For a skilled surgeon performing general surgery, tiny hand tremors are usually not a serious risk for patients. But what if the surgeon is operating inside the human eye or repairing microscopic nerve fibers?

Scientists from the Johns Hopkins University Whiting School of Engineering and Johns Hopkins School of Medicine, Baltimore, MD, are exploring the use of a specialized optical fiber sensor, a new “smart” surgical tool that can compensate for natural hand tremors by making hundreds of precise position corrections each second —fast enough to keep a surgeon’s hand on target. By combining Optical Coherence Tomography (OCT) imaging as a distance sensor with computer-controlled piezoelectric motors, they say that they can actively stabilize the tip of a surgical tool.

The new device, named SMART (Smart Micromanipulation Aided Robotic-surgical Tool), integrates an OCT-based high-speed high-precision distance sensor directly into a small, handheld surgical device that can hold a variety of surgical instruments at the tip.

By continually sending and receiving the near infrared laser beams, the high-speed fiber-optic sensor precisely measures the motion of the probe which is fed to a computer that sends signals to small piezoelectric motors integrated into the device to control the position of the tool tip.

During the next few years, they hope to take their instrument from the laboratory to the operating suite, and, with additional refinements, expand its use to other fine-scale surgeries.