中红外激光凭借其非接触、高效率和高精准度的显著优势，广泛应用于病变组织切除、组织整形和肿瘤间质光热疗法等临床外科手术中。在诸多中红外激光中，二氧化碳（CO₂）激光具备极高消融效率和高精准度的特点，广泛应用于皮肤、耳鼻喉和腹腔等手术中。然而，由于缺乏稳定、高性能的小尺度柔性能量传输介质，CO₂激光无法像钬激光、钕激光等近红外激光一样，通过成熟的石英光纤，以微创或无创的方式进入体内，在人体内部自然腔道中进行微创介入操作。目前CO₂激光通常通过导光臂、空心波导管等传输介质进行手术，这极大地制约了其优势在微创手术中的充分体现。为使CO₂激光更好地服务于临床外科医疗领域，本文总结了现有的医用CO₂激光能量传输介质，重点讨论了热拉式多材料光纤技术在CO₂激光医疗领域的研究进展，并展望了未来多功能柔性CO₂激光消融机器人光纤的发展趋势及应用前景。

Mid-infrared (MIR) lasers offer substantial benefits, including non-contact operation, high efficiency, and precision, making them widely utilized in clinical surgical procedures such as lesion tissue removal, tissue plasticity, and tumor interstitial photothermal therapy. Notably, carbon dioxide (CO₂) lasers, among various MIR lasers, are extensively employed in skin, ear, nose, throat, and abdominal surgeries due to their exceptionally high ablation efficiency and precision. However, the lack of stable and high-performance small-scale, flexible laser energy-delivering mediums for CO₂ lasers restricts their use in minimally invasive or noninvasive procedures, a capability present in mature silica fibers used in holmium, neodymium, and other near-infrared lasers for conducting minimally invasive interventional operations in natural cavities in vivo. Presently, CO₂ laser procedures typically rely on energy-delivering mediums such as articulated arms and hollow waveguides but this considerably hampers the application of CO₂ laser in minimally invasive surgeries. To enhance the role of CO₂ lasers in clinical medicine, we review and summarize existing medical CO₂ laser energy-delivering mediums, focusing on the advances in thermal-drawn multi-material fiber technology in CO₂ laser surgery, and explore future development trends and applications of multifunctional flexible CO₂ laser ablation robotic fibers.