Tendon-Adjustable Transoral Laser Support for Expanded Laryngeal Access
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Solution Overview
Problem
Conventional trans-oral laser surgery techniques face challenges such as surgeon fatigue, poor controllability, anatomical strain, limited working area, instrument manipulability, and integration issues with robotic systems, leading to restricted access and potential tissue damage.
Innovation Solution
A trans-oral surgery device featuring a scaffold with a flexible optical fiber support adjustable via tendons, allowing precise positioning and orientation of a blade and laser beam for enhanced control and access to hypopharynx and larynx tissues, incorporating a control unit for automated path planning and execution.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If a fixed micro-mirror mechanism is integrated into the distal tip of the scope, then laser beam steering is achieved, but the working distance is reduced to about 20mm which restricts the working area and affects beam angle of incidence
Solution Approach 1:
The device divides the laser delivery system into separate functional components: a distal scaffold with optical fiber for light delivery, and an independent proximal steerable mirror mechanism. This segmentation allows the mirror to be positioned optimally for beam steering while maintaining adequate working distance at the distal tip, resolving the contradiction between steering capability and working area.
Solution Approach 2:
A steerable mirror positioned at an intermediate location between the laser source and target tissue serves as a mediator to redirect the laser beam. This intermediate mirror enables beam steering without requiring the distal tip to contain complex steering mechanisms, thereby preserving the working distance and expanding the working area while maintaining operational flexibility.
2Ease of operation
If the working distance is reduced to achieve near field surgery, then the laser beam can be steered more effectively, but the angle of incidence exceeds 15 degrees causing tilted cutting and enlarged spot size
Solution Approach 1:
The steerable mirror mechanism provides dynamic control of the laser beam angle, allowing the system to maintain the optimal 15-degree incidence angle while steering the beam across different tissue locations. This dynamic adjustment capability enables effective beam steering without compromising cutting precision, as the mirror can compensate for angle variations in real-time.
3Measurement precision
If a rigid suspension laryngoscope is used to create a direct line-of-sight working channel, then the laser beam can be delivered accurately, but the surgeon experiences fatigue and anatomical strain on cervical vertebrae
Solution Approach 1:
The device employs a flexible blade with a distal scaffold that can be inserted through the oral cavity to reach the larynx and hypopharynx without requiring rigid suspension and direct line-of-sight alignment. This flexible approach maintains laser delivery accuracy while eliminating the need for prolonged awkward positioning, thereby reducing surgeon fatigue and anatomical strain on cervical vertebrae.
4Ease of operation
If a micro-fabricated laser deflection mechanism is integrated into the scope tip, then near field surgery is enabled, but the available space for other surgical instruments such as forceps is restricted
Solution Approach 1:
The device separates the laser delivery function (distal scaffold with optical fiber) from the surgical instrument functions. This segmentation allows multiple surgical instruments such as forceps to be integrated into the blade structure alongside the laser delivery system, as the laser mechanism does not occupy the distal tip space where instruments would be positioned, thereby maintaining versatility.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
Enables improved surgeon comfort, increased controllability, reduced anatomical strain, and precise, repeatable laser surgery with expanded working area, while allowing integration of additional surgical instruments.
Implementation Method 1
a flexible optical fiber for delivering light to the subject
Data Source
AI summary
A trans-oral surgery device has a scaffold insertable into the vicinity of the larynx or hypopharynx of a subject. A support is arranged for holding a flexible optical fiber for delivering light to the subject. A plurality of tendons is connected to the support, and slidably anchors the support to the scaffold. The tendons are adjustable to move the support relative to the scaffold. The scaffold is provided at the front end of a blade, and the blade is non-straight.