Toward robot-assisted stapes fenestration with a handheld micromanipulator

Stapedectomy is a delicate surgical procedure of the middle ear to improve hearing. In the middle ear there are anatomical structures that can be damaged during the surgery. Suppression of tremor during the procedure may reduce the likelihood of damage. This paper reports on a study of the feasibility of using Micron, a fully handheld micromanipulator, in stapedectomy. An ergonomic handle, a special tip, and a brace attachment were designed for this purpose and tested in a perforation task through a fixed speculum. Fenestration area and time in forbidden zones were analyzed in a penetration task under two conditions: unaided, and aided by tremor compensation. Preliminary results show a statistically significant improvement in cross-sectional area of fenestration and in time spent in forbidden zones.