Design of a Bone-Attached Parallel Robot for Percutaneous Cochlear Implantation

Access to the cochlea requires drilling in close proximity to bone-embedded nerves, blood vessels, and other structures, the violation of which can result in complications for the patient. It has recently been shown that microstereotactic frames can enable an image-guided percutaneous approach, remo...

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Bibliographic Details
Published in:IEEE transactions on biomedical engineering 2011-10, Vol.58 (10), p.2904-2910
Main Authors: Kratchman, Louis B., Blachon, Grégoire S., Withrow, Thomas J., Balachandran, Ramya, Labadie, Robert F., Webster, Robert J.
Format: Article
Language:English
Subjects:
Accuracy
Applied sciences
Bone-attached robot
Bones
Cochlea - surgery
cochlear implant
Cochlear Implantation - instrumentation
Cochlear Implantation - methods
Computed tomography
Computer science
control theory
systems
Control theory. Systems
Equipment Design
Exact sciences and technology
Gough-Stewart platform
Humans
microtable
minimally invasive surgery (MIS)
parallel robot
Phantoms, Imaging
Robot kinematics
Robotics
Robotics - instrumentation
Software
Surgery, Computer-Assisted - instrumentation
Temporal Bone - surgery
Tomography, X-Ray Computed
Trajectory
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Summary:Access to the cochlea requires drilling in close proximity to bone-embedded nerves, blood vessels, and other structures, the violation of which can result in complications for the patient. It has recently been shown that microstereotactic frames can enable an image-guided percutaneous approach, removing reliance on human experience and hand-eye coordination, and reducing trauma. However, constructing current microstereotactic frames disrupts the clinical workflow, requiring multiday intrasurgical manufacturing delays, or an on-call machine shop in or near the hospital. In this paper, we describe a new kind of microsterotactic frame that obviates these delay and infrastructure issues by being repositionable. Inspired by the prior success of bone-attached parallel robots in knee and spinal procedures, we present an automated image-guided microstereotactic frame. Experiments demonstrate a mean accuracy at the cochlea of 0.20 ± 0.07 mm in phantom testing with trajectories taken from a human clinical dataset. We also describe a cadaver experiment evaluating the entire image-guided surgery pipeline, where we achieved an accuracy of 0.38 mm at the cochlea.
ISSN:0018-9294
1558-2531
DOI:10.1109/TBME.2011.2162512