Design of Surgical Robotic Systems for Skull Base Interventions

Abstract

Flexible medical devices provide many advantages over their rigid counterparts. In the surgical realm, where applying too much force in the wrong place can have catastrophic consequences, having some amount of intrinsic compliance can be very beneficial. However, this also makes accurate control much more difficult. The overall aim of this dissertation is to advance the design of surgical robotic systems to help deliver this new generation of flexible devices into the human body in a manner that is both safe and conscious of the surgical workflow. A pair of systems are presented- one for controlling flexible instruments, and one for delivering flexible implants. For the first, a new multi-arm concentric tube robot is introduced for transnasal surgery. The system features a mobile surgeon interface console, a variable view-angle endoscope, and modular tool cartridges that can be changed intraoperatively. Its capabilities are demonstrated by performing the first robotic resection of tumors growing behind the eyes in the orbital apex region. The second example is a system for improving the placement of cochlear implants. A robotic insertion tool and omnidirectional electromagnet operate in tandem to guide a magnet-tipped cochlear implant into optimal position. Experiments in both phantom models and cadavers demonstrate a 50\% reduction of insertion forces. Additionally, the first real-time sensing method is introduced for estimating the intracochlear position of the implant during insertion.