2. Virtual Scalpel system for laser microsurgery

Virtual Scalpel system for laser microsurgery

The outcomes of precision laser microsurgeries are directly linked to the control of the aiming and activation of the high power laser used for the interventions. However, such control is extremely difficult even with state-of-the-art surgical devices. This makes the surgeon’s experience and dexterity critical factors dictating the quality of the operations.

To solve this laser controllability problem, we developed the Virtual Scalpel system. This system allows surgeries to be safely and precisely performed using a graphics pen directly over a live video from the surgical site. This was shown to eliminate hand-eye coordination problems that affect other microsurgery systems and to make full use of the operator’s manual dexterity without requiring extra training.

The Virtual Scalpel is based on a tablet PC and a motorized laser micromanipulator (such as our CALM device). Custom robotic controllers guarantee precise matching between a point touched on the live video and the laser aiming point at the surgical site.

In addition, the system allows automatic laser control based on new intraoperative planning software, and also offers features for safety improvements based on virtual features.

 Virtual%20scalpel%20interface

 The Virtual Scalpel system for laser microsurgery

 

Extensive experimentation was performed to compare the Virtual Scalpel system with many different laser control methods. The Virtual Scalpel was deemed the most intuitive, accurate and safe control method.

Comparisons against state-of-the-art systems used in operating rooms demonstrated this new interface enables around 50% reduction in trajectory tracing RMS errors with similar reduction in the magnitude of maximum absolute errors. These results provide evidence of the great improvements in terms of precision and controllability provided by the technology.

Virtual%20Scalpel%20vs%20Acublade

Sample results from comparative trials between the Virtual Scalpel system (bottom row) and the state-of-the-art AcuBlade system (top row). The controllability enhancement provided by the Virtual Scalpel system is evident

Tele-surgery and tele-cooperation

The Virtual Scalpel laser control method has demonstrated to be a very versatile technology not only for precision laser surgeries, but also to allow remote surgery and tele-cooperation during surgical procedures. It’s graphical interface and intraoperative planning capabilities allow remote surgeons to watch and participate to procedures using smart devices. They can even define trajectories for the laser in real-time using graphical overlays. These are then execute by the system with high accuracy upon the issue of a laser activation command.

Mobile laser surgery

 Virtual Scalpel interface on a smart device: Enabling technology for tele-cooperation and remote surgery

 

 Related Publications

  1. Mattos, L., Deshpande, N., Barresi, G., Guastini, L., Peretti, G., “A Novel Computerized Surgeon–Machine Interface for Robot-Assisted Laser Phonomicrosurgery,” The Laryngoscope, http://dx.doi.org/10.1002/lary.24566, August 2014
  2. Mattos, L., Dagnino, G., Becattini, G., Dellepiane, M., Caldwell, D., “A virtual scalpel system for computer-assisted laser microsurgery,” Proceedings of the IEEE International Conference on Intelligent Robots and Systems, IROS 2011, https://doi.org/10.1109/IROS.2011.6094574, September 2011
  3. Barresi, G., Deshpande, N., Mattos, L., Brogni, A., Guastini, L., Peretti, G., Caldwell, D., “Comparative Usability and Performance Evaluation of Surgeon Interfaces in Laser Phonomicrosurgery,” Proceedings of the 2013 IEEE International Conference on Intelligent Robots and Systems (IROS 2013), https://doi.org/10.1109/IROS.2013.6696871, Tokyo, Japan, November 2013
  4. Dagnino, G., Mattos, L., Becattini, G., Dellepiane, M., Caldwell, D., “Comparative Evaluation of User Interfaces for Robot-Assisted Laser Phonomicrosurgery,” Proceedings of the 2011 International Conference of the IEEE Engineering in Medicine and Biology Society, EMBC 2011, August 2011
  5. Mattos, L., Caldwell, D., “Safe Teleoperation based on Flexible Intraoperative Planning for Robot-Assisted Laser Microsurgery,” Proceedings of the 2012 International Conference of the IEEE Engineering in Medicine and Biology Society, EMBC 2012, August 2012
  6. Ortiz, J., Mattos, L., Caldwell, D., “Smart devices in robot-assisted laser microsurgery: Towards ubiquitous tele-cooperation,” Proceedings of the 2012 IEEE International Conference on Robotics and Biomimetics, ROBIO 2012, December 2012
  7. Dagnino, G., Mattos, L., Caldwell, D., “A Vision-Based System for Fast and Accurate Laser Scanning in Robot-Assisted Phonomicrosurgery,” International Journal of Computer Assisted Radiology and Surgery, http://dx.doi.org/10.1007/s11548-014-1078-9, vol.10(2), pp. 217-229, February 2015
  8. Mattos, L., Guastini, L., Mora, F., Caldwell, D., Peretti, G., “Robot-Assisted System for Free-Beam Transoral Laser Microsurgery,” XIV Mediterranean Conference on Medical and Biological Engineering and Computing (MEDICON 2016), Paphos, Cyprus, March 2016
  9. Deshpande, N., Mattos, L., Caldwell, D., “New Motorized Micromanipulator for Robot-Assisted Laser Phonomicrosurgery,” Proceedings of the 2015 IEEE International Conference on Robotics and Automation (ICRA 2015), Seattle, USA, May 2015
  10. Deshpande, N., Mattos, L., Barresi, G., Brogni, A., Dagnino, G., Guastini, L., Peretti, G., Caldwell, D., “Imaging based Metrics for Performance Assessment in Laser Phonomicrosurgery,” Proceedings of the 2013 IEEE International Conference on Robotics and Automation (ICRA 2013), https://doi.org/10.1109/ICRA.2013.6631269, Karlsruhe, Germany, May 2013
  11. Dagnino, G., Mattos, L., Caldwell, D., “New Software Tools for Enhanced Precision in Robot-Assisted Laser Phonomicrosurgery,” Proceedings of the 2012 International Conference of the IEEE Engineering in Medicine and Biology Society, EMBC 2012, August 2012
  12. Mattos, L., Dellepiane, M. , Caldwell, D., “Next-Generation Micromanipulator for Computer-Assisted Laser Phonomicrosurgery,” Proceedings of the 2011 International Conference of the IEEE Engineering in Medicine and Biology Society, EMBC 2011, August 2011
  13. Mattos, L., Caldwell, D., Dellepiane, M., Grant, E., “Design and Control of a Robotic System for Assistive Laser Phonomicrosurgery,” Proceedings of the 32nd Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBC 2010, September 2010