Robotics is making its way into ear surgery in Malaysia, with Hospital Canselor Tuanku Muhriz becoming the first in the country to carry out a robotic-assisted endoscopic ear procedure.
Performed on March 12 at Universiti Kebangsaan Malaysia, the operation treated a 59-year-old woman with hearing loss using a combination of robotic support and piezoelectric technology.
At its core is a simple upgrade to how surgeons work. It involves a robotic endoscopic holder that steadies the camera to maintain a clear view throughout the procedure.Instead of splitting focus between holding the scope and operating, both hands are free to use surgical instruments. In a confined area like the ear canal, that added control makes a noticeable difference.
The procedure, led by Associate Professor Dr Noor Dina Hashim and assisted by Dr Wan Nabila Wan Mansor, also introduced piezosurgery to endoscopic ear operations in Malaysia. The technique utilises ultrasonic vibrations to cut bone without affecting the surrounding soft tissue. It replaces the conventional drill, which can affect nearby structures if not handled with extreme precision.
This technique is crucial in the middle ear, where critical structures sit close together. By focusing only on bone, the piezo tool reduces the risk of accidental damage, even with slight movement. It is a method already familiar in dentistry, now being adapted for more specialised procedures.
For patients, the impact is straightforward. The approach can reduce surgery time, limit discomfort and speed up recovery. In this case, the patient reported minimal pain and was discharged the following day, despite it being a repeat surgery on the same ear.
The technology is not universal. It is less suited to dense bone and does not apply to soft tissue procedures such as tonsil or nasal polyp removal. Even so, its potential use in sinus and skull base operations points to a wider shift towards more controlled, minimally invasive treatment.
