Intraoperative Robotic-Assisted Large-Area High-Speed Microscopic Imaging and Intervention.

Abstract

Probe-based confocal endomicroscopy is an emerging high-magnification optical imaging technique that provides in vivo and in situ cellular-level imaging for real-time assessment of tissue pathology. Endomicroscopy could potentially be used for intraoperative surgical guidance, but it is challenging to assess a surgical site using individual microscopic images due to the limited field-of-view and difficulties associated with manually manipulating the probe. In this paper, a novel robotic device for large-area endomicroscopy imaging is proposed, demonstrating a rapid, but highly accurate, scanning mechanism with image-based motion control, which is able to generate histology-like endomicroscopy mosaics. The device also includes, for the first time in robotic-assisted endomicroscopy, the capability to ablate tissue without the need for an additional tool. The device achieves preprogrammed trajectories with positioning accuracy of less than 30 [Formula: see text], while the image-based approach demonstrated that it can suppress random motion disturbances up to [Formula: see text]. Mosaics are presented from a range of ex vivo human and animal tissues, over areas of more than [Formula: see text], scanned in approximate [Formula: see text]. This paper demonstrates the potential of the proposed instrument to generate large-area, high-resolution microscopic images for intraoperative tissue identification and margin assessment. This approach presents an important alternative to current histology techniques, significantly reducing the tissue assessment time, while simultaneously providing the capability to mark and ablate suspicious areas intraoperatively.