1. 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

2. 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

3. 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

4. Problem
Otologic surgery requires delicate maneuvering in limited space
Current method requires large hand movement

5. 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.

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

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

8. The Task
There are different kinds of tips
grasping
cutting
spreading

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

10. 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

11. Research and Brainstorming

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

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

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

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

16. Questions?