Fiber-optic OCT sensor guided “SMART” micro-forceps for microsurgery

Abstract

A handheld Smart Micromanipulation Aided Robotic-surgery Tool (SMART) micro-forceps guided by a fiber-optic common-path optical coherence tomography (CP-OCT) sensor is presented. A fiber-optic CP-OCT distance and motion sensor is integrated into the shaft of a micro-forceps. The tool tip position is manipulated longitudinally through a closed loop control using a piezoelectric motor. This novel forceps design could significantly enhance safety, efficiency and surgical outcomes. The basic grasping and peeling functions of the micro-forceps are evaluated in dry phantoms and in a biological tissue model. As compared to freehand use, targeted grasping and peeling performance assisted by active tremor compensation, significantly improves micro-forceps user performance.

Review of intraoperative optical coherence tomography: technology and applications [Invited]

“…The Kang group at Johns Hopkins University demonstrated that Ascans could be acquired adjacent to the tooltip by mounting a fiber-optic common-path (CP) OCT probe along [107,108] or within [109][110][111] the shafts of forceps and needles for vitreoretinal surgery (Fig. 3(a)).…”

“…In its most recent iteration [108], the probe used a 100 kHz swept-source with a 1060 nm central wavelength, and M-scan images could be acquired and processed with GPU-accelerated software. The OCT probe was primarily used as a single-point axial ranger with micrometer-scale resolution to quantify hand tremor [111] and drive active motion cancellation systems [107,108,110], and to provide ranging feedback for a cooperative robotic surgery platform [109] (discussed in detail in Section 5.2). The Joos group at Vanderbilt University incorporated a needle-based OCT probe [105] capable of Bscan imaging into the shaft of 23-gauge surgical forceps [112] (Fig.…”

“…10). In contrast to the master-slave system, other studies explored the utility of OCT-guided cooperative robots, in which the surgeon controlled the robot with their hand instead of a haptic device [107][108][109][110][111]. These robots utilized OCT integrated into the surgical instruments to provide closed loop feedback for applications such as tremor reduction or tool depth locking.…”

“…These robots utilized OCT integrated into the surgical instruments to provide closed loop feedback for applications such as tremor reduction or tool depth locking. Song et al incorporated CP-OCT into two different microsurgical instruments coupled to high speed piezoelectric motors used to drive the axial positioning of the instruments [107,110]. The OCT system did not scan the beam in the transverse plane but was instead used as a single point micrometer-scale axial ranger.…”

Accurate real-time depth control for CP-SSOCT distal sensor based handheld microsurgery tools

“…Our research group has established a potential role for a real-time OCT intraoperative guidance system with fast computational speed using a graphic processing unit (GPU) that is forward viewing and incorporated into the actual handheld tools [24][25][26][27][28][29][30][31][32][33][34][35]. Unlike typical OCT imaging, this application uses OCT as a distal sensor and its potential effectiveness for ocular microsurgery has been demonstrated [29][30][31][32][33][34][35]. The motion compensation that is based on the feedback from the OCT distal sensor effectively suppresses undesired axial motion; as a result, the frequency region related to hand tremor is significantly decreased [34].…”