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Clinical Trial
. 2014:2014:384646.
doi: 10.1155/2014/384646. Epub 2014 Aug 14.

A medical manipulator system with lasers in photodynamic therapy of port wine stains

Xingtao Wang  1 , Chunlai Tian  1 , Xingguang Duan  2 , Ying Gu  3 , Naiyan Huang  3
Affiliations
Clinical Trial

A medical manipulator system with lasers in photodynamic therapy of port wine stains

Xingtao Wang et al. Biomed Res Int. 2014.

Abstract

Port wine stains (PWS) are a congenital malformation and dilation of the superficial dermal capillary. Photodynamic therapy (PDT) with lasers is an effective treatment of PWS with good results. However, because the laser density is uneven and nonuniform, the treatment is carried out manually by a doctor thus providing little accuracy. Additionally, since the treatment of a single lesion can take between 30 and 60 minutes, the doctor can become fatigued after only a few applications. To assist the medical staff with this treatment method, a medical manipulator system (MMS) was built to operate the lasers. The manipulator holds the laser fiber and, using a combination of active and passive joints, the fiber can be operated automatically. In addition to the control input from the doctor over a human-computer interface, information from a binocular vision system is used to guide and supervise the operation. Clinical results are compared in nonparametric values between treatments with and without the use of the MMS. The MMS, which can significantly reduce the workload of doctors and improve the uniformity of laser irradiation, was safely and helpfully applied in PDT treatment of PWS with good therapeutic results.

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Figures

Figure 1
Figure 1
PWS symptom. (a) PWS in face. (b) PWS in neck. (c) PWS in arm and hand. (d) PWS in leg.
Figure 2
Figure 2
The uneven power density distribution of laser spot. (a) Laser beam image. (b) Gray handled image with MATLAB.
Figure 3
Figure 3
The manual operation of laser fiber by doctor.
Figure 4
Figure 4
The medical manipulator system.
Figure 5
Figure 5
The mechanism of medical manipulator.
Figure 6
Figure 6
The seven-DOF arrangement of medical manipulator.
Figure 7
Figure 7
The operation of passive arm.
Figure 8
Figure 8
The kinematics model of medical manipulator.
Figure 9
Figure 9
Treatment modes of medical manipulator assisted PDT for PWS.
Figure 10
Figure 10
The safety precautions of MMS.
Figure 11
Figure 11
The clinical treatment with MMS. (a) Lesion selection and patient protection. (b) Passive arm operation. (c) The human-computer interface. (d) Active wrist operating the laser fiber. (e) Lesion response diagnosis. (f) Another case of MMS assisted PDT treatment of PWS.
Figure 12
Figure 12
The clinical outcome of MMS assisted PDT treatment for PWS. (a) Before treatment. (b) After treatment.
Figure 13
Figure 13
The statistical comparison of traditional and MMS assisted PDT treatment of PWS.
See this image and copyright information in PMC

References

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