Abstract
Minimally-invasive laser surgeries could benefit from a fiber-optic laser-induced breakdown spectroscopy (FO-LIBS) setup for real-time tissue characterization. In FO-LIBS, the sample receives limited light irradiance due to the fiber's low damage threshold and diminished laser beam quality. Therefore, the plasma created with FO-LIBS is less luminant than that of free-space LIBS. Furthermore, only a small portion of plasma emission can be collected, as the lens's size at the fiber tip is restricted to fit inside the narrow channel of an endoscope. A high optical throughput Echelle spectrometer was developed to compensate for low-intensity light collection with FO-LIBS. The Echelle spectrometer was tested for tissue differentiation when combined with a flexible fiber bundle delivery setup and a small lens at the bundle's tip. The customized FO-LIBS setup, coupled with multivariate data analysis, successfully differentiated bone from surrounding soft tissue (muscle, fat, and bone marrow) with 100% cross-validated (CV) sensitivity and specificity. The CV sensitivity and specificity for differentiation between all tissues were 90.2% and 96.7%, respectively. The results demonstrate, to the best of our knowledge, the first flexible FO-LIBS system, which may provide a further step towards the development of a smart endoscopic laser scalpel.
Highlights
Traditional mechanical tools used for bone cutting — the gold standard in osteotomy for thousands of years — require a certain degree of mechanical force to function [1,2]
This study aims to develop a method capable of providing optical feedback on the type of tissue being cut, namely bone, bone marrow, muscle, and fat, using the flexable fiber delivery system and a custom-made sensitive Echelle spectrometer dedicated to this application
For use in minimally-invasive surgery, fiberoptic laser-induced breakdown spectroscopy (LIBS) (FO-LIBS) must collect the plasma light using the same fiber employed for laser beam delivery, as space inside the endoscope is limited
Summary
Traditional mechanical tools (e.g., saws, drills, chisels) used for bone cutting — the gold standard in osteotomy for thousands of years — require a certain degree of mechanical force (like grinding or hammering) to function [1,2]. Several studies have been carried out to compare the performance of laserosteotomy with the conventional mechanical saws and drills as well as piezoelectric cutting tools. Using a laser beam offers a high axial and lateral resolution, allowing for a high degree of freedom when cutting This freedom provides significant advantages during surgery, oral and maxillofacial surgery, where implants are used to replace parts of the bone. Real-time feedback is vital to preventing damage to the surrounding soft tissues during laserosteotomy To avoid such damage, several optical approaches have been developed, including laser-induced breakdown spectroscopy (LIBS), laser-induced breakdown thresholding, diffuse reflectance spec-
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