A Magnetic Laser Scanner for Endoscopic Microsurgery
Creators: name: ACEMOGLU, ALPEREN
Publisher: name: Universit� degli studi di Genova
Year: 2018

description: Laser scanners increase the quality of the laser microsurgery enabling fast tissue ablation with less thermal damage. Such technology is part of state-of-the-art freebeam surgical laser systems. However, laser scanning has not been incorporated to fiber-based lasers yet. This is a combination that has potential to greatly improve the quality of laser microsurgeries on difficult-to-reach surgical sites. Current fiberbased tissue ablations are performed in contact with the tissue, resulting in excessive thermal damage to healthy tissue in the vicinity of the ablated tissue. This is far from ideal for delicate microsurgeries, which require high-quality tissue incisions without any thermal damage or char formation. However, the possibility to perform scanning laser microsurgery in confined workspaces is restricted by the large size of currently available actuators, which are typically located outside the patient and require direct line-of-sight to the microsurgical area. Thus, it is desired to have the laser scanning feature in an endoscopic system to provide high incision quality in hard-to-reach surgical sites. This thesis aims to introduce a new endoscopic laser scanner to perform 2D position control and high-speed scanning of a fiber-based laser for operation in narrow workspaces. It also presents a technology concept aimed at assisting in incision depth control during soft-tissue microsurgery. The main objective of the work presented in this thesis is to bring the benefits of free-beam lasers to laser-based endoscopic surgery by designing an end-effector module to be placed at the distal tip of a flexible robot arm. To this end, the design and control of a magnetic laser scanner for endoscopic microsurgeries is presented. The system involves an optical fiber, electromagnetic coils, a permanent magnet and optical lenses in a compact system for laser beam deflection. The actuation mechanism is based on the interaction between the electromagnetic field and the permanent magnets. A cantilevered optical fiber is bended with the magnetic field induced by the electromagnetic coils by creating magnetic torque on the permanent magnet. The magnetic laser scanner provides 2D position control and high-speed scanning of the laser beam. The device includes laser focusing optics to allow non-contact incisions. A proof-of-concept device was manufactured and evaluated. It includes four electromagnetic
coils and two plano-convex lenses, and has an external diameter of 13 mm. A 4�4 mm2 scanning range was achieved at a 30 mm distance from the scanner
tip. Computer-controlled trajectory executions demonstrated repeatable results with 75 m precision for challenging trajectories. Frequency analysis demonstrated stable response up to 33 Hz for 3 dB limit. The system is able to ablate tissue substitutes with a 1940 nm wavelength surgical diode laser.
Tablet-based control interface has been developed for intuitive teleoperation. The performance of the proof-of-concept device is analysed through control accuracy and usability studies. Teleoperation user trials consisting in trajectory-following tasks involved 12 subjects. Results demonstrated users could achieve an accuracy of 39 m with the magnetic laser scanner system. For minimally invasive surgeries, it is essential to perform accurate laser position control. Therefore, a model based feed-forward position control of magnetic laser scanner was developed for automated trajectory executions. First, the dynamical model of the system was identified using the electromagnets current (input) and the laser position (output). Then, the identified model was used to perform feedforward control. Validation experiments were performed with different trajectory types, frequencies and amplitudes. Results showed that desired trajectories can be executed in high-speed scanning mode with less than 90 m (1.4 mrad bending angle) accuracy for frequencies up to 15 Hz. State-of-the-art systems do not provide incision depth control, thus the quality of such control relies entirely on the experience and visual perception of the surgeons. In order to provide intuitive incision depth control in endoscopic microsurgeries, the concept of a technology was presented for the automated laser incisions given a desired depth based on a commercial laser scanner. The technology aims at automatically controlling laser incisions based on high-level commands from the surgeon, i.e. desired incision shape, length and depth. A feed-forward controller provides (i) commands to the robotic laser system and (ii) regulates the parameters of the laser source to achieve the desired results. The controller for the incision depth is extracted from experimental data. The required energy density and the number of passes are calculated to reach the targeted depth. Experimental results demonstrate that targeted depths can be achieved with �100 m accuracy, which proves the feasibility of this approach.
The proposed technology has the potential to facilitate the surgeon?s control over laser incisions. The magnetic laser scanner enables high-speed laser positioning in narrow and difficult-to-reach workspaces, promising to bring the benefits of scanning laser microsurgery to flexible endoscopic procedures. In addition, the same technology can be potentially used for optical fiber based imaging, enabling for example the creation of new family of scanning endoscopic OCT or hyperspectral probes.