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Optical coherence tomography image-guided smart laser knife for surgery.

Nitesh Katta1, Austin B McElroy2, Arnold D Estrada2

  • 1Department of Electrical and Computer Engineering, The University of Texas at Austin, Austin, Texas.

Lasers in Surgery and Medicine
|August 8, 2017
PubMed
Summary

This study introduces a smart laser knife combining optical coherence tomography (OCT) and a thulium (Tm) laser for precise surgical cutting. The system demonstrated effective tissue removal while avoiding damage to critical structures like blood vessels.

Keywords:
cancer surgeryimage guided therapyoptical coherence tomographythulium

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Area of Science:

  • Surgical Oncology
  • Biomedical Engineering
  • Laser Physics

Background:

  • Surgical oncology requires advanced tools for precise tissue manipulation.
  • Conventional laser systems can cause collateral thermal damage to adjacent tissues.
  • Optical coherence tomography (OCT) offers high-resolution imaging for surgical guidance.

Purpose of the Study:

  • To develop and evaluate a novel "smart laser knife" integrating OCT imaging with a nanosecond pulsed thulium (Tm) laser.
  • To assess the system's capability for precise tissue cutting and removal with minimal thermal damage.
  • To demonstrate the system's potential for blood vessel avoidance during surgical procedures.

Main Methods:

  • A bench-top system combining a 15W Tm fiber laser and a swept-source OCT was constructed.
  • A blow-off model was used to predict Tm laser tissue interaction parameters.
  • Experiments were conducted using tissue phantoms to validate the model and demonstrate precise cutting with OCT guidance.

Main Results:

  • The combined Tm/OCT system achieved precise laser cutting around phantom blood vessels, avoiding vessel wall damage.
  • Experimental tissue removal rate was measured at 5.5 mm³/sec, closely matching the model prediction of ~6 mm³/sec.
  • Depth imaging guided the Tm laser for targeted tissue removal.

Conclusions:

  • The developed smart laser knife effectively combines OCT imaging and Tm laser ablation for precise surgical applications.
  • The system shows promise for reducing collateral damage in delicate surgical environments.
  • The validated blow-off model aids in predicting laser tissue interaction for system optimization.