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Multi-scale System for Middle Ear Surgery

Abstract : Cholesteatoma is a disease affecting the middle ear, which can potentially lead to severe complications (e.g., hearing loss or facial palsy) in the absence of treatment. The sole treatment is a surgical intervention (resection). However, such a method is invasive and induces a high incidence of residual cholesteatoma, leading to second interventions. Thus, a novel robotic system has been proposed to tackle the problem of residual cholesteatoma by efficiently removing all the infected tissues. The proposed robotic system is composed of a robotic arm (macro-scale part), to which a flexible micro-tool (micro-scale part) is attached at its distal part. However, different challenges had to be solved for developing the new surgical procedures integrating the robotic solution, wherein the expected objectives were to make the robotized cholesteatoma resection easy, intuitive, and fast. Across this thesis, surgical issues and requirements related to surgical phases (i.e., preoperative, per-operative phases for the cholesteatoma resection) are detailed and the ideal solutions for tackling them are proposed. First, we deal with the main preoperative phase concern: an easy installation of the tool-tip inside the incision hole. The proposed solutions use shared vision/force control methods in which the linear motion is controlled by the operator (by force or position) and the rotational motion is managed by a vision-based controller. Then, control architectures are developed for controlling the tool-tip inside the middle ear during the per-operative phase. The control loops include a human operator and handle the tool-tip motion. Finally, the last contribution bears on automatically managing the developed robot to detect and eliminate the residual cholesteatoma with an embedded laser source. All the proposed controllers have shown good results in terms of accuracy after several experimental validations.
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Submitted on : Wednesday, July 6, 2022 - 1:03:51 PM
Last modification on : Wednesday, August 3, 2022 - 3:58:22 AM


Version validated by the jury (STAR)


  • HAL Id : tel-03715379, version 1


Jae Hun So. Multi-scale System for Middle Ear Surgery. Automatic. Sorbonne Université, 2022. English. ⟨NNT : 2022SORUS091⟩. ⟨tel-03715379⟩



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