Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Laboratory for Computational Sensing and Robotics, Johns Hopkins University, Baltimore, Maryland, USA.
Otolaryngol Head Neck Surg. 2019 Nov;161(5):852-855. doi: 10.1177/0194599819861526. Epub 2019 Jul 23.
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.
乳突切除术是耳科学中常见的手术。尽管非常适合实施机器人辅助，但目前还没有商业化的机器人系统在辅助该手术方面表现出实用性。本文介绍了一种使用为耳鼻喉头颈外科开发的协作式控制机器人系统进行图像引导乳突切除术的机器人技术。它具有增强手术精度的能力，可在模拟手术任务中减轻震颤。其运动学设计使得附着的手术器械的位置始终具有高度的准确性。这有助于图像配准和随后定义虚拟固定装置，这些装置划定手术工作空间的边界，并防止进入不希望进入的区域。在这项初步可行性研究中，我们展示了该系统在 5 个相同的颞骨模型中辅助新手外科医生进行皮质乳突切除术的临床实用性，平均用时为 221 ± 35 秒。
