title: From conception to application of a tele-operated assistance robot for middle ear surgery.
abstract: The authors' goal was to design and evaluate a robot dedicated to middle ear surgery. Specifications for dimensions, forces, and kinematics were collected, based on the otosclerosis procedure. The robot structure has a compact geometry with 3 linear and 3 rotatory motors. It is remotely piloted via a robot-surgeon interface under operative microscope. Ability to reach anatomical targets, to perform stapedectomy, and to place prosthesis in a model of stapedotomy was evaluated by 6 surgeons. Multiple anatomical targets in the middle ear could be successfully reached without damaging surrounding structures. The robot could be used under operative microscope with minimal visual field impairment or jointly with a 4-mm endoscope through the external auditory canal to perform stapedectomy in temporal bone specimens. Prosthesis could be inserted in the stapedotomy model. The assistance robot is the first prototype with 6 degrees of freedom, a kinematic structure, and dimensions optimized for tele-operated middle ear surgery.
authors.affiliation: Paris Diderot University, Paris, France.
authors.forename: Yann
authors.initials: Y
authors.lastname: Nguyen
authors.forename: Mathieu
authors.initials: M
authors.lastname: Miroir
authors.forename: Guillaume
authors.initials: G
authors.lastname: Kazmitcheff
authors.forename: Evelyne
authors.initials: E
authors.lastname: Ferrary
authors.forename: Olivier
authors.initials: O
authors.lastname: Sterkers
authors.forename: Alexis Bozorg
authors.initials: AB
authors.lastname: Grayeli
mesh_terms: D004424:Ear Canal / Q000033:anatomy & histology / Q000601:surgery; D004432:Ear, Middle / Q000033:anatomy & histology / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008866:Microsurgery / Q000295:instrumentation* / Q000379:methods*; D010040:Otosclerosis; D019919:Prosthesis Implantation / Q000295:instrumentation / Q000379:methods; D012371:Robotics / Q000295:instrumentation*; D013201:Stapes Surgery / Q000295:instrumentation* / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000295:instrumentation* / Q000379:methods*