Enhanced computer-assisted laser microsurgeries with a “virtual microscope” based surgical system

Ergonomic and human-centered approaches are increasingly important in the design of surgeon-machine interfaces. In the case of microsurgeries, the procedures suffer from susceptibility to variation in surgeon skill and equipment characteristics. This paper presents a novel, computer-assisted surgical interface for laser-based microsurgeries, called the “μRALP Surgical System”. With the system, surgeries can be performed with improved safety and precision using a three-part architecture: (i) a 3D viewer device providing stereoscopic visualization; (ii) a graphics stylus that controls a motorized micromanipulator for laser aiming and activation; and (iii) a configuration interface allowing system setup and modifications in real-time. The system combines the advantages of a computer-assisted platform while respecting the visualization and manipulation requirements of a microsurgical procedure. The features include intraoperative planning for automatic laser incisions and ablations as well as safety regions based on virtual overlays in the surgeon's field-of-view. A comparative evaluation of the proposed system against the traditional system points to the clear superiority of the new interface. The quantitative comparison shows that the proposed interface is safer, more precise, and better controlled. The qualitative comparison demonstrates that the interface is easier to use, easier to learn, and has a minimal training requirement. The technological advances presented here shall lead to enhanced interfaces, increasing the capacity of surgical systems through user-centered design approaches.