Minimally invasive surgical (MIS) techniques, such as laparoscopic surgery and endoscopy, provide reliable disease
control with reduced impact on the function of the diseased organ. Surgical lasers can ablate, cut and excise tissue while
sealing small blood vessels minimizing bleeding and risk of lymphatic metastases from tumors. Lasers with wavelengths
in the IR are readily absorbed by water causing minimal thermal damage to adjacent tissue, ideal for surgery near critical
MIS techniques have largely been unable to adopt the use of lasers partly due to the difficulty in bringing the laser into
the endoscopic cavity. Hollow waveguide fibers have been adapted to bring surgical lasers to endoscopy. However, they
deliver a beam that diverges rapidly and requires careful manipulation of the fiber tip relative to the target. Thus, the
principal obstacle for surgical lasers in MIS procedures has been a lack of effective control instruments to manipulate the
laser in the body cavity and accurately deliver it to the targeted tissue.
To overcome this limitation, we have designed and built an endoscopic laser system that incorporates a miniature dual
wedge beam steering device, a video camera, and the control system for remote and /or robotic operation. The dual
wedge Risley device offers the smallest profile possible for endoscopic use. Clinical specifications and design
considerations will be presented together with descriptions of the device and the development of its control system.