激光器
烧蚀
生物医学工程
介入性磁共振成像
磁共振成像
激光烧蚀
医学
经口激光显微手术
计算机科学
材料科学
外科
放射科
光学
喉
物理
内科学
喉切除术
作者
Ge Fang,Marco Chow,Justin Ho,Zhuoliang He,Kui Wang,T. H. Ng,James Kit-Hon Tsoi,Pui-Kwong Chan,Hing-Chiu Chang,Danny Chan,Yunhui Liu,F. Christopher Holsinger,Jason Chan,Ka-Wai Kwok
出处
期刊:Science robotics
[American Association for the Advancement of Science (AAAS)]
日期:2021-08-11
卷期号:6 (57)
被引量:33
标识
DOI:10.1126/scirobotics.abg5575
摘要
Magnetic resonance (MR) imaging (MRI) provides compelling features for the guidance of interventional procedures, including high-contrast soft tissue imaging, detailed visualization of physiological changes, and thermometry. Laser-based tumor ablation stands to benefit greatly from MRI guidance because 3D resection margins alongside thermal distributions can be evaluated in real time to protect critical structures while ensuring adequate resection margins. However, few studies have investigated the use of projection-based lasers like those for transoral laser microsurgery, potentially because dexterous laser steering is required at the ablation site, raising substantial challenges in the confined MRI bore and its strong magnetic field. Here, we propose an MR-safe soft robotic system for MRI-guided transoral laser microsurgery. Owing to its miniature size (Ø12 × 100 mm), inherent compliance, and five degrees of freedom, the soft robot ensures zero electromagnetic interference with MRI and enables safe and dexterous operation within the confined oral and pharyngeal cavities. The laser manipulator is rapidly fabricated with hybrid soft and hard structures and is powered by microvolume (<0.004 milliter) fluid flow to enable laser steering with enhanced stiffness and lowered hysteresis. A learning-based controller accommodates the inherent nonlinear robot actuation, which was validated with laser path-following tests. Submillimeter laser steering accuracy was demonstrated with a mean error < 0.20 mm. MRI compatibility testing demonstrated zero observable image artifacts during robot operation. Ex vivo tissue ablation and a cadaveric head-and-neck trial were carried out under MRI, where we employed MR thermometry to monitor the tissue ablation margin and thermal diffusion intraoperatively.
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