Geometric Atlas of the Middle Ear and Paranasal Sinuses for Robotic Applications

Michel, Guillaume; Salunkhe, Durgesh Haribhau; Bordure, Philippe; Chablat, Damien

doi:10.1177/15533506211039675

Cited by 1 publication

(3 citation statements)

References 17 publications

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“…When the surgeon holds the endoscope, the surgery is performed with a single hand ( Figure 1 b). This one-handed surgery is responsible for a long learning curve, as it is used in a very restricted workspace, with an average volume of the eardrum of 0.99 cm 3 [ 5 ]. The surgeon should not touch the sensitive components of the middle ear (ossicles, facial nerve, …).…”

Section: Endoscope Holders and General Anaesthesiamentioning

confidence: 99%

“…An endoscope robot should enable the surgeon to see particular areas of the middle ear and sinuses. These regions were characterised in [ 5 ] to define the rotational movements of the endoscope, taking into account the anatomy of the ears and sinuses, and the mobility of the patient when lying on the operating table. This study allows for the characterisation of the rotational movements of the RCM.…”

Section: Analysis Of the Need For The Mobility Of An Endoscope Holdermentioning

confidence: 99%

“…With only one hand to operate, they may have major difficulties in achieving haemostasis when bleeding occurs in otologic surgery [1]. Although the working space is larger in the sinus than that in the ear [5], progress is still needed in ergonomics during endoscopic surgery. The analysis of operating videos revealed that 20-50% of surgical time is spent on tasks such as blood suctioning to allow for the operating area to be seen [6].…”

Section: Endoscope Holders and General Anaesthesiamentioning

confidence: 99%

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A New Robotic Endoscope Holder for Ear and Sinus Surgery with an Integrated Safety Device

Michel

Bordure

Chablat

2022

Sensors

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In the field of sinus and ear surgery, and more generally in microsurgery, the surgeon is faced with several challenges. The operations are traditionally carried out under binocular loupes, which allows for the surgeon to use both hands for a microinstrument and an aspiration tool. More recently, the development of endoscopic otological surgery allowed for seeing areas that are difficult to access. However, the need to handle the endoscope reduces the surgeon’s ability to use only one instrument at a time. Thus, despite anaesthesia, patient motions during surgery can be very risky and are not that rare. Because the insertion zone in the middle ear or in the sinus cavity is very small, the mobility of the endoscope is limited to a rotation around a virtual point and a translation for the insertion of the camera. A mechanism with remote center motion (RCM) is a good candidate to achieve this movement and allow for the surgeon to access the ear or sinus. Since only the translational motion along the main insertion axis is enabled, the ejection motion along the same axis is safe for the patient. A specific mechanism allows for inserting and ejecting the endoscope. In a sense, the position is controlled, and the velocity is limited. In the opposite sense, the energy stored in the spring allows for very quick ejection if the patient moves. A prototype robot is presented using these new concepts. Commercially available components are used to enable initial tests to be carried out on synthetic bones to validate the mobility of the robot and its safety functions.

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Section: Endoscope Holders and General Anaesthesiamentioning

confidence: 99%

Section: Analysis Of the Need For The Mobility Of An Endoscope Holdermentioning

confidence: 99%