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.

翻译：上呼吸道消化道（UADT）的治疗常采用经口激光微创手术（TLM），用于切除肿瘤或息肉等操作。在TLM中，激光束用于切割目标组织，而镊子则用于在UADT内抓取、操纵和稳定组织。尽管TLM系统可能依赖不同的技术与接口，镊子操作目前仍主要依赖手动执行，这带来了人体工学、精度和可控性方面的局限。本文提出了一种用于UADT手术中组织操作的新型机器人系统，其基于一种专为镊子控制设计的新型末端执行器。该系统集成于一个遥操作框架内，该框架采用具有编程远程运动中心（RCM）的机器人操纵器，能够在提升外科医生人体工效的同时，实现精确且受约束的器械运动。通过两项实验研究及专门的可用性评估，对所提方法进行了验证，结果证明了其有效性及对UADT手术应用的适用性。