title: A self-developed and constructed robot for minimally invasive cochlear implantation.
abstract: CONCLUSIONS
  A robot built specifically for stereotactic cochlear implantation provides equal or better accuracy levels together with a better integration into a clinical environment, when compared with existing approaches based on industrial robots.
  
  
  OBJECTIVE
  To evaluate the technical accuracy of a robotic system developed specifically for lateral skull base surgery in an experimental set-up reflecting the intended clinical application. The invasiveness of cochlear electrode implantation procedures may be reduced by replacing the traditional mastoidectomy with a small tunnel slightly larger in diameter than the electrode itself.
  
  
  METHODS
  The end-to-end accuracy of the robot system and associated image-guided procedure was evaluated on 15 temporal bones of whole head cadaver specimens. The main components of the procedure were as follows: reference screw placement, cone beam CT scan, computer-aided planning, pair-point matching of the surgical plan, robotic drilling of the direct access tunnel, and postoperative cone beam CT scan for accuracy assessment.
  
  
  RESULTS
  The mean accuracy at the target point (round window) was 0.56 ± 0.41 mm with an angular misalignment of 0.88 ± 0.40°. The procedural time for the registration process through the completion of the drilling procedure was 25 ± 11 min. The robot was fully operational in a clinical environment.
authors.affiliation: ARTORG Center, University of Bern, Switzerland.
authors.forename: Brett
authors.initials: B
authors.lastname: Bell
authors.forename: Christof
authors.initials: C
authors.lastname: Stieger
authors.forename: Nicolas
authors.initials: N
authors.lastname: Gerber
authors.forename: Andreas
authors.initials: A
authors.lastname: Arnold
authors.forename: Claude
authors.initials: C
authors.lastname: Nauer
authors.forename: Volkmar
authors.initials: V
authors.lastname: Hamacher
authors.forename: Martin
authors.initials: M
authors.lastname: Kompis
authors.forename: Lutz
authors.initials: L
authors.lastname: Nolte
authors.forename: Marco
authors.initials: M
authors.lastname: Caversaccio
authors.forename: Stefan
authors.initials: S
authors.lastname: Weber
mesh_terms: D019929:Cochlear Implantation / Q000295:instrumentation*; D006801:Humans; D008866:Microsurgery / Q000295:instrumentation; D019060:Minimally Invasive Surgical Procedures; D012371:Robotics