Force-based flexible path plans for robotic electrode insertion

Pile, Jason; Wanna, George B.; Simaan, Nabil

doi:10.1109/icra.2014.6906625

Cited by 14 publications

(11 citation statements)

References 30 publications

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“…More recently, other groups have also developed motorized insertion tools in laboratory experiments [21][22][23] and although they were also not designed for use under sterile conditions, valuable findings have resulted from these works [9,11,21,[24][25][26][27][28][29]. For example, automated EA insertions have shown its capability in reducing critical peak insertion forces [9,10,30]-subsequently promising to reduce insertion trauma.…”

Section: Introductionmentioning

confidence: 99%

A simple tool to automate the insertion process in cochlear implant surgery

et al. 2020

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Purpose Automated insertion of electrode arrays (EA) in cochlear implant surgery is presumed to be less traumatic than manual insertions, but no tool is widely available in the operating room. We sought (1) to design and create a simple tool able to automate the EA insertion process; and (2) to perform preliminary evaluations of the designed prototype. Methods A first prototype of a tool with maximum simplicity was designed and fabricated to take advantage of hydraulic actuation. The prototype facilitates automated forward motion using a syringe connected to an infusion pump. Initial prototype evaluation included: (1) testing of forward motion at different velocities (2) EA insertion trials into an artificial cochlear model with force recordings, and (3) evaluation of device handling, fixation and positioning using cadaver head specimens and a surgical retractor. Alignment of the tool was explored with CT imaging. Results In this initial phase, the prototype demonstrated easy assembly and ability to respond to hydraulic actuation driven by an infusion pump at different velocities. EA insertions at an ultra-slow velocity of 0.03 mm/s revealed smooth force profiles with mean maximum force of 0.060 N ± 0.007 N. Device positioning with an appropriate insertion axis into the cochlea was deemed feasible and easy to achieve. Conclusions Initial testing of our hydraulic insertion tool did not reveal any serious complications that contradict the initially defined design specifications. Further meticulous testing is needed to determine the safety of the device, its reliability and clinical applicability.

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Section: Introductionmentioning

confidence: 99%

A simple tool to automate the insertion process in cochlear implant surgery

et al. 2020

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“…Zhang et al 2010 demonstrated the feasibility of deployment of steerable electrode arrays using robotic technology. In-vivo sensing and subsequent adaptation of a surgical plan for inserting perimodiolar electrode arrays was demonstrated Pile et al (2014) together with the capability of failure prediction during the insertion process (Pile et al 2016). Clark et al 2012 demonstrated efficacy of applying magnetically induced torque to the electrode array as a clinical strategy towards improved cochlear implant surgery.…”

Section: Introductionmentioning

confidence: 99%

Instrument flight to the inner ear

et al. 2017

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Surgical robot systems can work beyond the limits of human perception, dexterity and scale making them inherently suitable for use in microsurgical procedures. However, despite extensive research, image-guided robotics applications for microsurgery have seen limited introduction into clinical care to date. Among others, challenges are geometric scale and haptic resolution at which the surgeon cannot sufficiently control a device outside the range of human faculties. Mechanisms are required to ascertain redundant control on process variables that ensure safety of the device, much like instrument-flight in avionics. Cochlear implantation surgery is a microsurgical procedure, in which specific tasks are at sub-millimetric scale and exceed reliable visuo-tactile feedback. Cochlear implantation is subject to intra- and inter-operative variations, leading to potentially inconsistent clinical and audiological outcomes for patients. The concept of robotic cochlear implantation aims to increase consistency of surgical outcomes such as preservation of residual hearing and reduce invasiveness of the procedure. We report successful image-guided, robotic CI in human. The robotic treatment model encompasses: computer-assisted surgery planning, precision stereotactic image-guidance, in-situ assessment of tissue properties and multipolar neuromonitoring (NM), all based on in vitro, in vivo and pilot data. The model is expandable to integrate additional robotic functionalities such as cochlear access and electrode insertion. Our results demonstrate the feasibility and possibilities of using robotic technology for microsurgery on the lateral skull base. It has the potential for benefit in other microsurgical domains for which there is no task-oriented, robotic technology available at present.

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“…[38] was subsequently adapted to steer perimodiolar electrode arrays (PEA). [23][24][25][26] In addition, other works (e.g. Refs.…”

Section: Introductionmentioning

confidence: 99%

“…In-vivo force measurements were used in ref. [26] to facilitate electrode array insertion despite errors in the registration of the robot to the anatomy. This work aims to extend the concept of using intra-operative measurements to improve outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Robot-assisted perception augmentation for online detection of insertion failure during cochlear implant surgery

2016

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SUMMARYDuring the past decade, robotics for cochlear implant electrode array insertion has been limited to manipulation assistance. Going beyond manipulation assistance, this paper presents the new concept of perception augmentation to detect and warn against the onset of intracochlear electrode array tip folding. This online failure detection method uses a combination of intraoperative electrode insertion force data and a predictive model of insertion force profile progression as a function of insertion depth. The predictive model uses statistical characterization of insertion force profiles during normal robotic electrode array insertions as well as the history of intra-operative insertion forces. Online detection of onset of tip folding is achieved using the predictive model as an input into a support vector machine classifier. Results show that the detection of tip folding onset can be achieved with an accuracy of 88% despite the use of intra-operative insertion force data representing incomplete insertion. This result is significant because it allows the surgeon or robot to choose a corrective action for preventing intra-cochlear complications.

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Force-based flexible path plans for robotic electrode insertion

Cited by 14 publications

References 30 publications

A simple tool to automate the insertion process in cochlear implant surgery

A simple tool to automate the insertion process in cochlear implant surgery

Instrument flight to the inner ear

Robot-assisted perception augmentation for online detection of insertion failure during cochlear implant surgery

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