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This paper reports on a study whose goal is to control the tissue temperature at a specific spot during laser surgery, for the purpose of, e.g., inducing coagulation or sealing blood vessels. We propose a solution that relies on the automatic adjustment of the laser focus (and thus how concentrated the laser beam is), combined with the use of an infrared thermal camera for non-contact temperature monitoring. One of the main challenges in the control of thermal laser-tissue interactions is that these interactions can be hard to predict due to the inherent variability in the molecular composition of biological tissue. To tackle this challenge, we explore two different control approaches: (1) a model-less controller using a Proportional- Integral (PI) formulation, whose gains are set via a tuning procedure performed on laboratory-made tissue phantoms; and (2) a model-based controller using an adaptive formulation that makes it robust to tissue variability. We report on experiments, performed on four types of tissue specimens, showing that both controllers can consistently achieve temperature tracking with a Root-Mean-Square Error (RMSE) ≈ 1 ◦C.
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Losing Focus: Can It Be Useful in Robotic Laser Surgery?
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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- Award ID(s):
- 1922761
- PAR ID:
- 10463927
- Date Published:
- Journal Name:
- THE HAMLYN SYMPOSIUM ON MEDICAL ROBOTICS
- Page Range / eLocation ID:
- 135 to 136
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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- Free Publicly Accessible Full Text
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Accepted Manuscript1.0
- Conference Paper:
- https://doi.org/10.31256/HSMR2023.68
