Workflow assessment as a preclinical development tool: Surgical process models of three techniques for minimally invasive cochlear implantation

Research output: Contribution to journalArticleResearchpeer review

Authors

  • Samuel Müller
  • Lüder A. Kahrs
  • Johannes Gaa
  • Sebastian Tauscher
  • Marcel Kluge
  • Samuel John
  • Thomas S. Rau
  • Thomas Lenarz
  • Tobias Ortmaier
  • Omid Majdani

Research Organisations

External Research Organisations

  • Hannover Medical School (MHH)
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Details

Original languageEnglish
Pages (from-to)1389-1401
Number of pages13
JournalInternational journal of computer assisted radiology and surgery
Volume14
Issue number8
Early online date5 Jun 2019
Publication statusPublished - 1 Aug 2019

Abstract

Purpose: Minimally invasive cochlear implant surgery is a challenging procedure due to high demands on accuracy. For clinical success, an according assistance system has to compete against the traditional approach in terms of risk, operating time and cost. It has not yet been determined what kind of system is the most suited. The purpose of this study is a proof of concept of surgical process modeling as a preclinical development tool and the comparison of workflow concepts for this new approach. Methods: Three preclinical systems (two stereotactic and one robotic) for minimally invasive cochlear implant surgery are compared using the method of surgical process modeling. All three systems were successfully tested with ex vivo human specimen to create minimally invasive surgical access to the cochlea. Those systems where chosen for comparison, because they represent three diverse approaches with different corresponding workflows for the same intervention. The experiments were used to create a process model for each system by recording the interventions. Results: All three conceptual systems developed by our group have shown their eligibility. The recorded process models provide a convenient method for direct comparison. Reduction in the surgical time has a higher impact on the process, than time that is needed for setting up a system beforehand. The stereotactic approaches have little preparation effort and are low cost in terms of hardware compared to the robotic approach, which in return is beneficial in terms of workload reduction for the surgeon. Conclusion: Surgical process modeling is suitable for comparison of different assistant systems for minimally invasive cochlear implantation. The benefit of reduced trauma, compared to the traditional mastoidectomy, can now be assessed with consideration of the workflow of each technique. The process models enable an assessment in the regard of surgical time and workload.

Keywords

    Cochlear implant, Minimally invasive surgery, Surgical process model, Surgical robotics, System evaluation

ASJC Scopus subject areas

Cite this

Workflow assessment as a preclinical development tool: Surgical process models of three techniques for minimally invasive cochlear implantation. / Müller, Samuel; Kahrs, Lüder A.; Gaa, Johannes et al.
In: International journal of computer assisted radiology and surgery, Vol. 14, No. 8, 01.08.2019, p. 1389-1401.

Research output: Contribution to journalArticleResearchpeer review

Müller S, Kahrs LA, Gaa J, Tauscher S, Kluge M, John S et al. Workflow assessment as a preclinical development tool: Surgical process models of three techniques for minimally invasive cochlear implantation. International journal of computer assisted radiology and surgery. 2019 Aug 1;14(8):1389-1401. Epub 2019 Jun 5. doi: 10.1007/s11548-019-02002-3
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title = "Workflow assessment as a preclinical development tool: Surgical process models of three techniques for minimally invasive cochlear implantation",
abstract = "Purpose: Minimally invasive cochlear implant surgery is a challenging procedure due to high demands on accuracy. For clinical success, an according assistance system has to compete against the traditional approach in terms of risk, operating time and cost. It has not yet been determined what kind of system is the most suited. The purpose of this study is a proof of concept of surgical process modeling as a preclinical development tool and the comparison of workflow concepts for this new approach. Methods: Three preclinical systems (two stereotactic and one robotic) for minimally invasive cochlear implant surgery are compared using the method of surgical process modeling. All three systems were successfully tested with ex vivo human specimen to create minimally invasive surgical access to the cochlea. Those systems where chosen for comparison, because they represent three diverse approaches with different corresponding workflows for the same intervention. The experiments were used to create a process model for each system by recording the interventions. Results: All three conceptual systems developed by our group have shown their eligibility. The recorded process models provide a convenient method for direct comparison. Reduction in the surgical time has a higher impact on the process, than time that is needed for setting up a system beforehand. The stereotactic approaches have little preparation effort and are low cost in terms of hardware compared to the robotic approach, which in return is beneficial in terms of workload reduction for the surgeon. Conclusion: Surgical process modeling is suitable for comparison of different assistant systems for minimally invasive cochlear implantation. The benefit of reduced trauma, compared to the traditional mastoidectomy, can now be assessed with consideration of the workflow of each technique. The process models enable an assessment in the regard of surgical time and workload.",
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TY - JOUR

T1 - Workflow assessment as a preclinical development tool

T2 - Surgical process models of three techniques for minimally invasive cochlear implantation

AU - Müller, Samuel

AU - Kahrs, Lüder A.

AU - Gaa, Johannes

AU - Tauscher, Sebastian

AU - Kluge, Marcel

AU - John, Samuel

AU - Rau, Thomas S.

AU - Lenarz, Thomas

AU - Ortmaier, Tobias

AU - Majdani, Omid

N1 - Funding information: Funding The authors acknowledge the financial support by the Federal Ministry of Education and Research of Germany (BMBF Project Numbers 13GW0019C and 13GW0019E).

PY - 2019/8/1

Y1 - 2019/8/1

N2 - Purpose: Minimally invasive cochlear implant surgery is a challenging procedure due to high demands on accuracy. For clinical success, an according assistance system has to compete against the traditional approach in terms of risk, operating time and cost. It has not yet been determined what kind of system is the most suited. The purpose of this study is a proof of concept of surgical process modeling as a preclinical development tool and the comparison of workflow concepts for this new approach. Methods: Three preclinical systems (two stereotactic and one robotic) for minimally invasive cochlear implant surgery are compared using the method of surgical process modeling. All three systems were successfully tested with ex vivo human specimen to create minimally invasive surgical access to the cochlea. Those systems where chosen for comparison, because they represent three diverse approaches with different corresponding workflows for the same intervention. The experiments were used to create a process model for each system by recording the interventions. Results: All three conceptual systems developed by our group have shown their eligibility. The recorded process models provide a convenient method for direct comparison. Reduction in the surgical time has a higher impact on the process, than time that is needed for setting up a system beforehand. The stereotactic approaches have little preparation effort and are low cost in terms of hardware compared to the robotic approach, which in return is beneficial in terms of workload reduction for the surgeon. Conclusion: Surgical process modeling is suitable for comparison of different assistant systems for minimally invasive cochlear implantation. The benefit of reduced trauma, compared to the traditional mastoidectomy, can now be assessed with consideration of the workflow of each technique. The process models enable an assessment in the regard of surgical time and workload.

AB - Purpose: Minimally invasive cochlear implant surgery is a challenging procedure due to high demands on accuracy. For clinical success, an according assistance system has to compete against the traditional approach in terms of risk, operating time and cost. It has not yet been determined what kind of system is the most suited. The purpose of this study is a proof of concept of surgical process modeling as a preclinical development tool and the comparison of workflow concepts for this new approach. Methods: Three preclinical systems (two stereotactic and one robotic) for minimally invasive cochlear implant surgery are compared using the method of surgical process modeling. All three systems were successfully tested with ex vivo human specimen to create minimally invasive surgical access to the cochlea. Those systems where chosen for comparison, because they represent three diverse approaches with different corresponding workflows for the same intervention. The experiments were used to create a process model for each system by recording the interventions. Results: All three conceptual systems developed by our group have shown their eligibility. The recorded process models provide a convenient method for direct comparison. Reduction in the surgical time has a higher impact on the process, than time that is needed for setting up a system beforehand. The stereotactic approaches have little preparation effort and are low cost in terms of hardware compared to the robotic approach, which in return is beneficial in terms of workload reduction for the surgeon. Conclusion: Surgical process modeling is suitable for comparison of different assistant systems for minimally invasive cochlear implantation. The benefit of reduced trauma, compared to the traditional mastoidectomy, can now be assessed with consideration of the workflow of each technique. The process models enable an assessment in the regard of surgical time and workload.

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