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Image-Guided Mastoidectomy with a Cooperatively Controlled ENT Microsurgery Robot.

Christopher R Razavi1, Paul R Wilkening2, Rui Yin2

  • 1Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|July 24, 2019
PubMed
Summary

This study introduces a novel robotic technique for image-guided mastoidectomy, enhancing surgical precision. A novice surgeon successfully performed cortical mastoidectomies using the system in temporal bone models.

Keywords:
image guidanceotologyrobotic mastoidectomyrobotic surgery

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Area of Science:

  • Otology
  • Robotic Surgery
  • Surgical Navigation

Background:

  • Mastoidectomy is a common otologic procedure.
  • Existing robotic systems lack demonstrated utility for mastoidectomy.
  • Robotic assistance offers potential for enhanced precision and tremor dampening.

Purpose of the Study:

  • To describe a novel robotic technique for image-guided mastoidectomy.
  • To evaluate the feasibility and utility of an experimental cooperatively controlled robotic system in mastoidectomy.
  • To assess the system's ability to enhance operative precision and define virtual fixtures.

Main Methods:

  • Development of an experimental cooperatively controlled robotic system for otolaryngology.
  • Implementation of image guidance and virtual fixtures to define surgical boundaries.
  • Performance of cortical mastoidectomy by a novice surgeon in 5 temporal bone models.

Main Results:

  • The robotic system demonstrated high fidelity in tracking surgical instrument location.
  • Virtual fixtures effectively demarcated surgical workspace boundaries.
  • A novice surgeon successfully completed cortical mastoidectomies with a mean time of 221 ± 35 seconds.

Conclusions:

  • The described robotic technique shows clinical utility for image-guided mastoidectomy.
  • The experimental system facilitates enhanced operative precision and tremor dampening.
  • This approach holds promise for improving mastoidectomy procedures, particularly for novice surgeons.