μRALP and Beyond

Micro-Technologies and Systems for Robot-Assisted Endoscopic Laser Microsurgery

verfasst von

Leonardo S. Mattos, Alperen Acemoglu, André Geraldes, Andrea Laborai, Andreas Schoob, Brahim Tamadazte, Brian Davies, Bruno Wacogne, Christian Pieralli, Corina Barbalata, Darwin G. Caldwell, Dennis Kundrat, Diego Pardo, Edward Grant, Francesco Mora, Giacinto Barresi, Giorgio Peretti, Jesùs Ortiz, Kanty Rabenorosoa, Laurent Tavernier, Lionel Pazart, Loris Fichera, Luca Guastini, Lüder A. Kahrs, Micky Rakotondrabe, Nicolas Andreff, Nikhil Deshpande, Olivier Gaiffe, Rupert Renevier, Sara Moccia, Sergio Lescano, Tobias Ortmaier, Veronica Penza

Abstract

Laser microsurgery is the current gold standard surgical technique for the treatment of selected diseases in delicate organs such as the larynx. However, the operations require large surgical expertise and dexterity, and face significant limitations imposed by available technology, such as the requirement for direct line of sight to the surgical field, restricted access, and direct manual control of the surgical instruments. To change this status quo, the European project μRALP pioneered research towards a complete redesign of current laser microsurgery systems, focusing on the development of robotic micro-technologies to enable endoscopic operations. This has fostered awareness and interest in this field, which presents a unique set of needs, requirements and constraints, leading to research and technological developments beyond μRALP and its research consortium. This paper reviews the achievements and key contributions of such research, providing an overview of the current state of the art in robot-assisted endoscopic laser microsurgery. The primary target application considered is phonomicrosurgery, which is a representative use case involving highly challenging microsurgical techniques for the treatment of glottic diseases. The paper starts by presenting the motivations and rationale for endoscopic laser microsurgery, which leads to the introduction of robotics as an enabling technology for improved surgical field accessibility, visualization and management. Then, research goals, achievements, and current state of different technologies that can build-up to an effective robotic system for endoscopic laser microsurgery are presented. This includes research in micro-robotic laser steering, flexible robotic endoscopes, augmented imaging, assistive surgeon-robot interfaces, and cognitive surgical systems. Innovations in each of these areas are shown to provide sizable progress towards more precise, safer and higher quality endoscopic laser microsurgeries. Yet, major impact is really expected from the full integration of such individual contributions into a complete clinical surgical robotic system, as illustrated in the end of this paper with a description of preliminary cadaver trials conducted with the integrated μRALP system. Overall, the contribution of this paper lays in outlining the current state of the art and open challenges in the area of robot-assisted endoscopic laser microsurgery, which has important clinical applications even beyond laryngology.

Organisationseinheit(en)

Institut für Mechatronische Systeme

Externe Organisation(en)

Istituto Italiano di Tecnologia (IIT)
Guglielmo da Saliceto Hospital
Yuanda Robotics GmbH
Université Paris 6
Imperial College London
Universite de Bourgogne
Universite de Franche-Comte
Louisiana State University
North Carolina State University
IRCCS Policlinico San Martino Hospital
Università degli studi di Genova (UniGe)
Worcester Polytechnic Institute
University of Toronto
Scuola Superiore Sant'Anna di Studi Universitari e di Perfezionamento
Université de Toulouse

Typ

Übersichtsarbeit

Journal

Frontiers in Robotics and AI

Band

8

Publikationsdatum

08.09.2021

Publikationsstatus

Veröffentlicht

Peer-reviewed

Ja

ASJC Scopus Sachgebiete

Angewandte Informatik, Artificial intelligence

Ziele für nachhaltige Entwicklung

SDG 3 – Gute Gesundheit und Wohlergehen

Elektronische Version(en)

https://doi.org/10.3389/frobt.2021.664655 (Zugang: Offen)