Image Directed Robotic Surgery
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Below is a description of one of the fist if not the first applications of robotic surgery in otolaryngology - head and neck surgery.

The Triologic Society is one of the oldest Societies in the field of Otology, Rhinology, and Laryngology.  It is dedicated to furthering teaching, clinical practice and research in Otolaryngology.  Admission to the Society requires nomination and approval of the general membership.  Unlike other societies, the Triologic also requires the submission and approval of a thesis in the field of Otolaryngology which is of high scientific merit. 

Kavanagh KT. Triologic Thesis:   Applications of Image-Directed Robotics in Otolaryngologic Surgery. Laryngoscope. 104:283-293,1994.     ***View Abstract***      

Image-directed robotic surgery refers to a technique of:  

  • Viewing a patient's x-rays on a computer monitor.

  • Having a surgeon plan the surgical approach.

  • Finally, a robot will execute the operation being controlled by a computer but monitored by the surgeon.

Most of the experimentation in this technique has involved brain biopsies and hip surgery.  But it is readily adaptable to ear and sinus surgery.  A requirement is that the tissues remain fixed.  The robot must orient itself to the patient by the use of anatomical landmarks or metal pins (placed prior to obtaining patient x-rays).  Once oriented, the patient cannot move in relationship to the robot or surgical errors will occur.

robotic drill.jpg (55501 bytes)

 

An industrial robot used to drill the temporal (ear) bones.

Note the two metal round pins which were used to orient the robot.

 

 

robotics_control.jpg (70525 bytes)

 

Pre-Operative Planning is performed by displaying the patient's temporal bone CT scan on a computer.  The planned surgical defect is outlined in yellow.

 

Since the publication of Dr. Kavanagh's Triologic thesis, there has been continued research on robotic surgery.  Most of the research has centered on robotic surgery under direct surgeon control.  The two most common uses are to increase the surgeon's dexterity and to allow a surgeon to operate from a distant location, such as a surgeon in a hospital operating on a soldier in a battlefield.   Robotic surgery is currently not used in ear or sinus surgery.  However, several companies are marketing devices which orient the patient to a CT x-ray displayed on a computer that then monitors the location of the surgeon's tools as he is performing sinus surgery.

Page last updated 08/05/2016

Copyright 2000, 2002   Kevin T Kavanagh, All Rights Reserved   

 

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