Exploration of new concepts for sensor based tissue specific laser surgery

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The advantages of laser surgery can be diminished by the lack of haptic feedback during the ablation of tissue. A surgeon receives no information about the exact laser beam penetration depth or type of the ablated tissue at the bottom of the cut, risking to induce iatrogenic damage or destruction of anatomical structures like major nerves. Due to that the application of laser surgery is limited to superficial structures so far. To establish laser sugery as an universally applicable tool it is necessary to develp a tissue specific controlled surgical laser. It is the aim of this interdisciplinary research project to develp a sensorbased tissue specific feedback system to automatically control laser ablation in the surgical field. The research project sets a special focus on nerve preservation by remote optical tissue discrimination. Two surgical procedures are chosen for the experiments which typically inherit a high risk of iatrogenic nerve damage: the osteotomy of the mandible in the vicinity of the inferior alveolar nerve and the surgery of the parotid gland in the vicinity of the facial nerve. The tissue discrimination is conducted by diffuse reflectance and auto-fluorescence spectroscopy combined with optical process emissions caused by Er:YAG laser tissue ablation to provide a constant feedback mechanism during laser processing. After assessment of the experimental data, a proof-of-principle ablation sensor and feedback control system will be established and further validated on in vivo animal studies.