Robotic cochlear implantation: surgical procedure and first clinical experience.

Caversaccio, Marco; Gerber, Kate; Wimmer, Wilhelm; Williamson, Tom; Anso, Juan; Mantokoudis, Georgios; Gerber, Nicolas; Rathgeb, Christoph; Feldmann, Arne Niklas; Wagner, Franca; Scheidegger, Olivier; Kompis, Martin; Weisstanner, Christian; Zoka Assadi, Masoud; Rösler, Kai Michael; Bitterli, Lukas Peter; Huth, Markus; Weber, Stefan (2017). Robotic cochlear implantation: surgical procedure and first clinical experience. Acta oto-laryngologica, 137(4), pp. 447-454. Informa Healthcare 10.1080/00016489.2017.1278573

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CONCLUSION A system for robotic cochlear implantation (rCI) has been developed and a corresponding surgical workflow has been described. The clinical feasibility was demonstrated through the conduction of a safe and effective rCI procedure. OBJECTIVES To define a clinical workflow for rCI and demonstrate its feasibility, safety, and effectiveness within a clinical setting. METHOD A clinical workflow for use of a previously described image guided surgical robot system for rCI was developed. Based on pre-operative images, a safe drilling tunnel targeting the round window was planned and drilled by the robotic system. Intra-operatively the drill path was assessed using imaging and sensor-based data to confirm the proximity of the facial nerve. Electrode array insertion was manually achieved under microscope visualization. Electrode array placement, structure preservation, and the accuracy of the drilling and of the safety mechanisms were assessed on post-operative CT images. RESULTS Robotic drilling was conducted with an accuracy of 0.2 mm and safety mechanisms predicted proximity of the nerves to within 0.1 mm. The approach resulted in a minimal mastoidectomy and minimal incisions. Manual electrode array insertion was successfully performed through the robotically drilled tunnel. The procedure was performed without complications, and all surrounding structures were preserved.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ear, Nose and Throat Disorders (ENT)
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute for Surgical Technology & Biomechanics ISTB
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology
10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research
10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Image Guided Therapy > ARTORG Center - Artificial Hearing Research
10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Image Guided Therapy

UniBE Contributor:

Caversaccio, Marco; Gerber, Kate; Wimmer, Wilhelm; Williamson, Tom; Anso, Juan; Mantokoudis, Georgios; Gerber, Nicolas; Rathgeb, Christoph; Feldmann, Arne Niklas; Wagner, Franca; Scheidegger, Olivier; Kompis, Martin; Weisstanner, Christian; Zoka Assadi, Masoud; Rösler, Kai Michael; Bitterli, Lukas Peter; Huth, Markus and Weber, Stefan

Subjects:

600 Technology > 610 Medicine & health
500 Science > 570 Life sciences; biology

ISSN:

0001-6489

Publisher:

Informa Healthcare

Language:

English

Submitter:

Wilhelm Wimmer

Date Deposited:

29 May 2017 07:46

Last Modified:

12 Sep 2017 18:31

Publisher DOI:

10.1080/00016489.2017.1278573

PubMed ID:

28145157

Uncontrolled Keywords:

Robotic surgery; cochlear implantation; computed tomography imaging; facial nerve monitoring; image guidance; minimally invasive techniques; surgical planning

BORIS DOI:

10.7892/boris.94908

URI:

https://boris.unibe.ch/id/eprint/94908

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