论文标题

喉头中的光:一种小型的机器人光纤,用于在人声褶皱的办公室激光手术

Light in the Larynx: a Miniaturized Robotic Optical Fiber for In-office Laser Surgery of the Vocal Folds

论文作者

Chiluisa, Alex J., Pacheco, Nicholas E., Do, Hoang S., Tougas, Ryan M., Minch, Emily V., Mihaleva, Rositsa, Shen, Yao, Liu, Yuxiang, Carroll, Thomas L., Fichera, Loris

论文摘要

这封信报告了一种新型手持机器人的设计,构造和实验验证,用于在人声褶皱的办公室激光手术中。办公室内窥镜激光手术是喉咙学的一种新兴趋势:它有望以成本的一小部分提供相同的传统手术治疗(即手术室)的患者结局(即手术室)。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视线方式向前发出光,这严重限制了解剖学访问。我们在这封信中提出的机器人旨在克服这些挑战。机器人的最终效应子是可通的激光纤维,它是通过薄光纤纤维(0.225 mm)与肌腱型镍氨基烷凹口鞘的组合而产生的,该鞘提供弯曲。该设备可以与大多数市售的内窥镜无缝使用,因为它足够小(1.1 mm)可以通过工作通道。为了控制纤维,我们提出了一个可以安装在内窥镜手柄顶部的紧凑型致动单元,以便在手术过程中,手术医师可以单手同时操作内窥镜和可驾驶的纤维。我们报告了模拟和幻影实验,表明与当前的临床纤维相比,该提出的设备大大增强了手术通道。

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.

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