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
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.