A Compact Laser-Steering End-Effector for Transoral Robotic Surgery

Laryngeal cancer treatments, while curative, often lead to voice impairment. Minimally invasive surgical methods that facilitate greater preservation of healthy tissue have recently emerged, but they are still limited in important ways. In this work, we describe a device that combines the advantages of the two primary minimally invasive approaches: the high quality incision and reduced post-operative pain achievable with transoral laser microsurgery and the superior visualization and tissue manipulability afforded by transoral robotic surgery. Our 11mm diameter scanning system connects to focusing optics and a fiber optic laser source and can direct a laser beam across a 18 x 10mm plane with controllable trajectories at speeds up to 7m/s. We describe its design and benchtop validation and present avenues for further development within a clinical environment. While oncological treatment is a natural first application area for this technology, we anticipate that it may also yield important benefits for the minimally invasive treatment of benign laryngeal diseases.