HYPOTHESIS: Virtual fixtures can be enforced in cooperative-control robotic mastoidectomies with submillimeter accuracy. BACKGROUND: Otologic procedures are well-suited for robotic assistance due to consistent osseous landmarks. We have previously demonstrated the feasibility of cooperative-control robots (CCRs) for mastoidectomy. CCRs manipulate instruments simultaneously with the surgeon, allowing the surgeon to control instruments with robotic augmentation of motion. CCRs can also enforce virtual fixtures, which are safety barriers that prevent motion into undesired locations. Previous studies have validated the ability of CCRs to allow a novice surgeon to safely complete a cortical mastoidectomy. This study provides objective accuracy data for CCR-imposed safety barriers in cortical mastoidectomies. METHODS: Temporal bone phantoms were registered to a CCR using preoperative computed tomography (CT) imaging. Virtual fixtures were created using 3D Slicer, with 2D planes placed along the external auditory canal, tegmen, and sigmoid, converging on the antrum. Five mastoidectomies were performed by a novice surgeon, moving the drill to the limit of the barriers. Postoperative CT scans were obtained, and Dice coefficients and Hausdorff distances were calculated. RESULTS: The average modified Hausdorff distance between drilled bone and the preplanned volume was 0.351 ± 0.093 mm. Compared with the preplanned volume of 0.947 cm3, the mean volume of bone removed was 1.045 cm3 (difference of 0.0982 cm3 or 10.36%), with an average Dice coefficient of 0.741 (range, 0.665-0.802). CONCLUSIONS: CCR virtual fixtures can be enforced with a high degree of accuracy. Future studies will focus on improving accuracy and developing 3D fixtures around relevant surgical anatomy.
HYPOTHESIS: Virtual fixtures can be enforced in cooperative-control robotic mastoidectomies with submillimeter accuracy. BACKGROUND: Otologic procedures are well-suited for robotic assistance due to consistent osseous landmarks. We have previously demonstrated the feasibility of cooperative-control robots (CCRs) for mastoidectomy. CCRs manipulate instruments simultaneously with the surgeon, allowing the surgeon to control instruments with robotic augmentation of motion. CCRs can also enforce virtual fixtures, which are safety barriers that prevent motion into undesired locations. Previous studies have validated the ability of CCRs to allow a novice surgeon to safely complete a cortical mastoidectomy. This study provides objective accuracy data for CCR-imposed safety barriers in cortical mastoidectomies. METHODS: Temporal bone phantoms were registered to a CCR using preoperative computed tomography (CT) imaging. Virtual fixtures were created using 3D Slicer, with 2D planes placed along the external auditory canal, tegmen, and sigmoid, converging on the antrum. Five mastoidectomies were performed by a novice surgeon, moving the drill to the limit of the barriers. Postoperative CT scans were obtained, and Dice coefficients and Hausdorff distances were calculated. RESULTS: The average modified Hausdorff distance between drilled bone and the preplanned volume was 0.351 ± 0.093 mm. Compared with the preplanned volume of 0.947 cm3, the mean volume of bone removed was 1.045 cm3 (difference of 0.0982 cm3 or 10.36%), with an average Dice coefficient of 0.741 (range, 0.665-0.802). CONCLUSIONS: CCR virtual fixtures can be enforced with a high degree of accuracy. Future studies will focus on improving accuracy and developing 3D fixtures around relevant surgical anatomy.
Authors: Christopher R Razavi; Paul R Wilkening; Rui Yin; Nicolas Lamaison; Russell H Taylor; John P Carey; Francis X Creighton Journal: Otolaryngol Head Neck Surg Date: 2018-12-04 Impact factor: 3.497
Authors: Andrei Danilchenko; Ramya Balachandran; Jenna L Toennies; Stephan Baron; Benjamin Munske; J Michael Fitzpatrick; Thomas J Withrow; Robert J Webster; Robert F Labadie Journal: Otol Neurotol Date: 2011-01 Impact factor: 2.311
Authors: Allen L Feng; Christopher R Razavi; Pranav Lakshminarayanan; Zaid Ashai; Kevin Olds; Marcin Balicki; Zhen Gooi; Andrew T Day; Russell H Taylor; Jeremy D Richmon Journal: Laryngoscope Date: 2017-06-05 Impact factor: 3.325
Authors: Christopher R Razavi; Francis X Creighton; Paul R Wilkening; Joseph Peine; Russell H Taylor; Lee M Akst Journal: Laryngoscope Date: 2018-11-15 Impact factor: 3.325
Authors: Ali Uneri; Marcin A Balicki; James Handa; Peter Gehlbach; Russell H Taylor; Iulian Iordachita Journal: Proc IEEE RAS EMBS Int Conf Biomed Robot Biomechatron Date: 2010-09-01