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A Compact, Bone-Attached Robot for Mastoidectomy.

Neal P Dillon1, Ramya Balachandran2, J Michael Fitzpatrick3

  • 1Department of Mechanical Engineering, Vanderbilt University , 2301 Vanderbilt Place , PMB 351592 , Nashville, TN 37235

Journal of Medical Devices
|September 4, 2015
PubMed
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A novel robotic system automates mastoidectomy, a crucial step in otologic surgery. This bone-attached robot achieved high accuracy, preserving vital structures and demonstrating potential for safer, more precise ear surgeries.

Area of Science:

  • Neurosurgery
  • Robotics
  • Medical Devices

Background:

  • Otologic surgery, including mastoidectomy, requires precise removal of temporal bone to access the ear.
  • The procedure is challenging due to critical anatomical structures near the surgical site.
  • Current methods demand high accuracy with manual dissection tools.

Purpose of the Study:

  • To develop and evaluate a compact, bone-attached robotic system for automating mastoidectomy.
  • To assess the accuracy and safety of the robotic system in a surgical context.

Main Methods:

  • A four degrees-of-freedom (DOF) milling robot was designed, attached to the patient via a rigid frame screwed into the bone.
  • Surgeons identified target volumes on pre-operative CT scans, which were converted into robotic milling paths.

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  • The system's targeting error was evaluated in free space and in cadaveric temporal bone mastoidectomies.

    • Main Results:

    • The robotic system demonstrated a mean targeting error of 0.5 mm or less at vital structures in free space.
    • In cadaveric studies, the mean error along the border of the milled cavity was 0.38 mm.
    • All critical anatomical structures were preserved during the robotic mastoidectomies.

    Conclusions:

    • The proposed robotic system offers a viable solution for automating mastoidectomy in otologic surgery.
    • The system achieves high precision, with minimal error and preservation of essential anatomical structures.
    • This automation has the potential to enhance safety and accuracy in complex ear surgeries.