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Lasers are an essential tool in modern medical practice, and their applications span a wide spectrum of specialties. In laryngeal microsurgery, lasers are frequently used to excise tumors from the vocal folds [1]. Several research groups have recently developed robotic systems for these procedures [2-4], with the goal of providing enhanced laser aiming and cutting precision. Within this area of research, one of the problems that has received considerable attention is the automatic control of the laser focus. Briefly, laser focusing refers to the process of optically adjusting a laser beam so that it is concentrated in a small, well-defined spot – see Fig. 1. In surgical applications, tight laser focusing is desirable to maximize cutting efficiency and precision; yet, focusing can be hard to perform manually, as even slight variations (< 1 mm) in the focal distance can significantly affect the spot size. Motivated by these challenges, Kundrat and Schoob [3] recently introduced a technique to robotically maintain constant focal distance, thus enabling accurate, consistent cutting. In another study, Geraldes et al. [4] developed an automatic focus control system based on a miniaturized varifocal mirror, and they obtained spot sizes as small as 380 μm for a CO2 laser beam. Whereas previous work has mainly dealt with the problem of creating – and maintaining – small laser spots, in this paper we propose to study the utility of defocusing surgical lasers. In clinical practice, physicians defocus a laser beam whenever they wish to change its effect from cutting to heating – e.g., to thermally seal a blood vessel [5]. To the best of our knowledge, no previous work has studied the problem of robotically regulating the laser focus to achieve controlled tissue heating, which is precisely the contribution of the present manuscript. In the following sections, we first briefly review the dynamics of thermal laser-tissue interactions and then propose a controller capable of heating tissue according to a prescribed temperature profile. Laser-tissue interactions are generally considered hard to control due to the inherent inhomogeneity of biological tissue [6], which can create significant variability in its thermal response to laser irradiation. In this paper, we use methods from nonlinear control theory to synthesize a temperature controller capable of working on virtually any tissue type without any prior knowledge of its physical properties.
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When the End Effector Is a Laser: A Review of Robotics in Laser Surgery
Combining laser technology with robotic precision and accuracy promises to introduce significant advances in minimally invasive surgical interventions. Lasers have already become a widespread tool in numerous surgical applications. They are proposed as a replacement for traditional tools (i.e., scalpels and electrocautery devices) to minimize surgical trauma, decrease healing times, and reduce the risk of postoperative complications. Compared to other energy sources, laser energy is wavelength‐dependent, allowing for preferential energy absorption in specific tissue types. This potentially leads to minimizing damage to healthy tissue and increasing surgical outcomes control and quality. Merging robotic control with laser techniques can help physicians achieve more accurate laser aiming and pave the way to automatic control of laser–tissue interactions in closed loop. Herein, a review of the state‐of‐the‐art robotic systems for laser surgery is presented. The goals of this paper are to present recent contributions in advanced intelligent systems for robot‐assisted laser surgery, provide readers with a better understanding of laser optics and the physics of laser–tissue interactions, discuss clinical applications of lasers in surgery, and provide guidance for future systems design.
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- Award ID(s):
- 1922761
- PAR ID:
- 10376234
- Publisher / Repository:
- Wiley Blackwell (John Wiley & Sons)
- Date Published:
- Journal Name:
- Advanced Intelligent Systems
- Volume:
- 4
- Issue:
- 10
- ISSN:
- 2640-4567
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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