A novel drill design for photoacoustic guided surgeries

Fluoroscopy is currently the standard approach for image guidance of surgical drilling procedures. In addition to the harmful radiation dose to the patient and surgeon, fluoroscopy fails to visualize critical structures such as blood vessels and nerves within the drill path. Photoacoustic imaging is a well-suited imaging method to visualize these structures and it does not require harmful ionizing radiation. However, there is currently no clinical system available to deliver light to occluded drill bit tips. To address this challenge, a prototype drill was designed, built, and tested using an internal light delivery system that allows laser energy to be transferred from a stationary laser source to the tip of a spinning drill bit. Photoacoustic images were successfully obtained with the drill bit submerged in water and with the drill tip inserted into a thoracic vertebra from a human cadaver. Possible clinical applications include spinal fusion surgeries and orthopedic surgeries in general.