Metrology-based quality assurance for image-guided minimally invasive surgery at the lateral skull base

• Applicants: Dr. Julia Kristin; Professor Dr. Jörg Schipper; Professor Dr.-Ing. Robert Heinrich Schmitt
• Subject Area: Automation, Mechatronics, Control Systems, Intelligent Technical Systems, Robotics ; Medical Physics, Biomedical Technology
• Term: from 2015 to 2023
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 277205406

• Final Report Year: 2024

Final Report Abstract

The goal of the research project Mambo 2 was to develop an intraoperative assistance system for a handheld drilling device for minimally invasive cochlear implantation. The aim was to predict intraoperative damage due to temperature during drilling and provide surgeons with recommendations to secure the procedure. Temperature data was collected using a drill with integrated temperature and sound sensors which was developed in the first phase of the project and revised in this phase. As part of the revision, a smaller diameter, a longer drill length, and a temperature-optimized drill geometry were selected. To avoid energy supply dependency on drill rotation, an induction power supply was installed in a housing on the drill shaft. Currently, minimally invasive drilling is performed exclusively with robotic assistance, not by hand. Discussions with medical experts revealed no future demand for hand-guided drilling. Additionally, integrating extra equipment in the operating room adds burden to surgeons. Thus, further development focused on the robotic intervention demonstrated in the initial phase of the project. Models for temperature prediction during drilling were developed using experimental data from various bone equivalents and animal/human tissue. A Light Gradient Boosting Machine was chosen for deriving recommendations after analyzing different machine learning algorithms. The model suggests adjusted drilling parameters based on comparisons between current and potential drilling paths from training data, resulting in reduced CEM43 values, which assess drilling damage. However, CEM43 values are unpredictable, so temperature and sound data alone should be used for predicting the outcome of the drilling process. The project faced hurdles such as limited laboratory access due to the COVID-19 pandemic, delaying data collection, and relevant drill components being unavailable due to the chip crisis, further delaying drill finalization. Identifying and engaging drill manufacturers was time-consuming, and subsequent manufacturing was delayed due to staffing shortages.

Publications

• Metrological Support of Medical Drillings at the Lateral Skull Base. Current Directions in Biomedical Engineering, 7(1), 171-175.
  Knott, Anna-Lena; Kristin, Julia; Schipper, Jörg; Klenzner, Thomas; Prinzen, Tom & Schmitt, Robert H.
  
• Suitability Analysis of Industrial Drills for Minimally Invasive Skull Base Surgery. Current Directions in Biomedical Engineering, 8(1), 93–96.
  Knott, Anna-Lena; Prinzen, Tom; Klenzner, Thomas; Schipper, Jörg; Kristin, Julia & Schmitt, Robert H.
  
• Contactless Energy Supply for Medical Drill with Integrated Temperature Sensor. Current Directions in Biomedical Engineering, 10(2), 79-82.
  Knott, Anna-Lena; Sanders, Mark; Prinzen, Tom; Klenzner, Thomas; Schipper, Jörg; Kristin, Julia & Schmitt, Robert H.
  
• Kalibrierung und Messunsicherheitsbetrachtung eines medizinischen Bohrers mit integrierter Temperatursensorik zur Minimierung des Patientenrisikos bei minimalinvasiven Bohrungen an der lateralen Schädelbasis. tm - Technisches Messen, 91(7-8), 369-379.
  Knott, Anna-Lena; Huber, Meike; Karakus, Ugur; Müller, Tobias & Schmitt, Robert H.