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Loris Fichera

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Losing Focus: Can It Be Useful in Robotic Laser Surgery?

Apr 19, 2023
Nicholas Pacheco, Yash Garje, Aakash Rohra, Loris Fichera

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This paper proposes a method to regulate the tissue temperature during laser surgery by robotically controlling the laser focus. Laser-tissue interactions are generally considered hard to control due to the inherent inhomogeneity of biological tissue, which can create significant variability in its thermal response to laser irradiation. In this study, we use methods from nonlinear control theory to synthesize a temperature controller capable of working on virtually any tissue type without any prior knowledge of its physical properties. The performance of the controller is evaluated in ex-vivo experiments.

* Provisionally Accepted at the Hamlyn Symposium on Medical Robotics 2023 
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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

Figure 1 for Light in the Larynx: a Miniaturized Robotic Optical Fiber for In-office Laser Surgery of the Vocal Folds
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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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Multi Jet Fusion of Nylon-12: A Viable Method to 3D-print Concentric Tube Robots?

Apr 01, 2022
Kalani Picho, Brandon Persons, Jesse F. d'Almeida, Nicholas E. Pacheco, Colin Reynolds, Loris Fichera

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In this paper, we present a study on the viability of fabricating Concentric Tube Robots using Multi Jet Fusion (MJF) of Nylon-12, a type of elastic polymer commonly used in additive manufacturing. We note that Nylon-12 was already evaluated for the purpose of building CTRs in prior work, but fabrication was performed with Selective Laser Sintering (SLS), which produced unsatisfactory results. Our study is the first study to evaluate the suitability of MJF to 3Dprint CTRs.

* Proceedings of the Hamlyn Symposium 2022  
* in press 
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