Handheld micromanipulator for robot-assisted stapes footplate surgery

Area of Science:

• Otolaryngology
• Medical Robotics
• Surgical Technology

Background:

• Stapes footplate surgery is a critical middle ear procedure aimed at restoring hearing.
• High precision is essential to avoid damage to nearby delicate anatomical structures.
• Surgeon's hand tremor can compromise accuracy during these intricate operations.

Purpose of the Study:

• To evaluate the feasibility of a handheld active micromanipulator, named Micron, for stapes footplate surgery.
• To assess Micron's ability to enhance surgical accuracy by suppressing surgeon's tremor.
• To test custom-designed attachments for Micron tailored to stapes footplate surgery.

Main Methods:

• A novel handheld active micromanipulator (Micron) was designed with an ergonomic handle, custom tip, and brace attachment.
• The device was tested in a simulated fenestration task through a fixed speculum.
• Surgical accuracy was quantified by measuring mean position error and time spent in dangerous zones with Micron both on (aided) and off (unaided), using image guidance.

Main Results:

• Micron significantly reduced the mean position error compared to unaided conditions.
• The mean duration of time spent within critical dangerous zones was substantially decreased when using Micron.
• Image guidance was employed in both aided and unaided scenarios for comparative accuracy assessment.

Conclusions:

• The handheld active micromanipulator Micron demonstrates significant potential for improving accuracy in stapes footplate surgery.
• Micron's tremor-suppression capabilities can mitigate risks associated with delicate middle ear procedures.
• Further investigation into Micron's clinical application in stapes surgery is warranted.