Micromanipulator for enhancing surgeon's dexterity in cochlear atraumatic surgery.

The hybrid stimulation in cochlear implants requires changes in the design of electrode arrays. A new generation of flat electrode arrays that does not damage the cochlea is being developed. For the insertion of these flat array electrodes a groove must be milled in the antero-inferior area of the round window niche. Even for the most experienced surgeon, it is very difficult to carry out this operation without damaging the cochlea. That is why external help is needed. For helping the surgeon to mill the groove, a compliant mechanism based micromanipulator has been designed, manufactured and tested. A surgical milling tool is attached to a specially designed compliant mechanism and positioned properly along the auditory canal. The compliant mechanism guides the motion of the surgical tool, keeping tactile feedback and enhancing the dexterity of the surgeon for an accurate milling of the groove.