Interaction-aware dexterous robot for minimally invasive transcanal inner ear interventions

Intracochlear theranostics, particularly targeted drug delivery and microsampling, offers a promising solution to inner ear diseases. However, specialized medical devices remain limited by a fundamental design challenge imposed by anatomical constraints: balancing miniaturization, dexterity, and perceptive functionality. Here, we present a low-aspect-ratio, dual-segment continuum robot that integrates catheter, endoscopic and instrumental functions. Driven by antagonistic cables, the robot uses a transition-free backbone composed of saddle-shaped joints to achieve a minimum bending radius of 1.9 mm. Dual-segment motion decoupling yields programmable C-/S-shaped configurations, facilitating anatomical navigation. The microneedle, embedded in the central channel, serves as an end-effector with positioning accuracy of 17.9 ± 4.1 μm. Fiber Bragg grating sensors, mounted on the needle, measure axial force to estimate tool-tissue interaction. Validation is performed on cadavers and in vivo animals, demonstrating the feasibility of a transcanal, atraumatic robotic paradigm. Thus, this system provides a practical and accessible approach for early diagnosis and treatment, helping extend precision medicine to underserved areas.