Minimally invasive surgical techniques, including endoscopic and robotic procedures, continue to revolutionize patient care, for their ability to minimize surgical trauma, thus promoting faster recovery and reduced hospital stays. Yet, the suturing of soft tissues ensuring damage-free tissue bonding during these procedures remains challenging due to missing haptics and the fulcrum effect. Laser tissue soldering has potential in overcoming these issues, offering atraumatic seamless tissue fusion. To ensure the precision and safety of laser tissue soldering, the study introduces feedback-controlled fluorescent nanothermometry-guided laser tissue soldering using nanoparticle-protein solders within endoscopic and robotic contexts. Temperature-sensitive fluorescent nanoparticles embedded in the solder provide surgeons with immediate feedback on tissue temperatures during laser application, all while within the confines of minimally invasive (robotic) surgical setups. By integrating fluorescent nanothermometry-guided laser tissue surgery into endoscopic and robotic surgery, the study paves the way for a new approach for safe and atraumatic soft tissue joining, especially in regions where traditional suturing is unfeasible.

Biomedical Center Faculty of Medicine in Pilsen Charles University Alej Svobody 1655 76 Pilsen 32300 Czech Republic

Department of Surgery Faculty of Medicine in Pilsen Charles University Alej Svobody 923 80 Pilsen 32300 Czech Republic

Faculty of Medicine University of Zurich Rämistrasse 71 Zurich 8006 Switzerland

Fraunhofer Research Institution for Individualized and Cell Based Medical Engineering IMTE Mönkhoferweg 23562 Lübeck Germany

Nanoparticle Systems Engineering Laboratory Institute of Energy and Process Engineering ETH Zurich Sonneggstrasse 3 Zurich 8092 Switzerland

Nanophotonic Systems Laboratory Institute of Energy and Process Engineering ETH Zurich Sonneggstrasse 3 Zurich 8092 Switzerland

Particles Biology Interactions Laboratory Department of Materials Meet Life Swiss Federal Laboratories for Materials Science and Technology Lerchenfeldstrasse 5 St Gallen 9014 Switzerland

The Ingenuity Lab University Hospital Balgrist Forchstrasse 340 Zurich 8008 Switzerland

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