Improving the safety of telerobotic drilling of the skull base via photoacoustic sensing of the carotid arteries

摘要

One of the risks of the endonasal approach to skull base surgery is inadvertent damage to one of the two carotid arteries that are located behind the bone being drilled. Photoacoustic imaging, which combines a pulsed laser with an ultrasound receiver probe, has been shown to be able to image blood vessels behind bone. We therefore integrated a photoacoustic imaging system with a telerobotic system, where the pulsed laser is delivered via an optical fiber attached to the drill held by one robot arm and the ultrasound receiver is positioned, at some distance from the drilling site, by another robot arm. This paper describes a new method for accurately determining the safe region for drilling, which is defined by the center-line between the two carotid arteries, and presents the first phantom experiments with this system. The results show that the system can determine the center point with an accuracy better than 2 mm, which suggests that it may be sufficient for clinical scenarios where the two carotid arteries can be within 8 mm of each other.