Next-generation micromanipulator for computer-assisted laser phonomicrosurgery.

This paper describes a new motorized laser micromanipulator created for computer-assisted laser laryngeal microsurgeries. This new device is based on a single tip/tilt fast steering mirror driven by a parallel kinematics mechanism, which is shown to improve previous laser micromanipulator designs by offering highly accurate motorized laser aiming control from a small, simple, and robust system created for real operating settings. The integration of this new device to a previously developed assistive surgical system is also described, including the new calibration model implemented to enable precise laser beam control from the live microscope video displayed on a computer screen. High system accuracy is demonstrated by the results of trajectory following experiments, which reveal an average RMSE of only 0.06 mm over an 8.5 mm diameter circular path. These numbers are also shown to favorably compare to those obtained with a traditional laser micromanipulator, evidencing a 70% error reduction when using the new system. In addition, experiments under higher optical magnification (40× instead of 16×) demonstrate even better accuracy results, proving the new system is highly scalable and indicating it has the potential to greatly improve laser microsurgery quality and safety.