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