Robotics
Robotic-assisted cochlear implantation
Robot-assisted cochlear implantation represents a significant advance in the treatment of profound hearing loss. In Bern, a robot-assisted cochlear implantation was performed on humans for the first time worldwide in 2016. This innovative method enables particularly precise and minimally invasive placement of the implant in the inner ear, which can sustainably improve the hearing of affected patients. By using the latest robotic technology, procedures are carried out with the utmost precision, minimizing the risk of complications and maximizing the protection of sensitive structures in the ear. This technology opens up new possibilities in hearing rehabilitation and helps to significantly improve the quality of life of hearing-impaired patients. Since 2024, a robot has been used at Inselspital for the gentle placement of cochlear implant electrodes in the cochlea. The hearing implant center at Inselspital Bern has many years of experience with robotic surgery and is a world leader in this field
Video on JOVE website
Robot-assisted cochlear implantation for direct cochlear access
This video describes the procedure of robotic cochlear implantation for minimally invasive inner ear access. Robot-assisted systems offer great potential for more gentle and precise cochlear implantation. In this article, we provide a comprehensive overview of the clinical workflow for robotic cochlear implantation using a robotic system specifically designed for minimally invasive, direct cochlear access. The clinical workflow involves experts from various disciplines and requires training to ensure a smooth and safe procedure. The protocol briefly summarizes the history of robotic cochlear implantation. The clinical procedure is explained in detail, starting with the assessment of patient suitability, through surgical preparation, preoperative planning with specialized planning software, drilling of the middle ear access, intraoperative imaging to confirm the trajectory, milling of the inner ear access, insertion of the electrode array, and implant management. The steps that require special attention are discussed. As an example, the postoperative outcome of robotic cochlear implantation in a patient with advanced otosclerosis is presented. Finally, the procedure is discussed in the context of the authors' experience.
Link to the video (recording: Gianni Pauciello ENT Clinic Inselspital):
Robotic Cochlear Implantation for Direct Cochlear Access
International scientific publication in a journal, 30 manual vs. 30 robotic insertions
Study on trials of the novel robot-assisted system for implantation of cochlear implant electrodes
Purpose: As an increasing number of cochlear implant candidates exhibit residual inner ear function, hearing preservation strategies during implant insertion are gaining importance. Manual implantation is known to induce traumatic force and pressure peaks. In this study, we use a validated in-vitro model to comprehensively evaluate a novel surgical tool that addresses these challenges through motorized movement of a forceps.
Methoden: Using lateral wall electrodes, we examined two subgroups of insertions: 30 insertions were performed manually by experienced surgeons, and another 30 insertions were conducted with a robot-assisted system under the same surgeons’ supervision. We utilized a realistic, validated model of the temporal bone. This model accurately reproduces intracochlear frictional conditions and allows for the synchronous recording of forces on intracochlear structures, intracochlear pressure, and the position and deformation of the electrode array within the scala tympani.