title: Development of an auditory implant manipulator for minimally invasive surgical insertion of implantable hearing devices.
abstract: OBJECTIVE
  To present the auditory implant manipulator, a navigation-controlled mechanical and electronic system which enables minimally invasive ('keyhole') transmastoid access to the tympanic cavity.
  
  
  METHODS
  The auditory implant manipulator is a miniaturised robotic system with five axes of movement and an integrated drill. It can be mounted on the operating table. We evaluated the surgical work field provided by the system, and the work sequence involved, using an anatomical whole head specimen.
  
  
  RESULTS
  The work field provided by the auditory implant manipulator is considerably greater than required for conventional mastoidectomy. The work sequence for a keyhole procedure included pre-operative planning, arrangement of equipment, the procedure itself and post-operative analysis.
  
  
  CONCLUSIONS
  Although system improvements are necessary, our preliminary results indicate that the auditory implant manipulator has the potential to perform keyhole insertion of implantable hearing devices.
authors.affiliation: ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.
authors.forename: C
authors.initials: C
authors.lastname: Stieger
authors.forename: M
authors.initials: M
authors.lastname: Caversaccio
authors.forename: A
authors.initials: A
authors.lastname: Arnold
authors.forename: G
authors.initials: G
authors.lastname: Zheng
authors.forename: J
authors.initials: J
authors.lastname: Salzmann
authors.forename: D
authors.initials: D
authors.lastname: Widmer
authors.forename: N
authors.initials: N
authors.lastname: Gerber
authors.forename: M
authors.initials: M
authors.lastname: Thurner
authors.forename: C
authors.initials: C
authors.lastname: Nauer
authors.forename: Y
authors.initials: Y
authors.lastname: Mussard
authors.forename: M
authors.initials: M
authors.lastname: Kompis
authors.forename: L P
authors.initials: LP
authors.lastname: Nolte
authors.forename: R
authors.initials: R
authors.lastname: Häusler
authors.forename: S
authors.initials: S
authors.lastname: Weber
mesh_terms: D019929:Cochlear Implantation / Q000295:instrumentation* / Q000379:methods; D003054:Cochlear Implants; D004867:Equipment Design; D004868:Equipment Failure; D006801:Humans; D008416:Mastoid / Q000601:surgery; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods; D012371:Robotics / Q000295:instrumentation*; D025321:Surgery, Computer-Assisted / Q000295:instrumentation* / Q000379:methods; D014057:Tomography, X-Ray Computed