This letter reports the design, construction, and experimental validation of a novel hand-held robot for in-office laser surgery of the vocal folds. In-office endoscopic laser surgery is an emerging trend in Laryngology: It promises to deliver the same patient outcomes of traditional surgical treatment (i.e., in the operating room), at a fraction of the cost. Unfortunately, office procedures can be challenging to perform; the optical fibers used for laser delivery can only emit light forward in a line-of-sight fashion, which severely limits anatomical access. The robot we present in this letter aims to overcome these challenges. The end effector of the robot is a steerable laser fiber, created through the combination of a thin optical fiber (0.225 mm) with a tendon-actuated Nickel-Titanium notched sheath that provides bending. This device can be seamlessly used with most commercially available endoscopes, as it is sufficiently small (1.1 mm) to pass through a working channel. To control the fiber, we propose a compact actuation unit that can be mounted on top of the endoscope handle, so that, during a procedure, the operating physician can operate both the endoscope and the steerable fiber with a single hand. We report simulation and phantom experiments demonstrating that the proposed device substantially enhances surgical access compared to current clinical fibers.
翻译:该信报告了用于室内激光手术的新型手持机器人的设计、建造和实验性验证,用于室内声控折叠体的激光手术。在办公室内内内内镜激光手术是Larynglogy的一种新兴趋势:它承诺以一小部分成本提供传统外科治疗(即手术室)的相同病人结果。 不幸的是,办公室程序可能具有挑战性;用于激光输送的光纤只能以直线方式发出光线,严重限制解剖接触。我们在信中介绍的机器人旨在克服这些挑战。机器人的终端效果是一种可控的激光纤维,通过薄光纤(0.225毫米)的组合而产生,其作用与提供弯曲的红外科治疗(即手术室中)呈相同的病人结果。这一装置可以与最商业上可用的内镜相连接使用,因为它足够小(1.1毫米)通过一个工作频道。为了控制纤维,我们建议一个紧凑的动作动作装置,可以大量安装在顶部的临床纤维纤维纤维上, 并且通过一个可操作的直径直径镜操作的直径镜,我们可以操作一个手动的手动的手模操作操作器。