An autonomous surgical robot for drilling a cochleostomy–porcine trial

Abstract

Objectives. Cochlea implantation involves drilling a cochleostomy through which the electrode array can be inserted. This is a freehand procedure requiring great accuracy. On breaking through the medial bony cochlea wall the drill penetrates through the endosteal membrane traumatizing the basilar membrane and scala tympani and contaminates them with bone dust. This probably causes a destruction of any residual hearing. Our objective was to produce an autonomous surgical drilling robot capable of drilling a cochleostomy but stopping prior to disrupting the endosteal membrane.Method. The autonomous surgical robot senses the force and torque at the tool point and uses this information to predict the start of breaking through the medial bony cochlea wall. Drilling is stopped prior to penetrating the endosteal membrane. The autonomous robot was used to drill a cochleostomy in 5‐porcine cochlea's.Results. In all 5 procedures the autonomous surgical drilling robot stopped at the point of breakthrough. The endosteal membrane was not perforated in any of the specimens. The intact membrane was visible at the base of the cochleostomy.Conclusions. The autonomous surgical robot can drill a cochleostomy that minimizes damage to the membranous cochlea. The effect of this increased accuracy on residual hearing and post‐operative infection is under further investigation.