Magnetic resonance (MR) imaging (MRI) provides compelling features for the guidance of interventional procedures, including high-contrast soft tissue imaging, detailed visualization of physiological changes, and thermometry. Laser-based tumor ablation stands to benefit greatly from MRI guidance because 3D resection margins alongside thermal distributions can be evaluated in real time to protect critical structures while ensuring adequate resection margins. However, few studies have investigated the use of projection-based lasers like those for transoral laser microsurgery, potentially because dexterous laser steering is required at the ablation site, raising substantial challenges in the confined MRI bore and its strong magnetic field. Here, we propose an MR-safe soft robotic system for MRI-guided transoral laser microsurgery. Owing to its miniature size (Ø12 × 100 mm), inherent compliance, and five degrees of freedom, the soft robot ensures zero electromagnetic interference with MRI and enables safe and dexterous operation within the confined oral and pharyngeal cavities. The laser manipulator is rapidly fabricated with hybrid soft and hard structures and is powered by microvolume (<0.004 milliter) fluid flow to enable laser steering with enhanced stiffness and lowered hysteresis. A learning-based controller accommodates the inherent nonlinear robot actuation, which was validated with laser path–following tests. Submillimeter laser steering accuracy was demonstrated with a mean error < 0.20 mm. MRI compatibility testing demonstrated zero observable image artifacts during robot operation. Ex vivo tissue ablation and a cadaveric head-and-neck trial were carried out under MRI, where we employed MR thermometry to monitor the tissue ablation margin and thermal diffusion intraoperatively.

磁共振 (MR) 成像 (MRI) 为介入程序的指导提供了引人注目的功能，包括高对比度软组织成像、生理变化的详细可视化和温度测量。基于激光的肿瘤消融将从 MRI 引导中受益匪浅，因为可以实时评估 3D 切除边缘和热分布，以保护关键结构，同时确保足够的切除边缘。然而，很少有研究调查使用基于投影的激光，如经口激光显微手术，这可能是因为在消融部位需要灵巧的激光转向，这对受限的 MRI 孔及其强磁场提出了重大挑战。在这里，我们提出了一种用于 MRI 引导的经口激光显微手术的 MR 安全软机器人系统。由于其微型尺寸 (Ø12 × 100 mm)、固有的顺应性和五个自由度，软机器人确保了对 MRI 的零电磁干扰，并在狭窄的口腔和咽腔内实现安全和灵巧的操作。激光操纵器采用混合软硬结构快速制造，并由微体积（<0.004 毫升）流体流动提供动力，使激光转向具有更高的刚度和更低的滞后。基于学习的控制器适应固有的非线性机器人驱动，这已通过激光路径跟踪测试进行验证。亚毫米激光转向精度证明了平均误差 < 0.20 毫米。MRI 兼容性测试表明机器人操作期间可观察到的图像伪影为零。