Assistive functions for a novel laser surgery system – a pilot study

Background:

Several systems are available for transoral robotic surgery (TORS). However, laser-assisted TORS (L-TORS) has not been established in the clinical routine. The main reasons include financial burden, increased setup time, reachability of anatomical structures and non-compliance with standard laser systems. Therefore, further development of L-TORS systems is necessary. Here, we present a user study for assistive functions inside a novel L-TORS system for non-contact laser surgery in a pre-clinical setting.

Material and Methods:

The L-TORS system is composed of an extensible continuum manipulator with a multi-functional tip including a fix-focus laser beam, stereo vision, and illumination. The associated software framework enables real-time tissue depth estimation and 3D image stabilization within a customized user interface. Primarily, the device was applied to expose endolaryngeal structures in a porcine animal model. Additionally, subjects (n = 20) from medical and technical background were asked to use the device for setting a laser beam into optimal focus and for tele-operated laser path tracking.

Results:

All relevant anatomical structures were reached and exposed with the robotic prototype. The software-based feedback mechanisms significantly improved the ability of optimal focal placement. Execution time and accuracy of tele-operated path tracking were significantly optimized by the use of software assistance.

Conclusion:

The described robotic device was successfully applied to explore endolaryngeal anatomy. Software-based assistive functions simplify the application of a laser in L-TORS. Currently available systems and pre-clinical robotic systems should be adapted to ENT-specific needs in order to generate a benefit for the patients treated by TORS.

Publication History

Publication Date:
23 April 2019 (online)