A Novel Surface-Scanning Device for Intraoperative Tumor Identification and Therapy

Abstract

Tissue identification, tumor margin identification, and therapy are major concerns for surgeons. Endomicroscopy can provide in vivo, in situ cellular-level images for the real-time assessment of tissue pathology. Hence, laser ablation can be performed in a minimally invasive manner to kill cancerous tissue while preserving normal tissue, allowing less pain and shorter recovery time. Combining endomicroscopy with laser ablation is a new area and has high potential to be a promising system. However, it is challenging to assess a surgical site using individual microscopic images due to the limited field-of-view (FoV) and difficulties associated with manually manipulating the probe. In this paper, a novel robotic device for intraoperative large-area endomicroscopy imaging and image-guided ablation is proposed, demonstrating a highly accurate and stable surface-scanning mechanism to obtain histology-level endomicroscopy mosaics. The device also includes a laser ablation fiber to precisely ablate target tissue under image guidance without the need for an additional tool. The device achieves pre-programmed scanning trajectory with a high positioning accuracy of 0.21 mm and obtains a large FoV of more than 13.9 mm2 from a range of ex vivo human and animal tissue experiments. We perform in vivo image-guided ablation of porcine thyroid gland tissue in robotic-assisted endomicroscopy. The experimental results demonstrate that the proposed device can generate large-area, histology-level microscopic images, and ablate suspicious areas of diseased soft biological tissue, showing the potential of the device for future intelligent system and improve robotic-assisted surgery.