissues resulting from variation in anatomy and demonstrates the ability to control or avoid penetration of tissue layers as required and to respond to intended rather than involuntary motion of the surgeon operator. The advantage of hand guided over an arm supported system is that it offers flexibility in adjusting the drilling trajectory. This can be important to initiate cutting on a hard convex tissue surface without slipping and then to proceed on the desired trajectory after cutting has commenced. The results for trials on phantoms show that drill unit compliance is an important factor in the design.

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A Drilling Technology Sensing Interaction with Cut Mediums to Discriminate Behaviour and Properties of Mediums Ahead on the Tool Path

Brett

Wilde

2018

Mechatronics and Machine Vision in Practice 3

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A smart micro-drill for cochleostomy formation: A comparison of cochlear disturbances with manual drilling and a human trial

Cited by 16 publications

References 17 publications

A cadaver study of mastoidectomy using an image‐guided human–robot collaborative control system

A cadaver study of mastoidectomy using an image‐guided human–robot collaborative control system

Feasibility Study of a Hand Guided Robotic Drill for Cochleostomy

A Drilling Technology Sensing Interaction with Cut Mediums to Discriminate Behaviour and Properties of Mediums Ahead on the Tool Path

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