title: Robot-assisted stapedotomy: micropick fenestration of the stapes footplate.
abstract: OBJECTIVE
  Micropick fenestration of the stapes footplate, a difficult step in stapedotomy, was selected for trials evaluating the potential for robotic assistance (RA) to improve clinical measures of surgical performance.
  
  
  METHODS
  In a surgical model of stapedotomy, we measured accuracy of fenestration to a desired point location and force applied to the stapes footplate. Performance variables were measured for 3 experienced and 3 less-experienced surgeons.
  
  
  RESULTS
  RA significantly reduced the maximum force applied to the stapes footplate. For fenestration targeting, RA significantly improved accuracy for less-experienced surgeons and significantly worsened targeting for more-experienced surgeons.
  
  
  CONCLUSIONS
  RA significantly improves performance for micropick fenestration in a surgical model of stapedotomy. For certain tasks, RA differentially affects performance for users of different experience levels.
  
  
  CONCLUSIONS
  These are the first results showing quantitative improvements in performance during simulated ear surgery using RA and differential effects of RA on performance for users of different experience levels.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Hospital, MD 21287, USA. rothbaum@robotics.me.jhu.edu
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Rothbaum
authors.forename: Jaydeep
authors.initials: J
authors.lastname: Roy
authors.forename: Dan
authors.initials: D
authors.lastname: Stoianovici
authors.forename: Peter
authors.initials: P
authors.lastname: Berkelman
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Hager
authors.forename: Russell H
authors.initials: RH
authors.lastname: Taylor
authors.forename: Louis L
authors.initials: LL
authors.lastname: Whitcomb
authors.forename: Howard W
authors.initials: HW
authors.lastname: Francis
authors.forename: John K
authors.initials: JK
authors.lastname: Niparko
mesh_terms: D002983:Clinical Competence; D004427:Ear Diseases / Q000601:surgery*; D007758:Ear, Inner / Q000293:injuries; D004867:Equipment Design; D005276:Fenestration, Labyrinth / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D007759:Labyrinth Diseases / Q000209:etiology / Q000517:prevention & control; D008954:Models, Biological; D011183:Postoperative Complications; D012371:Robotics; D013201:Stapes Surgery / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*