Leonardo S. Mattos, Nikhil Deshpande, Giacinto Barresi, Luca Guastini, Giorgio Peretti

Objectives/Hypothesis: To introduce a novel computerized surgical system for improved usability, intuitiveness, accuracy, and controllability in robot-assisted laser phonomicrosurgery.

Study Design: Pilot technology assessment.

Methods: The novel system was developed involving a newly designed motorized laser micromanipulator, a touchscreen display, and a graphics stylus. The system allows the control of a CO2 laser through interaction between the stylus and the live video of the surgical area. This empowers the stylus with the ability to have actual effect on the surgical site. Surgical enhancements afforded by this system were established through a pilot technology assessment using randomized trials comparing its performance with a state-of-the-art laser microsurgery system. Resident surgeons and medical students were chosen as subjects in performing sets of trajectory-following exercises. Image processing–based techniques were used for an objective performance assessment. A System Usability Scale–based questionnaire was used for the qualitative assessment.

Results: The computerized interface demonstrated superiority in usability, accuracy, and controllability over the state-of-the-art system. Significant ease of use and learning experienced by the subjects were demonstrated by the usability score assigned to the two compared interfaces: computerized interface = 83.96% versus state-of-the-art = 68.02%. The objective analysis showed a significant enhancement in accuracy and controllability: computerized interface = 90.02% versus state-ofthe-art = 75.59%.

Conclusions: The novel system significantly enhances the accuracy, usability, and controllability in laser phonomicrosurgery. The design provides an opportunity to improve the ergonomics and safety of current surgical setups.

Key Words: Robotics, CO2 laser, microlaryngeal surgery, surgeon interface.
Level of Evidence: N/A