Interaction-aware dexterous robot for minimally invasive transcanal inner ear interventions

Intracochlear theranostics, particularly targeted drug delivery and microsampling, offers a promising solution to inner ear diseases. However, specialized medical devices remain limited by a fundamental design challenge imposed by anatomical constraints: balancing miniaturization, dexterity, and perceptive functionality. Here, we present a low–aspect-ratio, dual-segment continuum robot that integrates catheter, endoscopic and instrumental functions. Driven by antagonistic cables, the robot uses a transition-free backbone composed of saddle-shaped joints to achieve a minimum bending radius of 1.9 mm. Dual-segment motion decoupling yields programmable C-/S-shaped configurations, facilitating anatomical navigation. The microneedle, embedded in the central channel, serves as an end-effector with positioning accuracy of 17.9 ± 4.1 μm. Fiber Bragg grating sensors, mounted on the needle, measure axial force to estimate tool-tissue interaction. Validation is performed on cadavers and in vivo animals, demonstrating the feasibility of a transcanal, atraumatic robotic paradigm. Thus, this system provides a practical and accessible approach for early diagnosis and treatment, helping extend precision medicine to underserved areas. Inner ear diseases are difficult to treat due to anatomical constraints. Here, the authors present a dual-segment continuum robot integrating navigation, endoscopy, and a force-sensing microneedle for atraumatic transcanal access to the round window membrane.