Task Performance in Stapedotomy: Comparison Between Surgeons of Different Experience Levels

Rothbaum, Daniel L.; Roy, Jaydeep; Hager, Gregory D.; Taylor, Russell H.; Whitcomb, Louis L.; Francis, Howard W.; Niparko, John K.

doi:10.1067/mhn.2003.13

Cited by 29 publications

(21 citation statements)

References 18 publications

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“…Previous studies showed that the role of haptic feedback could be different for experienced and inexperienced surgeons [2][10] [11]. Our results are promising in terms of clinical practice, since enhanced perception performs well in a variety of different conditions.…”

Section: Discussionsupporting

confidence: 66%

Experimental evaluation of a coaxial needle insertion assistant with enhanced force feedback

Lorenzo

Koseki

Momi³

et al. 2011

2011 Annual International Conference of the IEEE Engineering in Medicine and Biology Society

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Abstract-During needle insertion in soft tissue, detection of change in tissue properties is important both for diagnosis to detect pathological tissue and for prevention to avoid puncture of important structures. The presence of a membrane located deep inside the tissue results in a relatively small force variation at the needle tip that can be masked by relatively large friction force between the needle shaft and the surrounding tissue. Also, user perception of force can be limited due to the overall small force amplitude in some applications (e.g. brain surgery).A novel robotic coaxial needle insertion assistant was developed to enhance operator force perception. The coaxial needle separates the cutting force at the needle tip from shear friction on the needle shaft. The assistant is force controlled (admittance control), providing the operator with force feedback that is a scaled version of the force applied by the needle tip to the tissue. The effectiveness of the assistant in enhancing the detection of different tissue types was tested experimentally. Users were asked to blindly insert a needle into artificial tissues with membranes at various depths under two force feedback conditions: (1) shaft and tip force together, and (2) only tip force. The ratio of successful to unsuccessful membrane detection was significantly higher when only the needle tip force is displayed to the user. The system proved to be compliant with the clinical applications requirements.

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Section: Discussionsupporting

confidence: 66%

Experimental evaluation of a coaxial needle insertion assistant with enhanced force feedback

Lorenzo

Koseki

Momi³

et al. 2011

2011 Annual International Conference of the IEEE Engineering in Medicine and Biology Society

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“…The success of the procedure is dependent on the surgeon's dexterity and experience [12]. Partial or complete restoration of conductive hearing loss is observed in up to 90% of cases [9].…”

Section: Rationalementioning

confidence: 99%

Design, Kinematic Optimization, and Evaluation of a Teleoperated System for Middle Ear Microsurgery

Miroir

Nguyen

Szewczyk

et al. 2012

The Scientific World Journal

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Middle ear surgery involves the smallest and the most fragile bones of the human body. Since microsurgical gestures and a submillimetric precision are required in these procedures, the outcome can be potentially improved by robotic assistance. Today, there is no commercially available device in this field. Here, we describe a method to design a teleoperated assistance robotic system dedicated to the middle ear surgery. Determination of design specifications, the kinematic structure, and its optimization are detailed. The robot-surgeon interface and the command modes are provided. Finally, the system is evaluated by realistic tasks in experimental dedicated settings and in human temporal bone specimens.

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“…Reports have been written of incus and stapes footplate stimulators constructed using wardbased materials [12,13], but reports of objective performance from their use have not been published. In a temporal bone model of stapedotomy [14], experienced and novice surgeons were compared by their performance during fenestration, the degree of force applied to the footplate, prosthesis crimp quality and prosthesis mobility during crimping. Based on their results of experienced surgeons better targeting the fenestration, less prosthesis migration during crimping and that the most common cause of failed stapes surgery is a migrated prosthesis, these authors suggest that in teaching techniques for enhancing precision in stapedotomy, strategies for dampening natural tremor and optimal instrument trajectory should be emphasized.…”

Section: Trainingmentioning

confidence: 99%

Who should be a stapes surgeon? An otologist or a generalist?

Statham

Pensak

2006

Current Opinion in Otolaryngology & Head and Neck Surgery

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Task Performance in Stapedotomy: Comparison Between Surgeons of Different Experience Levels

Abstract: The observed differences in task performance may contribute to an understanding of maneuvers that increase the risk of inadequate prosthesis placement and cochlear trauma-factors likely responsible for variable hearing results with strapedotomy.

Cited by 29 publications

References 18 publications

Experimental evaluation of a coaxial needle insertion assistant with enhanced force feedback

Experimental evaluation of a coaxial needle insertion assistant with enhanced force feedback

Design, Kinematic Optimization, and Evaluation of a Teleoperated System for Middle Ear Microsurgery

Who should be a stapes surgeon? An otologist or a generalist?

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