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Robotic-assisted micro-surgery of the throat: The trans-nasal approach

机译:机器人辅助的喉咙显微外科手术:经鼻方法

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Minimally Invasive Surgery of the throat is predominantly performed trans-orally. Although trans-oral (TO) access provides a scarless access into the airways, its outcomes are affected by complications, high cost, and long setup time. This paper investigates the clinical motivation for trans-nasal (TN) access to the throat and presents the design and hybrid position/compliant motion control of a rapidly deployable endo-nasal telerobotic system. The system exploits a unique ⊘5 mm surgical slave with force sensing capabilities used to enable semi-automating the insertion process. Working channels allow the deployment of surgical tools such as a fiberscope, positioning sensors, grippers, suction tubes, cautery, and laser fibers. The treatment of vocal fold paralysis is chosen as a benchmark application and a feasibility study for collagen injection is conducted. Experiments on a realistic human intubation trainer demonstrated successful and safe TN deployment of the end-effector and the feasibility of robotic-assisted treatment of vocal nerve paralysis. We believe this system constitutes a first step toward low-cost office-based head and neck surgical procedures.
机译:喉的微创手术主要是经口进行的。尽管经口(TO)通道提供了通向气道的通畅通道,但其结果受到并发症,高成本和长设置时间的影响。本文研究了经鼻(TN)进入喉咙的临床动机,并提出了一种可快速部署的鼻内远距离机器人系统的设计和混合位置/顺应性运动控制。该系统利用独特的⊘5mm外科手术从动装置,其具有力感应功能,可实现插入过程的半自动化。工作通道允许部署外科手术工具,例如纤维镜,定位传感器,夹具,吸管,烧灼器和激光纤维。选择声带麻痹的治疗方法作为基准应用,并进行了胶原蛋白注射的可行性研究。在现实的人体插管教练上进行的实验表明,成功,安全地部署了末端执行器的TN,以及机器人辅助治疗声神经麻痹的可行性。我们相信,该系统是朝着低成本的办公室式头颈外科手术迈出的第一步。

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