Image-Guided Mastoidectomy with a Cooperatively Controlled ENT Microsurgery Robot

Authors

Christopher R. Razavi, Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Paul R. Wilkening, Laboratory for Computational Sensing and Robotics, Johns Hopkins University, Baltimore, Maryland, USA.
Rui Yin, Laboratory for Computational Sensing and Robotics, Johns Hopkins University, Baltimore, Maryland, USA.
Samuel R. Barber, Department of Otolaryngology-Head and Neck Surgery, University of Arizona College of Medicine, Tucson, Arizona, USA.
Russell H. Taylor, Laboratory for Computational Sensing and Robotics, Johns Hopkins University, Baltimore, Maryland, USA.
John P. Carey, Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Francis X. Creighton, Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Document Type

Article

Abstract

Mastoidectomy is a common surgical procedure within otology. Despite being inherently well suited for implementation of robotic assistance, there are no commercially available robotic systems that have demonstrated utility in aiding with this procedure. This article describes a robotic technique for image-guided mastoidectomy with an experimental cooperatively controlled robotic system developed for use within otolaryngology-head and neck surgery. It has the ability to facilitate enhanced operative precision with dampening of tremor in simulated surgical tasks. Its kinematic design is such that the location of the attached surgical instrument is known with a high degree of fidelity at all times. This facilitates image registration and subsequent definition of virtual fixtures, which demarcate surgical workspace boundaries and prevent motion into undesired areas. In this preliminary feasibility study, we demonstrate the clinical utility of this system to facilitate performance of a cortical mastoidectomy by a novice surgeon in 5 identical temporal bone models with a mean time of 221 ± 35 seconds.

Medical Subject Headings

Humans; Mastoidectomy (instrumentation, methods); Microsurgery (instrumentation, methods); Models, Anatomic; Robotic Surgical Procedures (instrumentation, methods); Surgery, Computer-Assisted (instrumentation, methods)

Publication Date

11-1-2019

Publication Title

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery

E-ISSN

1097-6817

Volume

161

Issue

5

First Page

852

Last Page

855

PubMed ID

31331246

Digital Object Identifier (DOI)

10.1177/0194599819861526

Recommended Citation

Razavi, Christopher R.; Wilkening, Paul R.; Yin, Rui; Barber, Samuel R.; Taylor, Russell H.; Carey, John P.; and Creighton, Francis X., "Image-Guided Mastoidectomy with a Cooperatively Controlled ENT Microsurgery Robot" (2019). ENT and Skull Base Surgery. 68.
https://scholar.barrowneuro.org/ent-and-skull-base-surgery/68