Innovations in robot-assisted laser laryngeal microsurgery

L. Mattos¹, G. Dagnino¹, D. Caldwell¹, L. Guastini², F. Mora², G. Peretti^2
1Istituto Italiano di Tecnologia, Genoa, Italy, ²Università degli Studi di Genova, Italy

Introduction: Current commercial robotic laser microsurgery systems greatly improve surgical outcome, but are still limited in terms of the control interface, scan pattern definition and accessibility to the surgical site.

Material and methods: A new robotic system was developed based on the "virtual scalpel" concept, allowing surgeries to be performed using a stylus directly over live operating field video. It also allows real-time flexible planning of incisions and ablation patterns, which are precisely executed by a new motorized laser scanner.

Results: Preliminary path-following aiming trials demonstrated the new system is highly intuitive, effective and safe: Reductions of 80% in maximum absolute error and near 50% in RMS error were recorded under direct user control. Using planning, the recorded RMS error was only 0.03mm for a 40x microscope magnification. These developments have also resulted in the µRALP European project, which will further this technology and improve surgical site access via miniaturization and creation of a new endoscopic tool for laser laryngeal microsurgeries.