Robotic-guided minimally-invasive cochleostomy : first results

Due to increasing claims on high precision surgery, robotic assistance is becoming an emerging and highly demanded technology. Especially in surgical procedures in regions with complex anatomy mechatronical devices could help prevent iatrogen damaging of risk structures. In Otolaryngology particular cochlear implantation is a procedure characterized by a high degree of complexity and required accuracy. This surgery, which is accepted to be the most suitable solution for recovery from deafness, demands a exactly localized opening of the cochlea and an atraumatic insertion of a stimulating electrode array within the scala tympani. This paper presents a new minimally-invasive method for the preparation of the implant’s slot using a combination of high resolution imaging, stereo-optical navigation and a robotic manipulator. In this contribution, we introduce the hardware components of the system as well as its software structure and present first experimental results of a robot assisted minimal invasive cochleostomy.

[1]  J. Fitzpatrick,et al.  Image-guided surgery: what is the accuracy? , 2005, Current opinion in otolaryngology & head and neck surgery.

[2]  W A Kalender,et al.  [The use of flat-panel detectors for CT imaging]. , 2003, Der Radiologe.

[3]  T. Brady,et al.  High-resolution computed tomography of temporal bone: Part II: coronal preoperative anatomy. , 2005, Journal of computer assisted tomography.

[4]  Omid Majdani,et al.  Increase of Accuracy in Intraoperative Navigation Through High-Resolution Flat-Panel Volume Computed Tomography: Experimental Comparison With Multislice Computed Tomography-Based Navigation , 2007, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[5]  E Lehnhardt,et al.  [Intracochlear placement of cochlear implant electrodes in soft surgery technique]. , 1993, HNO.

[6]  Thomas Klenzner,et al.  Navigation as a quality management tool in cochlear implant surgery , 2004, The Journal of Laryngology & Otology.

[7]  T. Brady,et al.  High-resolution flat-panel volume-CT of temporal bone--part 1: axial preoperative anatomy. , 2005, Journal of computer assisted tomography.

[8]  T. Lenarz,et al.  A True Minimally Invasive Approach for Cochlear Implantation: High Accuracy in Cranial Base Navigation Through Flat-Panel-Based Volume Computed Tomography , 2008, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.