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Proceedings Paper

Preliminary testing of a compact bone-attached robot for otologic surgery
Author(s): Neal P. Dillon; Ramya Balachandran; Antoine Motte dit Falisse; George B. Wanna; Robert F. Labadie; Thomas J. Withrow; J. Michael Fitzpatrick; Robert J. Webster
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Paper Abstract

Otologic surgery often involves a mastoidectomy procedure, in which part of the temporal bone is milled away in order to visualize critical structures embedded in the bone and safely access the middle and inner ear. We propose to automate this portion of the surgery using a compact, bone-attached milling robot. A high level of accuracy is required t o avoid damage to vital anatomy along the surgical path, most notably the facial nerve, making this procedure well-suited for robotic intervention. In this study, several of the design considerations are discussed and a robot design and prototype are presented. The prototype is a 4 degrees-of-freedom robot similar to a four-axis milling machine that mounts to the patient's skull. A positioning frame, containing fiducial markers and attachment points for the robot, is rigidly attached to the skull of the patient, and a CT scan is acquired. The target bone volume is manually segmented in the CT by the surgeon and automatically converted to a milling path and robot trajectory. The robot is then attached to the positioning frame and is used to drill the desired volume. The accuracy of the entire system (image processing, planning, robot) was evaluated at several critical locations within or near the target bone volume with a mean free space accuracy result of 0.50 mm or less at all points. A milling test in a phantom material was then performed to evaluate the surgical workflow. The resulting milled volume did not violate any critical structures.

Paper Details

Date Published: 12 March 2014
PDF: 9 pages
Proc. SPIE 9036, Medical Imaging 2014: Image-Guided Procedures, Robotic Interventions, and Modeling, 903614 (12 March 2014); doi: 10.1117/12.2043875
Show Author Affiliations
Neal P. Dillon, Vanderbilt Univ. (United States)
Ramya Balachandran, Vanderbilt Univ. (United States)
Antoine Motte dit Falisse, Univ. Catholique de Louvain (Belgium)
George B. Wanna, Vanderbilt Univ. (United States)
Robert F. Labadie, Vanderbilt Univ. (United States)
Thomas J. Withrow, Vanderbilt Univ. (United States)
J. Michael Fitzpatrick, Vanderbilt Univ. (United States)
Robert J. Webster, Vanderbilt Univ. (United States)

Published in SPIE Proceedings Vol. 9036:
Medical Imaging 2014: Image-Guided Procedures, Robotic Interventions, and Modeling
Ziv R. Yaniv; David R. Holmes, Editor(s)

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