How did the first procedure with HEARO go?
It went well for my patient. We safely opened the inner ear and we smoothly placed the cochlear implant. The planning of the surgery was done using OTOPLAN software. When you plan the trajectory the decision making part of the surgery is already done. The HEARO system only performs the trajectory, that you planned.
What is the decisive advantage of using the HEARO procedure for cochlear implantation?
I think the most impressive trait is the accuracy of this system, it’s less than a thickness of your hair. So the precision is there and the precision is needed because we have to go through a facial recess—basically you have to pass over the facial nerve and underneath the chorda tympani. That’s about 2.3–2.5 mm and then you have to make an opening of 1.0 mm, and through that channel you have to manage to place an array into the cochlea.
Is the next step in the development of robotic cochlear implantation, that the surgeon will be replaced by the robot?
Robots are not a threat to the surgeon at all. This device will not work without a surgeon. It’s like an electric bike—it’s an electric boost, but if you don’t pedal as a cyclist, it’s not going to advance. Surgeons will always be needed, and it will always be human-to-human contact. The robot is just a tool and you should use it, you should learn how to use it, just to aim for better results for your patients.
When are you satisfied with a procedure?
When everything goes well for the patient. We had such a nice insertion angle, which I have really never seen in my personal series, and the electrode was covering the lateral wall perfectly as we aimed. In the future I’m convinced that the patients will come to us and ask for the HEARO procedure, a procedure that is safe and precise.
Prof. Dr. Vedat Topsakal and Prof. Dr. Paul van de Heyning performed the world’s first HEARO robotic cochlear implantation procedure on a patient in December 2018 at UZA Antwerp University Hospital. The HEARO system robotically drilled an access to the inner ear, opening a channel all the way to the round window of the cochlea to smoothly insert the electrode array of the cochlear implant. The HEARO system is the result of a close cooperation between MED-EL, an innovation leader in implatable hearing solutions, and CASCINATION. In this interview Prof. Dr. Topsakal talks about how it felt, pushing the boundaries of cochlear implantation.