Micro/Macro-Scale Robotic Approach for Middle Ear Surgery

This article deals with the development of a robotic solution for middle ear surgery. The surgical procedure consists of the resection of pathological tissues that occurs inside the middle ear cavity known as cholesteatoma. The current surgical procedure is performed manually, is invasive and does not guarantee an exhaustive cholesteatoma tissues removal leading to reoccurrence in 25-30% cases. To remedy this, we developed a new surgical protocol that combines a robotic solution and original surgical instruments. On one side, it consists of a redundant seven degrees of freedom (DoFs) robotic arm extended with a 2 DoFs flexible fibroscope (emulating a future microrobot under development). On the other side, different control architectures are proposed to achieve the surgical procedure. One control mode is based on the teleoperation of whole developed system using a joystick such as an Omni device. The other mode combines comanipulation of the 7 DoFs robotic arm using an embedded force/torque sensor and teleoperation of the remaining 2 DoFs fibroscope using a lab-made in-hand joystick. The proposed materials and methods were validated experimentally using a robotic setup. The obtained results using the different control schemes are discussed.