title: Semi-manual mastoidectomy assisted by human-robot collaborative control - A temporal bone replica study.
abstract: OBJECTIVE
  To develop an otological robot that can protect important organs from being injured.
  
  
  METHODS
  We developed a five degree-of-freedom robot for otological surgery. Unlike the other robots that were reported previously, our robot does not replace surgeon's procedures, but instead utilizes human-robot collaborative control. The robot basically releases all of the actuators so that the surgeon can manipulate the drill within the robot's working area with minimal restriction. When the drill reaches a forbidden area, the surgeon feels as if the drill hits a wall.
  
  
  RESULTS
  When an engineer performed mastoidectomy using the robot for assistance, the facial nerve in the segmented region was always protected with a more than 2.5mm margin, which was almost the same as the pre-set safety margin of 3mm.
  
  
  CONCLUSIONS
  Semi-manual drilling using human-robot collaborative control was feasible, and may hold a realistic prospect of clinical use in the near future.
authors.affiliation: Department of Electronic, Electrical, Control and Instrumentation Engineering, Hanyang University, Seoul, Republic of Korea.
authors.forename: Hoon
authors.initials: H
authors.lastname: Lim
authors.affiliation: Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. Electronic address: matunozo@med.kyushu-u.ac.jp.
authors.forename: Nozomu
authors.initials: N
authors.lastname: Matsumoto
authors.affiliation: Department of Advanced Medical Initiatives, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Byunghyun
authors.initials: B
authors.lastname: Cho
authors.affiliation: Department of Robotics Engineering, Daegu Gyeongbuk Institute of Science and Technology (DGIST), Daegu, Republic of Korea.
authors.forename: Jaesung
authors.initials: J
authors.lastname: Hong
authors.affiliation: Department of Advanced Medical Initiatives, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Yamashita
authors.affiliation: Department of Advanced Medical Initiatives, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Hashizume
authors.affiliation: Department of Electronic Systems Engineering, Hanyang University, Seoul, Republic of Korea.
authors.forename: Byung-Ju
authors.initials: BJ
authors.lastname: Yi
mesh_terms: D003198:Computer Simulation; D003299:Cooperative Behavior; D004867:Equipment Design; D006801:Humans; D008328:Man-Machine Systems; D008416:Mastoid / Q000601:surgery*; D008953:Models, Anatomic; D013506:Otologic Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D065287:Robotic Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D025321:Surgery, Computer-Assisted; D013701:Temporal Bone / Q000601:surgery
keywords: Image guidance; Mastoidectomy; Warning system