“SMART” LASER SCALPELS FOR ROBOTIC SURGERY

Background: Elaboration of automatized and robotic systems for precision and minimally traumatic surgery is one of the main areas of modern surgery. The concept of the so-called “smart” laser scalpels seems a  promising technical solution in this field. Aim: To develop organizational principles of a  feedback smart surgical laser devices based on CO₂ and fiber lasers. Materials and methods: As laser sources, we used a one mode wave CO₂ laser with a power of up to 25 W, high frequency pumping of the active media and radiation wavelength of 10.6 mcm, as well as a one mode fiber Er laser with a power of up to 5 W and radiation wavelength of 1.54  mcm. The laser device feedback was organized with an autodynic control of laser evaporation of biological tissues. The “smart” laser scalpel effects were studied in the porcine tissues in  vitro. The feedback laser devices were tested on normal and tumor animal tissues (white rats) in vitro and in vivo. Also, we tested the possibility of diagnostics of laser evaporation on human tumor tissues. Results: Taking the one mode CO₂ laser and one mode fiber Er laser as examples, it was shown that an autodynic signal arising during evaporation of various biological tissues has different spectral characteristics. This makes the bases for organization of a  feedback in surgical devices functioning as a  “smart” scalpel. A “smart” surgical feedback device based on CO₂ laser and a  decoy of a  “smart” surgical device based on a fiber Er laser were developed. We studied the possibilities of differential diagnostics of a type of a tissue being evaporated in vitro with the use of the data from laser scalpels. Also, pre-clinical trials of a CO₂ laser-based “smart” surgical device on biological tissues were performed. The trials showed that such a “smart” laser scalpel allows for intra-operative differentiation between normal and tumor tissues that would give the possibility to implement minimally traumatic surgery principles. Conclusion: The method of autodynic diagnostics of laser evaporation of biological tissues allows for development of surgical devices functioning as a “smart” laser. It gives the possibility of a real-time differentiation of various types of tissues, including normal and tumor ones.

smart surgical laser, “smart” laser scalpel, robotic surgery