2012 IEEE International Conference on Biomedical Robotics and Biomechatronics

Workshop on Robot-Assisted Laryngeal Microsurgery

On-site Laser Phonomicrosurgery – Challenges for an endoscopic system design with integrated augmented reality

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

Current laser phonomicrosurgeries rely completely on the dexterity of the surgeons. Since the tissue manipulation and laser application requires a direct line of sight between the surgical microscope and the vocal folds, tilting back the patient’s head might lead to a postoperative pain, i.e. for an elderly patient. Furthermore, the manual control of the laser is done via a mechanical micromanipulator mostly with a disadvantageous ergonomic setup.

In comparison to that, the μRALP on-site laser phonomicrosurgical approach targets the development of an endoscope containing all required technologies for an intervention in a more convenient position of the patient, 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 be passed through a work channel inside the device. A further challenge is the integration of the surgical laser into the endoscope requiring visual servoing based control of the laser spot. Due to the on-site limited control of the endoscope, an augmented reality system can support the surgeon by providing additional information through a live endoscopic video, pre-operative imaging and surgical planning.

During this talk, different types of endoscope kinematics are analyzed w.r.t. enabling high system integration and the appropriate degree of freedom for actuating of the distal tip. Recent approaches for endoscopic augmented reality are reviewed in order to determine their limitations and the expected challenges for on-site laser phonomicrosurgery.