A Medical Robotic System for Laser Phonomicrosurgery

Abstract

Phonomicrosurgery is a suite of complex otolaryngological surgical techniques related to the vocal folds. The primary operative challenges involve size and scaleability particularly when the carbon dioxide surgical laser is the operative tool of choice. The prevalent traditional methodology for remote control of the surgical laser is the mechanical micromanipulator. This device is capable of accurate laser aiming but is prone to error resulting from inexperience and ergonomic factors. Extensive training is required to employ the manual micromanipulator effectively. Many of the difficulties associated with use of the mechanical micromanipulator are rooted in the ergonomics of the device. By necessity it is located in a disadvantageous position, i.e., attached to the base of the surgical microscope. As a result, the clinician has no convenient way of steadying his/her hand while making the precise, delicate movements necessary to accurately and consistently aim the surgical laser. The fact that the required movements are relatively small in nature exacerbates the accuracy and consistency problem. The purpose of this dissertation is to document the design, development and application of a medical robotic system intended to improve this man machine interface. The primary goal of this research is the development of a device that moderates the operational challenges inherent in the classic manual micromanipulator, thereby enabling advances in clinical accuracy and efficiency.