Fingertip Controlled Otologic Surgical Instruments Brian Chow and Joy Nystrom Mechanical Engineer: Ryan Josefovsky Advisor: Russ Johnson, PhD-Smith and Nephew BME 273 February 12, 2001

Ear Surgery Otitis Media Closure of Tympanic Membrane Perforations 11 million cases per year upwards of 800,000 surgeries/year Closure of Tympanic Membrane Perforations

Ear Surgery Otosclerosis Removal of Tumors Cochlear Implants 10-18% of women aged 30-50 7-9% of men aged 30-50 boystown Removal of Tumors Cochlear Implants 14,000 Americans http://www.nidcd.nih.gov/health/pubs_hb/coch.htm#c

Problem Otologic surgery requires delicate maneuvering in limited space Current method requires large hand movement www.earsurgery.org

A large hand movement causes a small tip movement. 1 inch 1 inch A large hand movement causes a small tip movement. Movement requires compensation by user.

Proposal Create a system that will allow identical movement of the instrument in an ear of a patient with a fingertip-controlled drive mechanism

The Task Redesign the back end and drive mechanism for fingertip control Maintain tip movement identical to current instruments Back End/ Drive Mechanism Tip

The Task There are different kinds of tips grasping cutting spreading

Reasons Fingertip control allows for: Steadier hand control Higher precision with finger movement Better access to inner ear

Advantages Reduced motion of surgeon’s arm results in: A lowered margin of error A potential for reducing amount of training required for proficiency A potential for better ergonomics Similar cost

Research and Brainstorming

Patent Search New problem, few previous patents, little information Similar to laparoscopic surgery

Possible solutions Screw mechanism Pulleys (#5,976,122) Gears Slide Concentric Wheels

Initial Design To tip Concentric wheels designed to scale motion. Solid metal shafts

Future Work Obtain and sign NDA Talk to ENT surgeon Obtain Specifications Complete design on CAD program

Questions?