A Novel Approach in Laser Phonomicrosurgery using an Innovative Mechatronic Endoscope with Augmented Reality

Andreas Schoob and Benjamin Munske, Institute of Mechatronic Systems, Leibniz Universität Hannover, Germany

The µRALP project focuses on improving the state of the art in laser phonomicrosurgeries currently relying completely on the dexterity of the surgeons. Since the intervention requires a direct line of sight between the microscope and the vocal folds, tilting back of the patient’s head may lead to a postoperative pain, i.e. for an elderly patient. Furthermore, the control of the laser is done via a mechanical micromanipulator mostly with a disadvantageous ergonomic setup. µRALP targets the development of a mechatronic endoscope containing all required technologies enabling a laser phonomicrosurgical intervention in a more convenient position without the need of a direct line of sight. Hence, tools currently inserted through a laryngoscope need to be integrated into the distal tip of the endoscope or be small enough to fit into a work channel inside the device. In addition, an augmented reality system displays information provided by a live endoscopic video, pre-operative imaging and surgical planning. A further challenge is the integration of a micro robot to the endoscopic tip for laser control on the surgical site. Visual servoing and an intuitive user interface facilitate the guidance of the laser.

During the talk, recent technologies and concepts used in today’s endoscopy are reviewed. Especially, different types of endoscope kinematics are explained and the role of augmented reality in microsurgery is illustrated. The analysis of the limitations of current technologies leads to a discussion on the transferability of the presented research projects and commercial products to µRALP.

Open questions w.r.t. current approaches for integrating higher functionalities such as augmented reality and the actuation of the endoscope are presented and put up to discussion.