Mechanical strength of the rotator cuff and cable interface: a complete histological and biomechanical study.

Purpose: This study sought to evaluate the biomechanical properties of the interface between the rotator cuff and the semicircular humeral ligament or rotator cable (RCa) using histological and biomechanical techniques.

Methods: Out of 13 eligible cadaver specimens, 5 cadaver shoulders with an intact rotator cuff were included, 8 were excluded due to an injured rotator cuff. The histological study enables us to describe the capsule-tendon interface between the infraspinatus tendon (IST) or supraspinatus tendon (SST) and RCa, and to detect loose connective tissue layers to determine their precise location and measure their length along the interface.

Screening of factors influencing catheter rotation of a vascular interventional surgical robot using design of experiment approach.

Over the past decades, Vascular Interventional Surgery Robots (VISR) have been developed to address the risks associated with X-rays used in minimally invasive vascular surgery procedures. Manipulation of over-the-wire catheters is necessary to perform complex surgery but requires high forces on the robot's end effector during rotational movements. The VISR under study mimics the physician's fingers by rolling the catheter between two planar surfaces to rotate it.

Middle-ear microsurgery simulation to improve new robotic procedures.

Otological microsurgery is delicate and requires high dexterity in bad ergonomic conditions. To assist surgeons in these indications, a teleoperated system, called RobOtol, is developed. This robot enhances gesture accuracy and handiness and allows exploration of new procedures for middle ear surgery.

Definition of metrics to evaluate cochlear array insertion forces performed with forceps, insertion tool, or motorized tool in temporal bone specimens.

Introduction: In order to achieve a minimal trauma to the inner ear structures during array insertion, it would be suitable to control insertion forces. The aim of this work was to compare the insertion forces of an array insertion into anatomical specimens with three different insertion techniques: with forceps, with a commercial tool, and with a motorized tool.

Materials And Methods: Temporal bones have been mounted on a 6-axis force sensor to record insertion forces.

Effect of embedded dexamethasone in cochlear implant array on insertion forces in an artificial model of scala tympani.

Hypothesis: Loading otoprotective drug into cochlear implant might change its mechanical properties, thus compromising atraumatic insertion. This study evaluated the effect of incorporation of dexamethasone (DXM) in the silicone of cochlear implant arrays on insertion forces.

Background: Local administration of DXM with embedded array can potentially reduce inflammation and fibrosis after cochlear implantation procedure to improve hearing preservation and reduce long-term impedances.

Registration of a validated mechanical atlas of middle ear for surgical simulation.

This paper is centered on the development of a new training and rehearsal simulation system for middle ear surgery. First, we have developed and validated a mechanical atlas based on finite element method of the human middle ear. The atlas is based on a microMRI.

Validation method of a middle ear mechanical model to develop a surgical simulator.

Ossicular surgery requires a high dexterity for the manipulation of the fragile and small middle ear components. Currently, the only efficient technique for training residents in otological surgery is through the use of temporal bone specimens, where any existing surgical simulator does not provide useful feedback. The objective of this study was to develop a finite-element model of the human ossicular chain dedicated to surgical simulation and to propose a method to evaluate its behavior.

Design, kinematic optimization, and evaluation of a teleoperated system for middle ear microsurgery.

Middle ear surgery involves the smallest and the most fragile bones of the human body. Since microsurgical gestures and a submillimetric precision are required in these procedures, the outcome can be potentially improved by robotic assistance. Today, there is no commercially available device in this field.

Friction force measurement during cochlear implant insertion: application to a force-controlled insertion tool design.

Hypothesis: The aim of the study was to evaluate force profiles during array insertion in human cochlea specimens and to evaluate a mechatronic inserter using a 1-axis force sensor.

Background: Today, the surgical challenge in cochlear implantation is the preservation of the anatomic structures and the residual hearing. In routine practice, the electrode array is inserted manually with a limited sensitive feedback.

Cochlear implant insertion forces in microdissected human cochlea to evaluate a prototype array.

Cochlear implant array insertion forces are potentially related to cochlear trauma. We compared these forces between a standard (Digisonic SP; Neurelec, Vallauris, France) and an array prototype (Neurelec) with a smaller diameter. The arrays were inserted by a mechatronic tool in 23 dissected human cochlea specimens exposing the basilar membrane.

From conception to application of a tele-operated assistance robot for middle ear surgery.

The authors' goal was to design and evaluate a robot dedicated to middle ear surgery. Specifications for dimensions, forces, and kinematics were collected, based on the otosclerosis procedure. The robot structure has a compact geometry with 3 linear and 3 rotatory motors.

Minimally invasive computer-assisted approach for cochlear implantation: a human temporal bone study.

Computer-assisted navigation systems can now potentially guide the surgeon to the cochlea with a trajectory avoiding the facial nerve through a keyhole approach. Five temporal bone specimens, with 4 titanium screws placed in the mastoid cortex, were studied. Preoperative computed tomographic scan images were loaded on an electromagnetic computer-assisted surgery (CAS) system (Digipointeur, Collin, Bagneux, France).