Ein chirurgischer Mikromanipulator in der Ohrchirurgie

Abstract

The micromanipulator gave evidence of a stronger effect as regards individual improvement in accuracy and time span. The micromanipulator shows potential for improvements in accuracy as well as compensation for poor ergonomics.

Positioning Accuracy in Otosurgery Measured with Optical Tracking

“…The use of micromanipulators is under investigation in order to bypass surgeon dependent impacts. This technology has already been investigated during cochlear implantation, tympanoplasty, and stapes surgery [ 2 , 3 , 6 , 7 , 11 , 13 , 14 ].Another trend is robot-assisted surgery and the development of surgical robots [ 5 , 8 , 12 ].The latter new technologies are superior in precision to skilled surgeons. However, tactile feedback is lost while operating with remotely controlled robotic instruments.…”

“…However, tactile feedback is lost while operating with remotely controlled robotic instruments. Additionally, manipulating the robot requires a learning curve, just as with the traditional operative techniques [ 3 ]. Set-up time, operating time, and cost-effectiveness of robot technologies are still being monitored.…”

“…Manipulation during middle ear surgery requires high levels of technical skill and virtually tremor-free handwork. Despite the clinical significance of microsurgical precision in otology, there are little data dealing with the positioning accuracy of otologists [ 1 – 3 ]. Meanwhile, the number of publications about accuracy enhancement devices such as micromanipulators and surgical robots in otology is expanding [ 2 – 14 ].Since most otologists favor a conventional microsurgical training without the application of a tremor-reducing device and work free-handed, it seems to be useful to analyze their performance in improving surgical precision.…”

Evaluation eines Mikromanipulators für die Mittelohrchirurgie: Eine präklinische Studie

“…Hier wird aktuell ein mögliches Einsatzgebiet von Manipulatoren als chirurgisches Assistenzsystem gesehen. Experimentelle und erste klinische Versuche zur Anwendung eines Telemanipulators bei der Stapedotomie konnten Aussagen über Kraftverläu-fe und die Minimierung des Tremors erbringen [12]. Zudem konnten zunehmende Präzision und schnell steigende Lernkurven mithilfe eines Telemanipulators demonstriert werden [12].…”

“…Experimentelle und erste klinische Versuche zur Anwendung eines Telemanipulators bei der Stapedotomie konnten Aussagen über Kraftverläu-fe und die Minimierung des Tremors erbringen [12]. Zudem konnten zunehmende Präzision und schnell steigende Lernkurven mithilfe eines Telemanipulators demonstriert werden [12]. Die bisherigen klinischen Machbarkeitsstudien beschränken sich v. a. auf den Einsatz in der Mittelohrchirurgie [13].…”