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
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
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.
industrial robot used to drill the temporal (ear) bones.
Note the two metal round
pins which were used to orient the robot.
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
that then monitors the location of the surgeon's tools as he is performing sinus
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