A modular micro-macro robot system for instrument guiding in middle ear surgery

Abstract

Surgical interventions at the middle ear are very challenging tasks for surgeons. At an otosclerosis the stapes is immobile because of an abnormal bone growth so that the sound transmission is disturbed. Therefore, a stapedotomy is performed where the stapes is partly replaced by a small implant to reconstruct the path of sound transmission. The state of the art is to use handheld micro instruments. However, the structures are, as well as the required precision, in the range of sub-millimeters, and the view is limited due to the narrow ear canal. Because of the human hand tremor, which goes from some tenth millimeters up to some millimeters, the intervention is very delicate. Until now, there are no assistance systems for guiding surgical instruments available. In this contribution we present the further development of a formerly presented micromacro telemanipulator system. New functionality for coarse and fine positioning was implemented, as well as a processing unit and a quick-changer for exchanging the micro manipulator. In a preliminary experiment standard-based position repeatability is obtained. It is shown that the repeatability of the current macro robot is appropriate for the task and so the approach has high potential for supporting the surgeon in ENT surgery.

Micro/Macro-Scale Robotic Approach for Middle Ear Surgery

“…However, all these solutions are based on rigid tools and do not include any dexterous instrument for intracorporeal fine movement execution. Other works highlight the feasibility of robot-assisted ear surgery such as robotassisted mastoidectomy [6] and tool-guidance [7] which is not sufficient for the cholesteatoma treatment in which surgeons mainly suffer from a lack of dexterity and accuracy in tooltip positioning. The main contributions of this paper are the design of a redundant macro/micro-scale robotic structure with embedded teleoperation interface as well as the development of two control modes for robotic middle ear surgery execution.…”

Development Status and Multilevel Classification Strategy of Medical Robots

“…Some classification methods for medical robots are shown in Table 1. According to the shape and size, medical robots can be defined as macro-robots, micro-robots, and biological robots [41][42][43]. In this way, medical robots can be intuitively categorized by their appearance and this classification method has better applicability for medical robots at present and in the future.…”

Kinova Modular Robot Arms for Service Robotics Applications

“…Kinova's products are used in many applications and research work such as mobile manipulation (Dimitrov et al, 2013;Allan and Beaudry, 2014;Fathzadeh et al, 2014), computer vision algorithms (Jiang et al, 2013), human-robot interaction (Kondaxakis et al, 2014;Leroux et al, 2013), artificial intelligence (Lampe and Riedmiller, 2013), teleoperation (Bidwell et al, 2014), assistance (Cavallo et al, 2014;Maheu et al, 2011), medical applications (Entsfellner et al, 2012;Morse et al, 2013;Entsfellner et al, 2013), planning (Eich et al, 2014), tactile sensing (Lee et al, 2013), control interfaces (Bougrain et al, 2013;Lampe et al, 2014;Bassily et al, 2014;Ianov et al, 2013;Fall et al, 2015) and kinematics (Gosselin and Liu, 2014). Figure 19 shows an integration of JACO at Worcester Polytechnic Institute (WPI) (Dimitrov et al, 2013).…”