Swept source optical coherence tomography based smart handheld vitreoretinal microsurgical tool for tremor suppression

Abstract

Microsurgeons require the ability to make precise and stable maneuvers in order to achieve surgical objectives and to minimize surgical risks during freehand microsurgical procedures. This work presents a novel common path swept source optical coherence tomography based smart surgical tool that suppresses hand tremor. It allows enhanced tool tip stabilization, more accurate targeting and may lower surgical risk. Here the one dimensional motion tremor of a surgeon's hand is assessed by the surgical instrument. The ability to accurately locate a surgical target and the ability to maintain tool tip offset distances in a chicken embryo model are significantly improved as compared to freehand use.

Fig. 1

Smart surgical tool (a) computer rendering of the design of the tool. FH: front holder, BH: back holder, J: joint, T: tail, ON: outer needle, IN: inner needle, PM: piezoelectric motor, LL: luer-lock combination (b) the photo image after completing the assembly procedures

Fig. 2

The feedback control scheme of the smart surgical tool (a) feedback control schematic of the common path SS-OCT based surgical tool (b) detailed PID based control scheme.

Fig. 3

The characteristics of surgeon tremor with freehand use (a) attempting to hold steady at a defined offset height (b) swing the tool at offset height between 1000 μm and 2000 μm

Fig. 4

Comparison of freehand use and motion compensation of holding still at a offset height of 1000 μm from the dry phantom.

Fig. 5

Motion compensation in chicken embryo model (a) photo image of live chicken embryo model (b) Comparison of free hand tool motion and tool motion with tremor suppression.