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Design of a Bone-Attached Parallel Robot for Percutaneous Cochlear Implantation

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6 Author(s)
Kratchman, L.B. ; Dept. of Mech. Eng., Vanderbilt Univ., Nashville, TN, USA ; Blachon, G.S. ; Withrow, T.J. ; Balachandran, R.
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Access to the cochlea requires drilling in close proximity to bone-embedded nerves, blood vessels, and other structures, the violation of which can result in complications for the patient. It has recently been shown that microstereotactic frames can enable an image-guided percutaneous approach, removing reliance on human experience and hand-eye coordination, and reducing trauma. However, constructing current microstereotactic frames disrupts the clinical workflow, requiring multiday intrasurgical manufacturing delays, or an on-call machine shop in or near the hospital. In this paper, we describe a new kind of microsterotactic frame that obviates these delay and infrastructure issues by being repositionable. Inspired by the prior success of bone-attached parallel robots in knee and spinal procedures, we present an automated image-guided microstereotactic frame. Experiments demonstrate a mean accuracy at the cochlea of 0.20 ± 0.07 mm in phantom testing with trajectories taken from a human clinical dataset. We also describe a cadaver experiment evaluating the entire image-guided surgery pipeline, where we achieved an accuracy of 0.38 mm at the cochlea.

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Biomedical Engineering, IEEE Transactions on  (Volume:58 ,  Issue: 10 )