Robotic Tele-Operation for Upper Aerodigestive Tract Microsurgery: System Design and Validation

Abstract: Upper aerodigestive tract (UADT) treatments frequently employ transoral laser microsurgery (TLM) for procedures such as the removal of tumors or polyps. In TLM, a laser beam is used to cut target tissue, while forceps are employed to grasp, manipulate, and stabilize tissue within the UADT. Although TLM systems may rely on different technologies and interfaces, forceps manipulation is still predominantly performed manually, introducing limitations in ergonomics, precision, and controllability. This paper proposes a novel robotic system for tissue manipulation in UADT procedures, based on a novel end-effector designed for forceps control. The system is integrated within a teleoperation framework that employs a robotic manipulator with a programmed remote center of motion (RCM), enabling precise and constrained instrument motion while improving surgeon ergonomics. The proposed approach is validated through two experimental studies and a dedicated usability evaluation, demonstrating its effectiveness and suitability for UADT surgical applications.