Open AccessRobotic Tremor Suppression: A Tool for Stapes Surgery?
Author(s) -
Knisely Anna J.,
Hirsch Barry E.,
Becker Brian C.,
Riviere Cameron R.
Publication year - 2012
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599812451426a303
Subject(s) - bracing , position error , reduction (mathematics) , significant difference , stapes surgery , computer science , physical medicine and rehabilitation , acoustics , medicine , simulation , biomedical engineering , mathematics , structural engineering , brace , engineering , surgery , physics , statistics , otosclerosis , geometry , calibration
Objective 1) Create a custom micropick for Micron, a fully handheld robotic micromanipulator. 2) Demonstrate phenomenon of physiologic tremor and evaluate bracing technique in simulated otologic surgery. 3) Evaluate feasibility and efficacy of Micron, to decrease surgeon tremor, positioning error, and force applied in tasks simulating otologic surgery. Method Two positioning conditions tested: hovering mid‐air and lightly contacting surface. 3D axes error, tremor, and force measurements. Experimental conditions: 1) unaided, 2) unaided with bracing, 3) Micron alone, 4) Micron with bracing. Tremor and position error were analyzed with a high‐pass filter. Significance ( P <. 05)(*) via 2‐tailed t test. Results Positioning Error: Root mean square (RMS) and maximum error (ME) are reported. Reduction in ME was seen in the surface task, with bracing alone and Micron alone. However, the hover task showed significant benefits with only Micron + bracing. Force Error: RMS and maximum force error showed no difference between conditions. Tremor Error: Positioning error contains tremor and overall drift from the goal position. Statistically significant reduction in tremor both in RMS and ME is seen with Micron, bracing, and the combination. Micron + bracing produced the largest reduction in tremor. Conclusion Our initial results demonstrate Micron significantly reduced maximum positioning error (tremor) in simulated otologic surgery. Additionally, we confirmed bracing significantly dampens tremor. Interestingly, the use of Micron and bracing yielded the largest reduction in tremor, suggesting an additive effect. No difference in force applied was found.