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Alex J. Chiluisa

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Light in the Larynx: a Miniaturized Robotic Optical Fiber for In-office Laser Surgery of the Vocal Folds

Apr 27, 2022
Alex J. Chiluisa, Nicholas E. Pacheco, Hoang S. Do, Ryan M. Tougas, Emily V. Minch, Rositsa Mihaleva, Yao Shen, Yuxiang Liu, Thomas L. Carroll, Loris Fichera

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This letter reports the design, construction, and experimental validation of a novel hand-held robot for in-office laser surgery of the vocal folds. In-office endoscopic laser surgery is an emerging trend in Laryngology: It promises to deliver the same patient outcomes of traditional surgical treatment (i.e., in the operating room), at a fraction of the cost. Unfortunately, office procedures can be challenging to perform; the optical fibers used for laser delivery can only emit light forward in a line-of-sight fashion, which severely limits anatomical access. The robot we present in this letter aims to overcome these challenges. The end effector of the robot is a steerable laser fiber, created through the combination of a thin optical fiber (0.225 mm) with a tendon-actuated Nickel-Titanium notched sheath that provides bending. This device can be seamlessly used with most commercially available endoscopes, as it is sufficiently small (1.1 mm) to pass through a working channel. To control the fiber, we propose a compact actuation unit that can be mounted on top of the endoscope handle, so that, during a procedure, the operating physician can operate both the endoscope and the steerable fiber with a single hand. We report simulation and phantom experiments demonstrating that the proposed device substantially enhances surgical access compared to current clinical fibers.

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