Clinical experience with the RobOtol robotic operating system at the ENT Clinic at the Hradec Králové University Hospital

During the first quarter of 2024, the RobOtol robotic operating system, developed by the French company Collin Medical, was successfully used at the Clinic of Otorhinolaryngology and Head and Neck Surgery of the Hradec Králové University Hospital. The clinical use of the system was supervised from the professional side by the head of the clinic, Prof. Viktor Chrobok, M.D., Ph.D., together with other doctors of the ENT clinic. Application and technical support was provided by Promedica – the official distributor of this technology in the Czech Republic.

The RobOtol system is primarily used for gentle and precise insertion of the electrode bundle of cochlear implants into the patient’s inner ear. The main advantage over manual insertion is the slow and smooth speed of electrode insertion and the elimination of any tremors, resulting in less traumatization of the surrounding structures. The robotic system can also be used during middle ear surgery, either for gentle navigation of the surgical instruments or endoscope.

The Head of the Department of Otorhinolaryngology and Head and Neck Surgery of the Faculty of Medicine, Prof. MUDr. Viktor Chrobok, CSc., Ph.D. introduces the electrode bundle of the cochlear implant using the active arm of the RobOtol system.

During the loan period, 6 cochlear implantations were successfully performed, one of which was bilateral. This loan followed a previous presentation of the system at the clinic in 2022, during which 18 cochlear implantations were performed (5 paediatric and 9 adult patients, 4 of which were bilateral). The 2024 implantations used a new active arm, allowing the electrode to be inserted at a slow speed of 0.1mm/s, ensuring greater gentleness of the procedure. Furthermore, RobOtol was used in two eardrum surgeries using the endoscopic arm. The advantage of this arm is that the system holds and controls the endoscope and the operating physician has both hands free to manipulate the surgical instruments compared to conventional surgery.

Jan Mejzlík, M.D., Ph.D. performs eardrum surgery using the endoscopic arm of the RobOtol system.

All indications are that the future should bring the development of other potential indications for the use of this technology. Integration with a navigation system is currently being finalized that will allow the robotic arm to interface with image data from imaging modalities such as CT or MR to provide precise spatial navigation of the robotic instrument. Other types of tools are also under development, such as forceps for the insertion of middle ear prostheses, as well as tools for targeted drug delivery into the middle ear tympanic cavity.

We believe that the introduction of this innovative technology into clinical practice will benefit patients in particular.

Medical technologies divison