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Winnand P, Boernsen KO, Ooms M, Heitzer M, Vohl N, Lammert M, Hölzle F, Modabber A. Assessment of the Electrolyte Heterogeneity of Tissues in Mandibular Bone-Infiltrating Head and Neck Cancer Using Laser-Induced Breakdown Spectroscopy. Int J Mol Sci 2024; 25:2607. [PMID: 38473853 DOI: 10.3390/ijms25052607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 02/17/2024] [Accepted: 02/19/2024] [Indexed: 03/14/2024] Open
Abstract
Laser-induced breakdown spectroscopy (LIBS) was recently introduced as a rapid bone analysis technique in bone-infiltrating head and neck cancers. Research efforts on laser surgery systems with controlled tissue feedback are currently limited to animal specimens and the use of nontumorous tissues. Accordingly, this study aimed to characterize the electrolyte composition of tissues in human mandibular bone-infiltrating head and neck cancer. Mandible cross-sections from 12 patients with bone-invasive head and neck cancers were natively investigated with LIBS. Representative LIBS spectra (n = 3049) of the inferior alveolar nerve, fibrosis, tumor stroma, and cell-rich tumor areas were acquired and histologically validated. Tissue-specific differences in the LIBS spectra were determined by receiver operating characteristics analysis and visualized by principal component analysis. The electrolyte emission values of calcium (Ca) and potassium (K) significantly (p < 0.0001) differed in fibrosis, nerve tissue, tumor stroma, and cell-rich tumor areas. Based on the intracellular detection of Ca and K, LIBS ensures the discrimination between the inferior alveolar nerve and cell-rich tumor tissue with a sensitivity of ≥95.2% and a specificity of ≥87.2%. The heterogeneity of electrolyte emission values within tumorous and nontumorous tissue areas enables LIBS-based tissue recognition in mandibular bone-infiltrating head and neck cancer.
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Affiliation(s)
- Philipp Winnand
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, D-52074 Aachen, Germany
| | - Klaus Olaf Boernsen
- Institute of Chemistry and Bioanalytics, University of Applied Sciences Northwestern Switzerland, Hofackerstrasse 30, CH-4132 Muttenz, Switzerland
| | - Mark Ooms
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, D-52074 Aachen, Germany
| | - Marius Heitzer
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, D-52074 Aachen, Germany
| | - Nils Vohl
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, D-52074 Aachen, Germany
| | - Matthias Lammert
- Institute of Pathology, University Hospital RWTH Aachen, Pauwelsstraße 30, D-52074 Aachen, Germany
| | - Frank Hölzle
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, D-52074 Aachen, Germany
| | - Ali Modabber
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, D-52074 Aachen, Germany
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Ganta GK, Mosca RC, Varsani R, Murthy VR, Cheruvu K, Lu M, Arany PR. Automation in Dentistry with Mechanical Drills and Lasers for Implant Osteotomy: A Narrative-Scoping Review. Dent J (Basel) 2023; 12:8. [PMID: 38248216 PMCID: PMC10814723 DOI: 10.3390/dj12010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 12/11/2023] [Accepted: 12/28/2023] [Indexed: 01/23/2024] Open
Abstract
The popularity of implants is increasing with the aging population requiring oral-dental rehabilitation. There are several critical steps in the implant workflow, including case selection, implant design, surgical procedure, biological tissue responses, and functional restoration. Among these steps, surgical osteotomy procedures are a crucial determinant of clinical success. This brief review was aimed at outlining the current state of the field in automation-assisted implant surgical osteotomy technologies. A broad search of the literature was performed to identify current literature. The results are outlined in three broad categories: semi-automated static (image-guided) or dynamic (navigation-assisted) systems, and fully-automated robotic systems. As well as the current mechanical rotary approaches, the literature supporting the use of lasers in further refinement of these approaches is reviewed. The advantages and limitations of adopting autonomous technologies in practical clinical dental practices are discussed. In summary, advances in clinical technologies enable improved precision and efficacious clinical outcomes with implant dentistry. Hard-tissue lasers offer further advancements in precision, improved biological responses, and favorable clinical outcomes that require further investigation.
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Affiliation(s)
- Gopala Krishna Ganta
- Oral Biology, Biomedical Engineering & Surgery, University at Buffalo, Buffalo, NY 14214, USA
- Intercare Community Health Network, Bangor, MI 49013, USA
| | - Rodrigo Crespo Mosca
- Oral Biology, Biomedical Engineering & Surgery, University at Buffalo, Buffalo, NY 14214, USA
| | - Ridham Varsani
- Oral Biology, Biomedical Engineering & Surgery, University at Buffalo, Buffalo, NY 14214, USA
| | - Venkata Ramana Murthy
- Department of Maxillofacial Surgery, Anil Nirukonda Dental College, Visakhapatnam 531162, India
| | - Kamala Cheruvu
- Department of Orthodontics, Gandhi Institute of Technology and Management Dental College, Visakhapatnam 530045, India
| | - Michael Lu
- Oral Biology, Biomedical Engineering & Surgery, University at Buffalo, Buffalo, NY 14214, USA
| | - Praveen R. Arany
- Oral Biology, Biomedical Engineering & Surgery, University at Buffalo, Buffalo, NY 14214, USA
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Hamidi A, Bayhaqi YA, Drusová S, Navarini AA, Cattin PC, Canbaz F, Zam A. Multimodal feedback systems for smart laser osteotomy: Depth control and tissue differentiation. Lasers Surg Med 2023; 55:900-911. [PMID: 37870158 DOI: 10.1002/lsm.23732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 09/28/2023] [Accepted: 10/16/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVES The study aimed to improve the safety and accuracy of laser osteotomy (bone surgery) by integrating optical feedback systems with an Er:YAG laser. Optical feedback consists of a real-time visual feedback system that monitors and controls the depth of laser-induced cuts and a tissue sensor differentiating tissue types based on their chemical composition. The developed multimodal feedback systems demonstrated the potential to enhance the safety and accuracy of laser surgery. MATERIALS AND METHODS The proposed method utilizes a laser-induced breakdown spectroscopy (LIBS) system and long-range Bessel-like beam optical coherence tomography (OCT) for tissue-specific laser surgery. The LIBS system detects tissue types by analyzing the plasma generated on the tissue by a nanosecond Nd:YAG laser, while OCT provides real-time monitoring and control of the laser-induced cut depth. The OCT system operates at a wavelength of 1288 ± 30 nm and has an A-scan rate of 104.17 kHz, enabling accurate depth control. Optical shutters are used to facilitate the integration of these multimodal feedback systems. RESULTS The proposed system was tested on five specimens of pig femur bone to evaluate its functionality. Tissue differentiation and visual depth feedback were used to achieve high precision both on the surface and in-depth. The results showed successful real-time tissue differentiation and visualization without any visible thermal damage or carbonization. The accuracy of the tissue differentiation was evaluated, with a mean absolute error of 330.4 μm and a standard deviation of ±248.9 μm, indicating that bone ablation was typically stopped before reaching the bone marrow. The depth control of the laser cut had a mean accuracy of 65.9 μm with a standard deviation of ±45 μm, demonstrating the system's ability to achieve the pre-planned cutting depth. CONCLUSION The integrated approach of combining an ablative laser, visual feedback (OCT), and tissue sensor (LIBS) has significant potential for enhancing minimally invasive surgery and warrants further investigation and development.
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Affiliation(s)
- Arsham Hamidi
- Biomedical Laser and Optics Group (BLOG), Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Yakub A Bayhaqi
- Biomedical Laser and Optics Group (BLOG), Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Sandra Drusová
- Biomedical Laser and Optics Group (BLOG), Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Alexander A Navarini
- Digital Dermatology, Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Philippe C Cattin
- Department of Biomedical Engineering, Center for medical Image Analysis and Navigation (CIAN), University of Basel, Allschwil, Switzerland
| | - Ferda Canbaz
- Biomedical Laser and Optics Group (BLOG), Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Azhar Zam
- Biomedical Laser and Optics Group (BLOG), Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
- Division of Engineering, New York University Abu Dhabi, Abu Dhabi, UAE
- Department of Biomedical Engineering, Department of Electrical and Computer Engineering, Tandon School of Engineering, New York University, Brooklyn, New York, USA
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Xiao L, Guo J, Wang H, He Q, Xu Y, Yuan L, Yi Q, Zhang Q, Wang J, Min S, Zhao M, Xin X, Chen H. Thermal damage and the prognostic evaluation of laser ablation of bone tissue-a review. Lasers Med Sci 2023; 38:205. [PMID: 37676517 DOI: 10.1007/s10103-023-03868-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 08/28/2023] [Indexed: 09/08/2023]
Abstract
In recent years, an increasing number of scientists have focused on conducting experiments on laser ablation of bone tissue. The purpose of this study was to summarize the prognosis of tissue and the extent of thermal damage in past hard tissue ablation experiments, and review the evidence for the feasibility of laser osteotomy in surgery. An electronic search of PubMed, China National Knowledge Infrastructure (CNKI), and Web of Science (WOS) for relevant English-language articles published through June 2023 was conducted. This review includes 48 literature reports on laser ablation of hard tissues from medical and biological perspectives. It summarizes previous studies in which the ideal ablation rate, depth of ablation, and minimal damage to bone tissue and surrounding soft tissues were achieved by changing the laser type, optimizing the laser parameter settings, or adding adjuvant devices. By observing their post-operative healing and inflammatory response, this review aims to provide a better understanding of pulsed laser ablation of hard tissues. Previous studies suggest that laser osteotomy has yielded encouraging results in bone resection procedures. We believe that low or even no thermal damage can be achieved by experimentally selecting a suitable laser type, optimizing laser parameters such as pulse duration and frequency, or adding additional auxiliary cooling devices. However, the lack of clinical studies makes it difficult to conclusively determine whether laser osteotomy is superior in clinical applications.
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Affiliation(s)
- Liuyi Xiao
- Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, China
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, 610072, China
| | - Junli Guo
- Institute of Optics and Electronics, Chinese Academy of Sciences, Chengdu, 610209, China
- Key Laboratory of Optical Engineering, Chinese Academy of Sciences, Chengdu, 610209, China
| | - Huan Wang
- Ophthalmology Department, Eastern Hospital, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, 610072, China
| | - Qianxiong He
- Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, China
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, 610072, China
| | - Yang Xu
- Ophthalmology Department, Eastern Hospital, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, 610072, China
- Eye School, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Lu Yuan
- Ophthalmology Department, Eastern Hospital, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, 610072, China
- Eye School, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Qianya Yi
- Ophthalmology Department, Eastern Hospital, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, 610072, China
- Eye School, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Qian Zhang
- West China Forth University Hospital Ophthalmology Department, Chengdu, 610044, China
| | - Jin Wang
- Institute of Optics and Electronics, Chinese Academy of Sciences, Chengdu, 610209, China
- Key Laboratory of Optical Engineering, Chinese Academy of Sciences, Chengdu, 610209, China
| | - Shaokun Min
- Qianjiang Xinhua Middle School, Chongqing, 404100, China
| | - Menghan Zhao
- Pujiang County People's Hospital, Chengdu, 611630, China
| | - Xiaorong Xin
- Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, China.
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, 610072, China.
| | - Hui Chen
- Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, China.
- Eye School, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China.
- Department of Ophthalmology, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200080, China.
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, 200080, China.
- National Clinical Research Center for Eye Diseases, Shanghai, 200080, China.
- University of Shanghai for Science and Technology, Shanghai, 200093, China.
- Chengdu Medical College, Chengdu, 610083, China.
- Key Laboratory of Sichuan Province Ophthalmopathy Prevention & Cure and Visual Function Protection, Chengdu, 610209, China.
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Movaniya PN, Desai NN, Makwana TR, Matariya RG, Makwana KG, Patel HB, Patel YN. Effectiveness of Diode Laser in Intraoral Soft Tissue Surgeries - An Evaluative Study. Ann Maxillofac Surg 2023; 13:167-172. [PMID: 38405572 PMCID: PMC10883202 DOI: 10.4103/ams.ams_140_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 11/20/2023] [Accepted: 11/29/2023] [Indexed: 02/27/2024] Open
Abstract
Introduction The clinical application of the diode laser seems to have beneficial effects in surgery. The laser provides precise and rapid tissue dissection, excellent haemostasis and lessens post-operative inflammation. This study was done to assess the clinical effectiveness of diode laser in the management of different varieties of intraoral soft-tissue lesions. Materials and Methods After applying exclusion criteria, a total of 50 samples were selected with benign intraoral soft-tissue lesions treated with a diode laser under local anaesthesia between September 2017 and September 2020. Each patient was followed up on the 3rd, 7th and 15th post-operative days for healing, pain, infection and swelling. Results From all patients, a total of 50 were evaluated in the study; out of all, 60% of patients had no pain on the 2nd follow-up. As per the Landry Index of Healing, 54% of patients had excellent healing. None of the cases had post-operative bleeding, infection was present in 4% at the 1st-2nd follow-up, and in 2% of cases, post-operative swelling was present. The efficacy of diode lasers was tested using the Chi-square test and P < 0.01, which was statistically significant. Discussion Diode laser seems to be superior over conventional treatment modalities as it provides a bloodless dry field and increases patient comfort during surgery. It also lessens the post-operative pain and swelling. Diode laser can safely and effectively be used as a treatment modality for benign soft-tissue lesions, without any complication and without compromising the health and function of patients.
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Affiliation(s)
- Pratap N Movaniya
- Department of Oral and Maxillofacial Surgery, Siddhpur Dental College and Hospital, Siddhpur, Patan, Gujarat, India
| | - Nimisha N. Desai
- Department of Oral and Maxillofacial Surgery, Vaidik Dental College and Research Centre, Daman and Diu, India
| | - Tushar R. Makwana
- Department of Oral and Maxillofacial Surgery, Karnavati School of Dentistry, Karnavati University, Gandhinagar, Gujarat, India
| | - Riddhi G. Matariya
- Department of Oral and Maxillofacial Surgery, Karnavati School of Dentistry, Karnavati University, Gandhinagar, Gujarat, India
| | - Kalpesh G. Makwana
- Department of Oral and Maxillofacial Surgery, Goenka Research Institute of Dental Science, Gandhinagar, Gujarat, India
| | - Hirakben B. Patel
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, Dharamsinh Desai University, Nadiad, Gujarat, India
| | - Yama N. Patel
- Department of Oral and Maxillofacial Surgery, Goenka Research Institute of Dental Science, Gandhinagar, Gujarat, India
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Bayhaqi YA, Hamidi A, Navarini AA, Cattin PC, Canbaz F, Zam A. Real-time closed-loop tissue-specific laser osteotomy using deep-learning-assisted optical coherence tomography. BIOMEDICAL OPTICS EXPRESS 2023; 14:2986-3002. [PMID: 37342720 PMCID: PMC10278623 DOI: 10.1364/boe.486660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 05/15/2023] [Accepted: 05/18/2023] [Indexed: 06/23/2023]
Abstract
This article presents a real-time noninvasive method for detecting bone and bone marrow in laser osteotomy. This is the first optical coherence tomography (OCT) implementation as an online feedback system for laser osteotomy. A deep-learning model has been trained to identify tissue types during laser ablation with a test accuracy of 96.28 %. For the hole ablation experiments, the average maximum depth of perforation and volume loss was 0.216 mm and 0.077 mm3, respectively. The contactless nature of OCT with the reported performance shows that it is becoming more feasible to utilize it as a real-time feedback system for laser osteotomy.
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Affiliation(s)
- Yakub. A. Bayhaqi
- Biomedical Laser and Optics Group (BLOG), Department of Biomedical Engineering, University of Basel, 4123 Allschwil, Switzerland
| | - Arsham Hamidi
- Biomedical Laser and Optics Group (BLOG), Department of Biomedical Engineering, University of Basel, 4123 Allschwil, Switzerland
| | - Alexander A. Navarini
- Digital Dermatology Group, Department of Biomedical Engineering, University of Basel, 4123 Allschwil, Switzerland
| | - Philippe C. Cattin
- Center for medical Image Analysis and Navigation (CIAN), Department of Biomedical Engineering, University of Basel, 4123 Allschwil, Switzerland
| | - Ferda Canbaz
- Biomedical Laser and Optics Group (BLOG), Department of Biomedical Engineering, University of Basel, 4123 Allschwil, Switzerland
| | - Azhar Zam
- Biomedical Laser and Optics Group (BLOG), Department of Biomedical Engineering, University of Basel, 4123 Allschwil, Switzerland
- Division of Engineering, New York University Abu Dhabi, Abu Dhabi, 129188, United Arab Emirates
- Tandon School of Engineering, New York University, Brooklyn, NY, 11201, USA
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Winnand P, Ooms M, Heitzer M, Lammert M, Hölzle F, Modabber A. Real-time detection of bone-invasive oral cancer with laser-induced breakdown spectroscopy: A proof-of-principle study. Oral Oncol 2023; 138:106308. [PMID: 36682186 DOI: 10.1016/j.oraloncology.2023.106308] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/13/2022] [Accepted: 01/08/2023] [Indexed: 01/21/2023]
Abstract
OBJECTIVES Intraoperative definition of resection margin status in bone-invasive oral cancer is a fundamental problem in oncologic surgery due to the lack of rapid bone analysis methods. Laser-induced breakdown spectroscopy (LIBS) provides direct measurement with real-time examination of a minimal tissue sample. This proof-of-principle study aimed to evaluate the possibility of distinguishing tumorous and healthy areas with LIBS. MATERIALS AND METHODS LIBS experiments were executed on native segmental mandibulectomy specimens from 15 patients with bone-invasive oral cancer. Normalized and intensity-matched spectra were compared. Under biological derivation, peak area calculation and principal component analysis (PCA) were applied. The discriminatory power of the PCAs was correlated with the architectural and cytological characteristics of the lasered tumor tissue. Receiver operating characteristics analysis was used to evaluate the performance of LIBS in the real-time detection of bone-invasive cancer. RESULTS Calcium (Ca), which is high in healthy bone, is replaced by potassium (K) and sodium (Na) in bone-invasive cancer. The degree of stromal induction is significantly correlated with the discriminatory power between healthy and tumorous spectra. In this study, LIBS ensured an overall sensitivity of 95.51% and a specificity of 98.64% via the intracellular detection of K and Na. CONCLUSION This study demonstrated robust real-time detection of bone-invasive oral cancer with LIBS, which may lay the foundation for establishing LIBS as a rapid bone analysis method. Further development of a LIBS-guided assessment of bone tumor resection margins might reduce the extent of bony resection without compromising oncologic safety.
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Affiliation(s)
- Philipp Winnand
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, D-52074 Aachen, North Rhine-Westphalia, Germany.
| | - Mark Ooms
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, D-52074 Aachen, North Rhine-Westphalia, Germany.
| | - Marius Heitzer
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, D-52074 Aachen, North Rhine-Westphalia, Germany.
| | - Matthias Lammert
- Institute of Pathology, University Hospital RWTH Aachen, Pauwelsstraße 30, D-52074 Aachen, North Rhine-Westphalia, Germany.
| | - Frank Hölzle
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, D-52074 Aachen, North Rhine-Westphalia, Germany.
| | - Ali Modabber
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, D-52074 Aachen, North Rhine-Westphalia, Germany.
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Laser as an innovative tool, its implications and advances in dentistry: A systematic review. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY 2022. [DOI: 10.1016/j.jpap.2022.100148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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9
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Miniature parallel robot with submillimeter positioning accuracy for minimally invasive laser osteotomy. ROBOTICA 2021. [DOI: 10.1017/s0263574721000990] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
AbstractTo overcome the physical limitations of mechanical bone cutting in minimally invasive surgery, we are developing a miniature parallel robot that enables positioning of a pulsed laser with an accuracy below 0.25 mm and minimizes the required manipulation space above the target tissue. This paper presents the design, control, device characteristics, functional testing, and performance evaluation of the robot. The performance of the robot was evaluated within the scope of a path-following experiment. The required accuracy for continuous cuts was achieved and reached 0.176 mm on the test bench.
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Duverney C, Abbasi H, Berkelaar M, Pelttari K, Cattin PC, Barbero A, Zam A, Rauter G. Sterile Tissue Ablation Using Laser Light—System Design, Experimental Validation, and Outlook on Clinical Applicability. J Med Device 2021; 15. [DOI: 10.1115/1.4049396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Abstract
Abstract
Preparation of biological samples for further processing or analysis is generally performed manually by means of standard mechanical tools such as scalpels or biopsy punches. While this approach is uncomplicated and swift, it entails constraints such as low, operator-dependent cutting accuracy and reproducibility. Tissue segments surrounding the cut may further suffer mechanical and thermal damage due to shear forces and friction between tool and sample. These hindrances affect procedures both in the laboratory environment as well as within clinical settings. A system has been developed leveraging robotic positioning and laser light for precise, controlled, and contactless tissue ablation, and providing a concise and intuitive graphical user interface. Additionally, sterility of the process is demonstrated, a paramount element for clinical application. The proposed process does not require sterilization of the robotic components or the lasers, easing a prospective integration into existing workflows. In the context of this work, mainly cartilage repair surgery is targeted. The proposed system allows for highly accurate and reproducible shaping of the cartilage lesion area as well as its corresponding engineered cartilage graft, possibly leading to better and faster integration at the defect site. Promising results could be obtained in a first test series with human cartilage samples, validating the functionality of the preparation system and the feasibility of the sterility concept.
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Affiliation(s)
- Cédric Duverney
- Bio-Inspired RObots for MEDicine-Laboratory (BIROMED-Lab), Department of Biomedical Engineering, University of Basel, Gewerbestrasse 14, Allschwil, Basel-Landschaft 4123, Switzerland
| | - Hamed Abbasi
- Biomedical Laser and Optics Group (BLOG), Department of Biomedical Engineering, University of Basel, Gewerbestrasse 14, Allschwil, Basel-Landschaft 4123, Switzerland
| | - Majoska Berkelaar
- Department of Biomedicine, University of Basel and University Hospital Basel, Hebelstrasse 20, Basel, Basel-Stadt 4031, Switzerland
| | - Karoliina Pelttari
- Department of Biomedicine, University of Basel and University Hospital Basel, Hebelstrasse 20, Basel, Basel-Stadt 4031, Switzerland
| | - Philippe C. Cattin
- Center for medical Image Analysis and Navigation (CIAN), Department of Biomedical Engineering, University of Basel, Gewerbestrasse 14, Allschwil, Basel-Landschaft 4123, Switzerland
| | - Andrea Barbero
- Department of Biomedicine, University of Basel and University Hospital Basel, Hebelstrasse 20, Basel, Basel-Stadt 4031, Switzerland
| | - Azhar Zam
- Biomedical Laser and Optics Group (BLOG), Department of Biomedical Engineering, University of Basel, Gewerbestrasse 14, Allschwil, Basel-Landschaft 4123, Switzerland
| | - Georg Rauter
- Bio-Inspired RObots for MEDicine-Laboratory (BIROMED-Lab), Department of Biomedical Engineering, University of Basel, Gewerbestrasse 14, Allschwil, Basel-Landschaft 4123, Switzerland
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11
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Abbasi H, Canbaz F, Guzman R, Cattin PC, Zam A. Highly flexible fiber delivery of a high peak power nanosecond Nd:YAG laser beam for flexiscopic applications. BIOMEDICAL OPTICS EXPRESS 2021; 12:444-461. [PMID: 33659082 PMCID: PMC7899509 DOI: 10.1364/boe.405825] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 10/21/2020] [Accepted: 11/02/2020] [Indexed: 06/12/2023]
Abstract
Minimally invasive laser surgeries that require the use of a flexible endoscope (flexiscope) could benefit from high-energy nanosecond laser pulses delivered through fibers for real-time tissue characterization and phenotyping. The damage threshold of the fiber's glass material limits the maximum amount of deliverable peak power. To transmit high-energy pulses without damaging the fiber material, large-diameter fibers are typically used, leading to a limited bending radius. Moreover, in a large-core fiber, self-focusing can damage the fiber even if the tip remains intact. In this work, we tested a fused-end fiber bundle combined with a beam shaper capable of delivering more than 20 MW (>100 mJ/5 ns). The fiber bundle was tested over more than eight hours of operation, with different bending radiuses down to 15 mm. The results demonstrate, to the best of our knowledge, the highest peak power delivered through a flexible fiber, for a frequency-doubled Q-switched Nd:YAG laser.
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Affiliation(s)
- Hamed Abbasi
- Biomedical Laser and Optics Group (BLOG), Department of Biomedical Engineering, University of Basel, CH-4123 Allschwil, Switzerland
| | - Ferda Canbaz
- Biomedical Laser and Optics Group (BLOG), Department of Biomedical Engineering, University of Basel, CH-4123 Allschwil, Switzerland
| | - Raphael Guzman
- Department of Neurosurgery, University Hospital Basel, CH-4056 Basel, Switzerland
| | - Philippe C Cattin
- Center for medical Image Analysis and Navigation (CIAN), Department of Biomedical Engineering, University of Basel, CH-4123 Allschwil, Switzerland
| | - Azhar Zam
- Biomedical Laser and Optics Group (BLOG), Department of Biomedical Engineering, University of Basel, CH-4123 Allschwil, Switzerland
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