Preclinical Performance Evaluation of a Robotic Endoscope for Non-Contact Laser Surgery

verfasst von

D. Kundrat, R. Graesslin, A. Schoob, D. T. Friedrich, M. O. Scheithauer, T. K. Hoffmann, T. Ortmaier, L. A. Kahrs, P. J. Schuler

Abstract

Despite great efforts, transoral robotic laser surgery has not been established clinically. Patient benefits are yet to be proven to accept shortcomings of robotic systems. In particular, laryngeal reachability and transition from microscope to accurate endoscopic laser ablation have not been achieved. We have addressed those challenges with a highly integrated robotic endoscope for non-contact endolaryngeal laser surgery. The current performance status has been assessed in multi-level user studies. In addition, the system was deployed to an ex vivo porcine larynx. The robotic design comprises an extensible continuum manipulator with multifunctional tip. The latter features laser optics, stereo vision, and illumination. Vision-based performance assessment is derived from depth estimation and scene tracking. Novices and experts (n = 20) conducted teleoperated delineation tasks to mimic laser ablation of delicate anatomy. Delineation with motion-compensated and raw endoscopic visualisation was carried out on planar and non-planar nominal patterns. Root mean square tracing errors of less than 0.75 mm were feasible with task completion times below 45 s. Relevant anatomy in the porcine larynx was exposed successfully. Accuracy and usability of the integrated platform bear potential for dexterous laser manipulation in clinical settings. Cadaver and in vivo animal studies may translate ex vivo findings.

Organisationseinheit(en)

Institut für Mechatronische Systeme

Externe Organisation(en)

Imperial College London
Universität Ulm
Universität Augsburg
University of Toronto

Typ

Artikel

Journal

Annals of biomedical engineering

Band

49

Seiten

585-600

Anzahl der Seiten

16

ISSN

0090-6964

Publikationsdatum

02.2021

Publikationsstatus

Veröffentlicht

Peer-reviewed

Ja

ASJC Scopus Sachgebiete

Biomedizintechnik

Elektronische Version(en)

https://doi.org/10.1007/s10439-020-02577-y (Zugang: Offen)