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muRocs project

Robotic microsurgery of cholesteatoma (muRocs project)

Surgical interventions in the middle ear (such as the removal of a cholesteatoma) are frequent and very risky. In addition to the manipulative difficulties, there are problems related to the indirect vision by microscope. In the ANR muRocs project, we study the feasibility of a robotization of the cholesteatomy gesture.  This involves the use of a fine instrument such as a polyarticulated endoscope carried by a support arm. The task of ISIR in this project is to develop the means of an intuitive and powerful interfacing between the operator and the robotized system. In particular, different piloting modes are compared and the use of multimodal imaging is explored.

Context

Cholesteatoma is a serious disease of the middle ear with an incidence of 1/10000 per year. It consists of a cancerous growth of tissue that can reach the brain. The most effective treatment of the disease at present is surgery. This consists of resecting the cholesteatoma (first by scraping and then by laser ablation of the residues) either through the tympanic canal or through a milled passage in the mastoid. This operation is an example of the difficulties of microsurgery: narrow access, unwieldy tools, fragile tissues (optic nerve, tympano-ossicular chain), reduced indirect vision. Consequently, the failure rate is high (25%) and there is a great need to improve the procedure, particularly in terms of instrumentation. The muRocs project (ANR PRC 2018 consortium, Besançon University Hospital) aims at robotizing the cholesteatoma resection procedure to make it less invasive, less risky and more efficient.  In this project, ISIR is interested in the ergonomics of the new robotic system, in particular in terms of controllability and immersion of the operator in the surgical scene. 

Objectives

Results

Partnerships and collaborations 

µROCs (Micro-Robot for Cholesteatoma Surgery) is an ANR PRC 2018 project.

The ANR µROCs consortium is led by the University Hospital of Besançon (Laurent Tavernier, Olivier Gaiffe).

It also includes:

In this project, the clinical partners bring their experience in minimally invasive ear surgery. In particular, Dr Nguyen is a pioneer in robotic surgery of the middle ear as he was one of the first users of the robOtol, a robot designed at the ISIR and commercialized by the company Collin Médical. The Femto-ST laboratory is in charge of developing a miniature dexterous instrument capable of reaching all points of the surgical site. This instrument is based on the hybrid technology of cables and concentric tubes.

Project members

Jérôme Szewczyk
Professeur des Universités
Jae Hun So
Doctorant