New motorized micromanipulator for robot-assisted laser phonomicrosurgery

In laser-based laryngeal surgeries, motorized laser scanners offer greater aiming accuracy and efficiency. In this paper, a new motorized laser micromanipulator is presented, which is based on a spherical orienting device. It is a 2 degrees-of-freedom roll/pitch mechanism which actuates the laser beamsplitter mirror for improved aiming control and automated intraoperative planning. The combination of this device with state-of-the-art reflective laser focusing optics overcomes the drawbacks of an earlier prototype, providing increased operating distance and surgical range. This makes the device more suitable to real surgical scenarios in the operating room (OR). Improved system accuracy and usability is successfully demonstrated through comparative user trials against the traditional manual laser micromanipulator. The new device offers greater than 57% improvement in accuracy demonstrating its safety and usability. Preliminary ex-vivo trials were also performed with expert surgeons with the new mechanism. The surgeons evaluated the system positively and provided valuable and favourable feedback pointing to the suitability of the device for the OR and its potential to enhance the capacity of laser-based transoral microsurgeries.