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采用可控电极阵列的机器人辅助人工耳蜗植入手术的进展。

Inroads toward robot-assisted cochlear implant surgery using steerable electrode arrays.

机构信息

Department of Mechanical Engineering, Columbia University, New York, New York, USA.

出版信息

Otol Neurotol. 2010 Oct;31(8):1199-206. doi: 10.1097/MAO.0b013e3181e7117e.

Abstract

HYPOTHESIS

Robotic insertions of actively steerable perimodiolar electrode arrays can substantially reduce insertion forces and prevent electrode buckling.

BACKGROUND

Perimodiolar electrodes have been proven to be effective in reducing insertion forces. However, the dedicated techniques of atraumatic electrode insertion require intensive surgeon training. Although some specialized medical robots have been developed to help surgeons in certain minimally invasive surgeries, none are applicable to electrode insertions.

METHODS

A robot prototype capable of automatically inserting novel steerable electrode array and adjusting its approach angle toward the scala tympani has been constructed and tested. Comparisons of insertion forces using robotically assisted steerable and straight electrodes on scala tympani models are presented. Simulations and experiments are conducted to compare the robotic insertion outcomes and insertion forces.

RESULTS

The use of robotically assisted steerable electrodes for insertions significantly reduces the insertion forces compared with straight electrodes. Based on the results from the experiments, a second-generation robot with insertion force-sensing capability and haptic control to be used in the operating room has been designed for cochlear implant surgery.

CONCLUSION

Preliminary experimental results using robot-assisted steerable electrode prototype show that it is effective in reducing insertion forces and preventing electrode buckling. A second-generation robot has been designed and constructed for cochlear implant surgery under operating room conditions.

摘要

假设

主动可控的环绕式电极阵列的机器人插入可以显著降低插入力并防止电极弯曲。

背景

环绕式电极已被证明可以有效降低插入力。然而,专门的无创伤电极插入技术需要密集的外科医生培训。虽然已经开发了一些专门的医疗机器人来帮助外科医生进行某些微创手术,但没有一种适用于电极插入。

方法

已经构建并测试了一种能够自动插入新型可控电极阵列并调整其进入鼓室阶的方法的机器人原型。介绍了在鼓室阶模型上使用机器人辅助可控和直电极的插入力比较。进行了模拟和实验,以比较机器人插入结果和插入力。

结果

与直电极相比,使用机器人辅助可控电极进行插入可以显著降低插入力。根据实验结果,设计了第二代具有插入力感应功能和触觉控制的机器人,用于手术室中的耳蜗植入手术。

结论

使用机器人辅助可控电极原型的初步实验结果表明,它可以有效降低插入力并防止电极弯曲。已经设计和构建了第二代机器人,用于在手术室条件下进行耳蜗植入手术。

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