Cadaveric Feasibility Study of da Vinci Si–Assisted Cochlear Implant With Augmented Visual Navigation for Otologic Surgery

Liu, Wen P.; Azizian, Mahdi; Sorger, Jonathan M.; Taylor, Russell H.; Reilly, Brian K.; Cleary, Kevin; Preciado, Diego

doi:10.1001/jamaoto.2013.6443

Cited by 44 publications

(37 citation statements)

References 37 publications

(42 reference statements)

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“…In order to gauge the feasibility of robot-assisted cochlear implant surgery in combination with augmented reality image guidance, Liu et al [10] have recently undertaken the first reported human cadaveric study. Favourable clinical outcomes have been shown to depend critically on accurate cochleostomy placement and the angle of cochlear implant insertion.…”

Section: Image-guided Cochlear Implantationmentioning

confidence: 99%

Transoral Robotic Surgery: Image Guidance and Augmented Reality

Pratt

Arora

2018

ORL

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Transoral robotic surgery (TORS) is being used increasingly as an alternative to conventional open procedures, as its minimally invasive approach results in significant benefits for the patient. This includes faster recovery times and better functional outcomes, less postoperative pain and morbidity associated with open access, shorter operative times, and a reduction in the risk of infection. However, the confined working spaces and sensory deficit, due to a lack of haptic sensation, and proximity to critical vasculature and other vitally important anatomical structures bestow significant challenges on the surgeon. Recent advances in the field of surgical image guidance show promise in helping address these issues. This overview considers a number of important recent developments, all of which exploit imaging technologies that, to a lesser or greater extent, are integrated with the surgical robot platform. In its most advanced form, this combination of technologies results in a fusion of visual information such that the operative field is combined with navigational cues and representations of key anatomical structures through augmented reality registration and overlay. In terms of registration accuracy, image guidance as applied to TORS procedures is an exciting proposition, since the regions of interest (e.g., the tongue base, oropharynx) are typically adjacent to and enclosed by rigid anatomy. Clinical indications and overall effectiveness are discussed together with the limitations of the current technologies. Where appropriate, directions for future work are identified.

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Section: Image-guided Cochlear Implantationmentioning

confidence: 99%

Transoral Robotic Surgery: Image Guidance and Augmented Reality

Pratt

Arora

2018

ORL

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“…This is, of course, possible only on a limited scale as the commercially available perimodiolar implants are not developed and designed for this purpose, and additional intraoperative surgical assistance devices are necessary because an individually optimized insertion process can no longer be performed manually. Nevertheless, thanks to recent advances in surgical master-slave systems [ 12 ], and especially in robot-assisted devices for CI surgery [ 13 – 18 ], as well as in automated insertion tools [ 11 , 19 – 25 ], it seems to be only a question of time until accurate assistance devices can be used intraoperatively for electrode insertion.…”

Section: Introductionmentioning

confidence: 99%

Individual Optimization of the Insertion of a Preformed Cochlear Implant Electrode Array

Rau

Lenarz

Majdani

2015

International Journal of Otolaryngology

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Purpose. The aim of this study was to show that individual adjustment of the curling behaviour of a preformed cochlear implant (CI) electrode array to the patient-specific shape of the cochlea can improve the insertion process in terms of reduced risk of insertion trauma. Methods. Geometry and curling behaviour of preformed, commercially available electrode arrays were modelled. Additionally, the anatomy of each small, medium-sized, and large human cochlea was modelled to consider anatomical variations. Finally, using a custom-made simulation tool, three different insertion strategies (conventional Advanced Off-Stylet (AOS) insertion technique, an automated implementation of the AOS technique, and a manually optimized insertion process) were simulated and compared with respect to the risk of insertion-related trauma. The risk of trauma was evaluated using a newly developed “trauma risk” rating scale. Results. Using this simulation-based approach, it was shown that an individually optimized insertion procedure is advantageous compared with the AOS insertion technique. Conclusion. This finding leads to the conclusion that, in general, consideration of the specific curling behaviour of a CI electrode array is beneficial in terms of less traumatic insertion. Therefore, these results highlight an entirely novel aspect of clinical application of preformed perimodiolar electrode arrays in general.

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“…Possible indications are tumor removal, biopsy, drug delivery, brachytherapy, or cochlear implantation via two instruments and under direct endoscopic visual control. Liu et al showed the possibility of da Vinci Si-assisted cochlear implant surgery with augmented reality in cadaveric feasibility study [11]. The planning and future realization of multiple minimally invasive ports could be used to implement a similar master slave system.…”

Section: Introductionmentioning

confidence: 99%

Minimally Invasive Multiport Surgery of the Lateral Skull Base

Stenin

Hansen

Becker

et al. 2014

BioMed Research International

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Objective. Minimally invasive procedures minimize iatrogenic tissue damage and lead to a lower complication rate and high patient satisfaction. To date only experimental minimally invasive single-port approaches to the lateral skull base have been attempted. The aim of this study was to verify the feasibility of a minimally invasive multiport approach for advanced manipulation capability and visual control and develop a software tool for preoperative planning. Methods. Anatomical 3D models were extracted from twenty regular temporal bone CT scans. Collision-free trajectories, targeting the internal auditory canal, round window, and petrous apex, were simulated with a specially designed planning software tool. A set of three collision-free trajectories was selected by skull base surgeons concerning the maximization of the distance to critical structures and the angles between the trajectories. Results. A set of three collision-free trajectories could be successfully simulated to the three targets in each temporal bone model without violating critical anatomical structures. Conclusion. A minimally invasive multiport approach to the lateral skull base is feasible. The developed software is the first step for preoperative planning. Further studies will focus on cadaveric and clinical translation.

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Cadaveric Feasibility Study of da Vinci Si–Assisted Cochlear Implant With Augmented Visual Navigation for Otologic Surgery

Cited by 44 publications

References 37 publications

Transoral Robotic Surgery: Image Guidance and Augmented Reality

Transoral Robotic Surgery: Image Guidance and Augmented Reality

Individual Optimization of the Insertion of a Preformed Cochlear Implant Electrode Array

Minimally Invasive Multiport Surgery of the Lateral Skull Base

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