CN102006818A - Common bile duct surgical imaging system - Google Patents
Common bile duct surgical imaging system Download PDFInfo
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- CN102006818A CN102006818A CN2009801103002A CN200980110300A CN102006818A CN 102006818 A CN102006818 A CN 102006818A CN 2009801103002 A CN2009801103002 A CN 2009801103002A CN 200980110300 A CN200980110300 A CN 200980110300A CN 102006818 A CN102006818 A CN 102006818A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/313—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes
- A61B1/3132—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes for laparoscopy
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00002—Operational features of endoscopes
- A61B1/00043—Operational features of endoscopes provided with output arrangements
- A61B1/00045—Display arrangement
- A61B1/0005—Display arrangement combining images e.g. side-by-side, superimposed or tiled
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/04—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances
- A61B1/043—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances for fluorescence imaging
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/06—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements
- A61B1/0638—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements providing two or more wavelengths
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
- A61B5/0071—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence by measuring fluorescence emission
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/06—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements
- A61B1/063—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements for monochromatic or narrow-band illumination
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
- A61B5/0082—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes
- A61B5/0084—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes for introduction into the body, e.g. by catheters
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/74—Details of notification to user or communication with user or patient ; user input means
- A61B5/742—Details of notification to user or communication with user or patient ; user input means using visual displays
- A61B5/7425—Displaying combinations of multiple images regardless of image source, e.g. displaying a reference anatomical image with a live image
Abstract
A method and apparatus for imaging features of a CBD in a patient introduces a fluorescent contrast agent into the CBD. A light source transmits both a visible light and a fluorescent light into a patient's abdominal cavity via the laparoscope. Cameras attached to or integrated into the laparoscope detect visible light images and fluorescent emission light images. The visible light image and fluorescent image signals are processed to combine the fluorescent emission light image signals and visible image signals into a single display signal. The system adjusts the display characteristics, such as color, of the fluorescent emission light image so it contrasts well with the visual light image so the surgeon can easily distinguish between the two images. The display signal is sent to a video monitor where the surgeon views the visible light image and the fluorescent image as a single overlaid image.
Description
Technical field
The present invention relates to the imaging system of performing the operation, relate to the operation on gallbladder imaging system especially.
Background technology
The method that these chapters and sections are described is the method that can carry out, but must not be the method for before having conceived or having carried out.So unless indication is arranged in addition, should be not only because the intension of any method that these chapters and sections are described, and any method described in these chapters and sections of supposing is a prior art.
Operation on gallbladder uses laparoscopic technique to carry out at present.In this class operation process, the surgeon inserts the abdominal cavity with the pipe that some are called the trocar or port.The peritoneoscope of 10mm diameter optical range is inserted into one of them port.Peritoneoscope is attached to video camera, and video camera allows surgeon and operation team to observe the inside in abdominal cavity on video screen.Long very thin equipment is through other port, so that clamping, dissection and resection organization.
Laparoscopic surgery needs extra training, works in order that rely on the new equipment that uses the operative region two dimension visual field and operation.As the result of this technical limitation, because of carelessness causes important organ structure is damaged, even the incidence rate in experienced surgeon, also than higher in the open surgery.When the surgeon damaged or excise common bile duct (CBD) because of carelessness, the severe complications of operation on gallbladder will appear.In the U.S., this complication incidence rate in operation is 1/200 (0.5%).Thus, in about 800, the 000 routine peritoneoscope operation on gallbladder that the U.S. carries out every year, about 4000 patients are damaged by CBD will.
Description of drawings
By example, accompanying drawing the present invention is not described restrictively, in the accompanying drawings, identical Reference numeral indication components identical, wherein
Fig. 1 has described the sketch map that is used for the surgical apparatus of laparoscopic surgery according to embodiments of the present invention;
Fig. 2 is a sketch map of having described the bile duct anatomical model;
Fig. 3 is a sketch map of having described intraoperative cholangiography photo (IOC);
Fig. 4 has described the block diagram of the additional configurations of common bile duct imaging system according to embodiments of the present invention;
Fig. 5 has described the block diagram of the separate configurations of common bile duct imaging system according to embodiments of the present invention;
Fig. 6 is the sketch map of having described according to the optical layout that is used for the laparoscopic illumination system of embodiment of the present invention;
Fig. 7 is the sketch map of having described according to the optical layout that is used for the laparoscopic cameras system of embodiment of the present invention;
Fig. 8 has described to be used for injecting the sketch that the prior art of the surgical apparatus of liquid carries into execution a plan to gallbladder;
Fig. 9 has described according to embodiment of the present invention, and overlapping with fluorescent emission light image and visible images forms the sketch of single display;
Figure 10 is a block diagram of having described the computer system that embodiment can carry out thereon; And
Figure 11 has described the laparoscopically sketch map that has essential according to an embodiment of the present invention light source.
The specific embodiment
In the following description, for illustrative purposes, a plurality of concrete details are explained, in order that provide detailed understanding of the present invention.Yet it should be apparent that the present invention can be implemented under these detail situations not having.In other example, well-known structure and equipment are shown with the form of block diagram, to avoid unnecessarily obscuring the present invention.
In the following discussion, with reference to the accompanying drawings, identical Reference numeral is indicated identical parts in these views:
1.0 overview
2.0 system architecture overviewfig
3.0 case technology and process
3.1 common bile duct imaging system
3.2 imaging system optical layout
4.0 common bile duct fluorescence and demonstration
5.0 actuator--ardware overview
1.0 overview
Above the embodiment of the present invention of Zong Jieing are described in more detailed mode hereinafter, also have replaceable embodiments more of the present invention in addition.Although embodiment of the present invention described below are described in the environment of common bile duct (CBD) laparoscopic surgery, yet in replaceable embodiment of the present invention, application except that laparoscopic surgery also can replace, and can carry out similar operation to the application in the common bile duct laparoscopic surgery for execution.
Embodiment to gallbladder, cystic duct, CBD injection, perhaps by contrast agent intravenous injection and metabolism are entered bile by liver, is introduced CBD with fluorescent contrast agent by directly.Light source illuminates the light path in the peritoneoscope.Light emitted visible light and infrared (IR) light (or being called fluorescent exciting) enter the patient abdominal cavity through peritoneoscope.Fluorescent contrast agent is excited by arrowband luminous energy and produces light emission at specific band.Camera apparatus on the peritoneoscope can pass through electric wire, or passes through bluetooth (or any wireless technology) or WLAN with wireless mode, is communicated to connect to controller of camera.Camera apparatus comprises visible light detection camera and IR optical detection photographing unit.Be attached to laparoscopically photographing unit and survey visible images and fluorescent emission light image.
Visible image signal and fluorescence image signal from camera apparatus are processed, so that with fluorescence emission picture signal and the synthetic single shows signal of visual picture sets of signals, so that described two images are correctly overlapped with aiming at (or combination).System regulates the display property (for example color) of fluorescent emission light image, makes itself and visible images contrast obviously, thereby makes the surgeon can easily distinguish this two kinds of images.
Shows signal is sent to video-frequency monitor, the surgeon at this place with visible images and fluoroscopic image (or combination) image viewing as single overlapping.The surgeon can indication mechanism show fluoroscopic image with required color, thereby fluoroscopic image is correctly contrasted with visible images.
The overlapping image can be opened or closed by switch or software control by the user.System can handle several demonstrations that have different image combinations.Pick off can be contained in the photographing unit framework, and pick off allows the user to know the direction of floor or ceiling.This allows the surgeon to select and shows the orientation of photographing unit with reference to ceiling or floor.This operation to the NOTES type also is very helpful (hereinafter discussing).
System can externally or write down the visible light and the fluoroscopic image of combination on the internal digital recording equipment (for example CD, DVD, CD, hard disk or flash memory).System has Ethernet and connects, and allows the Internet or Intranet link, makes record can be formed at server or by the Internet or Intranet emission.
2.0 system architecture overviewfig
With reference to Fig. 1, as mentioned above, in the operation on gallbladder process, the surgeon inserts the abdominal cavity with the pipe 101 that some are called the trocar or port.The peritoneoscope 102 of 10mm diameter optical range is inserted into one of them port.Peritoneoscope is attached to video camera, and video camera allows surgeon and operation team to observe the inside in abdominal cavity on video screen.Long very thin equipment 103,104,105 passes other port, so that clamping, dissection and resection organization.
Fig. 2 has described the bile duct anatomical model.Common bile duct (CBD) 201 is transported to intestinal 203 with bile from liver 202 and is used for digestion.Gallbladder 204 is lateral sacks, and it is stored bile and gets into CBD 201 at table.Gallbladder 204 is attached to CBD 201 by cystic duct 205.Cystic duct 205 must be by clearly identification of surgeon, clamping or ligation, and then cuts with shears.If the surgeon thinks CBD 201 by mistake cystic duct 205, the CBD damage will take place.If the surgeon uses the electric cautery energy to make blood coagulation near CBD 201, he may damage CBD 201.
Uniquely can see that the method for CBD is to carry out intraoperative cholangiography photo (IOC) at present.This comprises: in operation, put conduit into cystic duct 205, and injection x ray contrast liquid, and use wear-type or portable fluorescence equipment, to see the x ray profile that forms by dyeing.This has provided the shape of CBD 201 and biliary tract and the indication of route.As shown in Figure 3, IOC picture 301 is displayed on the black and white screen and can be printed or preserves.Carry out IOC and be not considered to the standard of nursing, and, be not in all operations, all to carry out for the difficulty of cost, time and execution.In addition, the x ray exposure to patient and operation member also is the problem of being concerned about.The patient is exposed to the x ray emission for this specific operation process.All be exposed when carrying out this process yet operating room member is each.Yet research shows that when the surgeon carried out IOC, their patient was bearing the CBD damage of comparing half with the patient who does not carry out IOC.
Be clear that carrying out operation on gallbladder safely needs the surgeon to observe CBD.Yet, can not observe directly because it is positioned at the fatty tissue and the 1-3mm place, peritoneum below of overlapping.The method of the safest and the most effective observation CBD is in operation process, provides " on-the-spot ", real-time (or near real-time) CBD position and the image of circuit to the surgeon--be real-time IOC in essence.This allows the surgeon to know the position of CBD always, makes him can avoid unexpected or unintentional damage of CBD.This still is being unrealized before, and is because also there is not reliable and simple method, visual to the CBD that gos deep into visible surface in laparoscopic procedures.Embodiment to the bile duct imaging, and shows that the CBD image is as showing in real time for the surgeon in the operation on gallbladder process.This equipment can reduce at least 50% or more with CBD injury rate, thus approximately annual (in the U.S.) 2000 patients are saved the CBD damage torment with suffering from pain, and the whole surgery process is quickened, because CBD can be by quick identification and avoidance.
3.0 case technology and process
3.1 common bile duct imaging system
Embodiment can be built into present laparoscopically optional equipment or integrated autonomous system.Embodiment allows the surgeon to see CBD in the tram in the operation on gallbladder process.
Fig. 4 shows the embodiment of additional configurations, and additional configurations and present laparoscopically light source and video system are integrated.Fluorescence imaging module 404 is introduced IR light 407 optical channel of existing optical fiber illuminating system 403 and process peritoneoscope 406.Infrared acquisition bonder 405 is added into peritoneoscope 406, between peritoneoscope and visible light camera 409.Infrared acquisition bonder 405 comprises can be surveyed from fluorescent labeling or organize the photographing unit of the IR signal of autofluorescence.Infrared acquisition bonder 405 is communicated to connect to fluorescence imaging module 404.Adapter can be electric wire, optical fiber, wireless transmitting system or its any combination and/or quantity.Connecting line can disposablely maybe can reuse, and if the aseptic operative region of its contact, may need to be sterilized.Replacedly, the IR image can be transmitted near long-range IR photographing unit (it can be positioned at the fluorescence imaging module 404) by optical path.This is necessary under the incompatible situation of the dimensions of the size of IR photographing unit and bonder 405.
In operation process, light source 403 is through the optical fiber visible emitting in the peritoneoscope 406., fluorescence imaging module 404 is launched IR light (fluorescent exciting) simultaneously through the optical fiber in the peritoneoscope 406.Controller of camera 402 receives the visible image signal (using the true visual field of the operative region of visible light) from the existing photographing unit 409 that is mounted to peritoneoscope 406.Controller of camera 402 is treated to visible image signal the visible images shows signal and the visible images shows signal is sent to fluorescence imaging module 404.
IR (fluorescence) the light image signal that fluorescence imaging module 404 receives from infrared acquisition bonder 405.The visible images shows signal that fluorescence imaging module 404 is handled the fluorescence emission picture signal and received from controller of camera 402, to produce video output signals 408, it comprises the real-time overlapping (or combination) of fluorescence emission picture signal and visible images shows signal.Fluorescence imaging module 404 use a computer system or special microprocessor are handled the fluorescence emission picture signal with digital form, to produce the satisfactory and true lively demonstration of CBD.Fluorescence imaging module 404 can be used any known technology, and fluorescence emission picture signal and visible images shows signal are combined as the single display signal, in order that these two kinds of images are correctly overlapped with aiming at.This can comprise simple dependence common focus, at this place, two photographing units before operation, be aligned and two kinds of picture signals so that straight mode is combined, perhaps comprise and use software so that survey two kinds of common reference points in the picture signal automatically, in order that correctly aim at this two kinds of images.
Video output signals 408 is sent to video-frequency monitor 401, the surgeon at this place with visible images and fluoroscopic image image viewing as single overlapping.The surgeon can indicate fluorescence imaging module 404 to show fluoroscopic image with required color, shape or texture, so fluoroscopic image is correctly contrasted with visible images.
Replacedly, spare system can need to replace one of assembly of current peritoneoscope system, camera head 409, controller of camera 402 or light source 403.In this case, system is connected with the input or the outfan of remaining component at these equipment.
Fig. 5 has described the independently embodiment of CBD imaging system, and this system is integrated into IR light source, IR detection system, visible light source and visible images detection system complete and independently, has the peritoneoscope imaging system of enhanced optical performance.This embodiment is merged into single camera accessories 505 with visible light camera and IR photocamera, and it is attached to peritoneoscope 504 or is integrated in the peritoneoscope 504.Light source 503 all is emitted to optical fiber in the peritoneoscope 504 with visible light and IR light.Replacedly, visible light source and IR light source can be integrated in the peritoneoscope 504 itself or the trocars, to remove being connected to the demand of the optical fiber cable of peritoneoscope 504 from controller of camera 502, make the lighter and easier operation of laparoscopic apparatus thus.
In normal running, light source 503 is indicated by controller of camera 502, illuminates the light path in the peritoneoscope 504.Light source 503 is to peritoneoscope 504 (according to demand) visible emitting and infrared light.The signal that controller of camera 504 receives from the photographing unit in the peritoneoscope 504.Camera apparatus 505 can pass through electric wire, optical fiber, pass through the wireless mode of bluetooth (or any wireless technology) or WLAN, or any combination and/or its quantity, is communicated to connect to controller of camera 504.Camera apparatus 505 comprises visible light detection camera and IR optical detection photographing unit.Photographing unit in the peritoneoscope 504 is surveyed visible images and fluorescent emission light image.Replacedly, camera apparatus 505 can comprise the detector of other type, and it can finish the detection of visible images and fluorescent emission light image as photographing unit.
Visible image signal and fluorescence image signal from camera apparatus 505 are handled by controller of camera 504.As fluorescence imaging module mentioned above, controller of camera 504 can use any known technology, and fluorescence emission picture signal and visible image signal are combined into single shows signal, in order that these two kinds of images are correctly overlapped with aiming at.In this case, because two photographing units are in the camera apparatus 505 of integral body, photographing unit will have parallactic error hardly, and can aim at (factory aligned) during fabrication.Two kinds of picture signals are then to be combined to straight mode.
Photographing unit can also be aligned to common focus before operation.Replacedly, software can be used for automatically surveying the common reference points of two kinds of picture signals, so that correctly aim at this two kinds of images.
Controller of camera 504 is regulated the display property (for example color) of fluorescent emission light image, makes itself and visible images contrast obviously, so the surgeon can easily distinguish this two kinds of images.
Shows signal is sent to video-frequency monitor 501, the surgeon at this place with visible images and fluoroscopic image as single overlapping image viewing.The surgeon can indicate controller of camera 504 to show fluoroscopic image with required color, shape or texture, so fluoroscopic image is correctly contrasted with visual picture.
Replacedly, UV, visible or IR fluorescent probe can be identical CCD equipment, are used to survey visible light.Single CCD can be used to survey IR and visible light.CCD can be controlled by controller circuitry, side by side or with visible light alternately (interlacing scan detection), allow to survey the optical signal of emission.This detection can require to use passive or active filter and exchanging mechanism.Visible and fluorescent emission optical signal from CCD then will be transferred to electronic circuit, and this circuit separates fluorescent emission optical signal and visible light signal, is used for other digital processing of branch.
Modern laparoscopic cameras often has three CCD chips (red, blue, green).Three chipsets can use as described in the previous paragraph, to survey visible and fluorescent emission optical signal.Another replaceable situation is to set up the laparoscopic cameras of four-core sheet, five chips or greater number chip.Such photographing unit will comprise three and be used for the CCD chip that visible light is surveyed, and be used for any additional CCD that fluorescence signal is surveyed.As seen or the light of UV wavelength the separately special CCD that is used for the detection of fluorescence emission will be optimised be positioned at IR, NIR, so that survey.Detection can need active or passive filter and exchange control unit.Advantage will be that the fluorescent emission photo-detector can be activated and screened from the visible light controller individually.
Under the situation of the laparoscopic cameras system of one chip, three chips, four-core sheet, five chips or greater number chip, whole device will, by permanently being designed to the assembly of endoscope head, perhaps be miniaturized and be placed on the tip of endoscope, be attached to peritoneoscope, endoscope, thoracoscope or cystoscope via the regracting framework of observing on the end with the configuration of " chip on the tip ".Under all these situations, independent collar, spacer or beam splitting box will do not needed.All optical controls will be performed in the photographing unit framework.Photographing unit will be by electric wire, perhaps by bluetooth (or any wireless technology) or WLAN wirelessly, is connected to its controller box.
Figure 11 has described the embodiment with the peritoneoscope 1101 of integrated optical source 1102 and photographing unit 1103.Light source 1102 can be: standard white light modulation bubble, the light that is filtered, lamp, LED, laser instrument or the like.Light source 1102 can pass through: electric wire, internal cell or induction coupling are powered.In the inside of light source 1102 main bodys, lens combination is Radix Rumicis or narrow angle with beam shaping, and this can be selected by the user.
The variant of light source can be essentially cylindrical and have a plurality of smooth surfaces around its circumference.This shape and when not being attached to peritoneoscope 1101, helps to stop light source 1102 to tumble from table because its smooth surface can prevent to roll.
3.2 imaging system optical layout
With reference to figure 6, in embodiments, from the light and the light combination that is used for CBD 603,604 navigation and aiming of broad band source 602 (this is used for visible light camera).Target is identification CBD, and making can not have physiological damage to CBD in the process of operation on gallbladder or removal gallbladder.The light that is used to discern CBD can be: unicolor, comprise multiple monochromater or secondary color.It can be random polarization, linear polarization or circular polarization.Light source can be that be concerned with or noncoherent.Light source can be continuous wave or pulse in addition.
Light source is arranged in shell 601 (light box).In case light source uses beam splitter or synthesizer 605 combinations, their directed optical fiber 606 (this can be a fibre bundle) that enters.Optical fiber 606 1 ends are connected to light box 606, and the other end is connected to the adapter on the peritoneoscope.Adapter on the peritoneoscope has attached fibre bundle on it.In case optical signal is in optical fiber, they are directed through peritoneoscope and leave peritoneoscope and enter in patient's body.Optical signal illuminates the abdominal cavity, in this case more particularly: gallbladder, CBD and near organ.This is an excitation path.A plurality of light sources can be used for light box 601, and light source allows multiple fluorescent dye or autofluorescence to organize side by side or excite with the form of rapid succession.If the wavelength of two or more light sources overlaps, then the light source of Jiao Dieing must alternately be triggered, and makes relevant photographing unit survey correct fluoroscopic image.If do not overlap, light source can be illuminated simultaneously.
Organic material has optical characteristics unique for single material.System uses these unique characteristic identification CBD.In this case, system surveys biliary fluorescence among the CBD, adds the biliary biliary fluorescence that has fluorescent dye, the perhaps autofluorescence of tissue itself among the CBD.
Organic material absorbs photon and then sends more long wavelength's photon (Stokes shift (Stokes shift)).The light that is sent is called as fluorescence emission and can assembles by peritoneoscope.There are a series of lens, the length of extend through pipe in laparoscopically shaft portion.With reference to figure 7, light is assembled and is gone to the other end of equipment by first lens, light leaves and can be detected device from here and obtains, in this case, light is by beam splitter 704 beam split and the directed photographing unit that has specific filter, and described specific filter is blocked all light except fluorescence emission 703.In this case, these emissions are forms of image.Peritoneoscope also is converted into image with visible light, and they can be by naked eyes or are preferably seen by photographing unit.Visible light is by the photographing unit of beam splitter 704 beam split and sensing visible images 702.Photographing unit can be that the quantity of individual chip and photographing unit can vary depending on the application.The focusing arrangement (not shown) can be positioned over photographing unit 702,703 fronts, in order that proofread and correct any beam aberration that occurs in the light path.Light by the beam splitter beam split to particular camera.
Compact framework 701 is optionally and can be used for front independently embodiment shown in Figure 5.If use additional embodiment shown in Figure 4, can not adopt compact framework 701.
Two kinds of images, (i.e. the navigation with aiming) of visible and fluorescence superposeed in real time each other, so the surgeon can see CBD and can not damage it.
4.0 common bile duct fluorescence and demonstration
The CBD imaging system comprises following steps:
1. the fluoroscopic visualization material is placed among the CBD.
2. using can be that ultraviolet, light source infrared or visible light come excitation fluorescent material.
3. detection fluorescence.
4. processing fluoroscopic image is to remove illusion and scattering.
5. show real operation image and fluoroscopic image in real time together, on monitor, clearly show the position of CBD for the surgeon.
The fluoroscopic visualization material is placed in the bile duct.
Fluorescent agent can be fluorescigenic any medicament in ultraviolet, visible or infrared (IR) scope.This medicament can be an optically active substance, for example indole viridescent (ICG), fluorescein, methylene blue, isosulfan blue, perhaps any new visible medium or labelling based on fluorescence or color.If fluorescent agent is arranged into bile (for example ICG), fluorescent agent can be used to enter the venous mode before operation or in the operation.Under the situation of ICG, provide to comprise biomarker, the biocompatible solution that is used to inject, and the necessary pipe and the mean for applying of instruction.The time that IV uses before the operation of ICG is 40-60 minute before the operation beginning.ICG can be used as part chemistry " cocktail " injection, and the optical characteristics of ICG can be optimized, strengthens or be changed to chemistry " cocktail ".
With reference to figure 2 and 8, replacedly, fluorescent contrast agent can be put into CBD by direct injection gallbladder 204, cystic duct 205 or CBD 201.Because gallbladder away from CBD, injects gallbladder with medicament and has easily, do not need to dissect in advance and safe advantage.There is special equipment 801, liquid injected gallbladder 802 and then to inject CBD (as U.S. Patent No. 5,224,931 is described).
Select as another, new laparoscopic device can be specifically designed to the fluoroscopic visualization material is injected gallbladder.Such equipment can have the axle of 5mm diameter, the pawl of clamping gallbladder, and the passage of injection fluorescent material.Injection catheter can separate or cross pawl with pawl, make that fluorescent material can directly be injected gallbladder and not overflow (stinging the spitting image of Serpentis) when gallbladder is held.
Fluorescent material can also be introduced into CBD through cystic duct 205 (cystic duct is connected to CBD with gallbladder) rather than through gallbladder 204.For this reason, cystic duct is freely dissected with standard mode, is used for standard intraoperative cholangiography photo (IOC).The IOC conduit is put into bile duct, fixing, and contrast agent is injected into cystic duct and then injects CBD.Embodiment makes the CBD imaging on this, however its successfully dissect Choledochal before needing, before the CBD imaging, the patient is exposed in the dangerous process of certain (if not very big) thus.
With light energy source fluorescence excitation contrast agent
Medicament can be comprised the optical excitation of the different wave length of ultraviolet (UV), visible or infrared (IR).Energy source can be one or more wide spectrum lamps, one or more laser instrument or one or more light emitting diode (LED).Described energy source is called the arrowband energy source at this.Typically, the narrow wavelength band in UV, IR or the visible-range is used to excite specific fluorescence molecule.The arrowband energy source can be a part peritoneoscope light source, perhaps can adopt the distinct methods that light is pointed to tissue, is loaded into independent framework.
As mentioned above, the arrowband energy source is coupled to the peritoneoscope light source by the optical coupling box, visible light and narrow band light is combined in to be connected in the laparoscopically existing optical fiber thus.Replacedly, narrow-band light source can be passed through complete isolating photosystem, for example second peritoneoscope, dedicated optical probe, perhaps by the active trocar of one or more optics, with optical projection to tissue.Narrow-band light source can produce luminous energy on one or more narrow wavelength, and its intensity and wavelength are that the user is adjustable.
If there is not fluorescent agent to be used, the arrowband energy source can be used to change the type that projects to the visible light on the operative region.The light of one or more wavelength has or does not have white light, all can be used to illuminate operative region.This effect can be used for strengthening contrast, the degree of depth, the difference of different tissues, and this depends on its optical reflectivity, absorption characteristic and autofluorescence.If (substitute peritoneoscope or additional to peritoneoscope) projection only from one or more independent sources, then the color of light, intensity and spatial distribution can be controlled by the user and change, and reaching multiple radiography effect, thereby strengthen depth perception.The Electronic Control box that needs to specialize is used for this, and the user can use stick, switch or knob to control the illumination factor of being mentioned.Being used in combination of the light of different colours and intensity together with the change of the spatial distribution of light source, can and be organized at depth perception and help the surgeon aspect the difference.
In an embodiment, the light combined I CG preserved material with producing from the IR laser instrument of light box (as mentioned above)/led light source produces enough fluorescence so that by existing laparoscopic cameras system imaging, and needn't add IR optical detection photographing unit to peritoneoscope.Thus, this embodiment will add ICG preserved material/equipment and discharge and aforesaid IR laser instrument/LED light box, and does not have additional camera arrangement.The surgeon can use existing laparoscopic cameras and monitor to observe operative region, can also observe the image of the CBD in the operative region.
Survey contrast agent
Fluorescent contrast agent is excited by arrowband luminous energy and produces light emission at specific band.The energy of emission can be introduced endoscope, peritoneoscope, thoracoscope, cystoscope, operating microscope or second optical probe of body cavity for this purpose and be caught.If desired, then isolate by beam splitter or other light filter apparatus through the luminous energy of above-mentioned capture device, and directed detector.The method of surveying fluorescent contrast agent has been discussed above.Specific wave filter can be used for filtering unwanted optical wavelength from the luminous energy of assembling, to strengthen the detection of fluorescent material.Wave filter can be static or variable, and can be controlled by electronic controller.
Handle fluoroscopic image
In case survey and be converted to digital signal, the fluorescent emission optical signal is through microprocessor or computer, to extract crucial tissue image information.This processing can use software algorithm to strengthen image, changes size of images, shape and texture, changes the color of image, and/or change computer and produce the image of drawing.All these parameters can or arrange a predetermined group selection by user's adjusting, to satisfy different user preferences.
Show real operation image and fluoroscopic image
With reference to figure 9, show the image of series of displays visible images and fluorescent emission light image.Come from the numeral output of handling the fluorescent emission optical signal and make up, overlap with the no seam that produces two kinds of images with digital form and visible images.The combination of image and/or overlapping can be carried out by the software in computer or the microprocessor.The parameter that overlaps and the existence of every kind of image layer are at user option.
Visible/the fluoroscopic image of combination is presented on existing standard peritoneoscope CRT, display, video-frequency monitor, flat faced display, projector or the Helmet Mounted Display.The digital picture of combination with current market on the form output of standard monitor compatibility.The overlapping image can be opened or closed by switch or software control by the user, and switch or software control can be alternately by voice activations.The overlapping image presents image, and its presentation mode makes the surgeon to see the position of CBD by the fluorescent emission that comes from any normal direction visual angle when its work.Some surgeon may like having two monitors, and one does not overlap image and another has the overlapping image.System can handle multiple demonstration with the various combination of image.System can also show the overlapping image with the visible images that picture-in-picture mode shows, any image can show as master image in picture-in-picture mode, and the little image in other show as sprite.
The visible images 901 of bile duct and tremulous pulse top tissue is not illustrated with having overlapping.The fluoroscopic image 902 same nothings of bile duct and tremulous pulse are not illustrated with overlapping.Two types image does not have to pass on enough information to the surgeon alone.The combination of two kinds of images allows the surgeon to describe under the tissue and what tissue itself is.The mode 903 that normal and enhanced bile duct image overlaps with essence together is presented on the operation image, so even be positioned under the tissue of overlapping, CBD also is visible for the surgeon.The surgeon can use the image of overlapping now, avoids damaging CBD.
When the image overlapping was activated, visible images can change on color and/or intensity, to emphasize fluoroscopic image.Fluoroscopic image can be changed into any color of wanting by the user.Because fluoroscopic image is endoceliac fluorescence, fluoroscopic image is easy to be enhanced.
The software that is used for Flame Image Process allows the user before operation, after the operation neutralization operation, configuration and control CBD visualization system.This control can be performed by computer keyboard, special-purpose keyseat, touch screen, foot switch, sound control, head up displays or the like.Control can be provided for the surgeon as foot switch on the floor in the sterilization overcoat of for example plastic closure, perhaps the nurse that can be walked uses with non-sterilizing equipment decontaminating apparatus.
The computer that is used for the control of the digital processing of image and image detection can comprise and being used for externally or internal record equipment (for example CD, DVD, CD, hard disk or flash memory) is gone up the software and hardware of the visible and fluoroscopic image of record combination.Can have the ability of on printing paper, printing static combination image in the system.System can provide Ethernet to connect, and allows the Internet or Intranet link, makes record can be formed at server or transmits on the Internet or Intranet, is used for training objectives.
NOTES uses
The nature opening through intracavity sight glass operation (Natural Orifice Translumenal Endoscopic Surgery) (NOTES)
TMBe to develop in response to following notion several years ago, this notion promptly, the patient will: 1), recognize the benefit of less intervene operation by reducing recovery time; 2) the experience less physiology misery relevant with conventional procedure; And 3) after this type of operation, there is not obvious visible scar.All these advantages are impelled discussion and research forward, the new equipment and the technology of encouraging the exploitation of doctor and research worker to use in the NOTES process.
As an example, in natural open surgery, gallbladder can be removed through the oral cavity.The doctor inserts pipe downwards from esophagus, makes little otch in stomach or digestive tract, leads to the passage in abdominal cavity and is exteriorized by same path obtaining.Some operations can also be passed through rectum, vagina, urethra or bladder and implement.
One of subject matter of NOTES operation is spatial orientation and visual.But the optical axis that this changes when being inserted into peritoneal cavity owing to softish endoscope.In addition, the quality of endoscope's visual image is usually less than standard peritoneoscope system.
In NOTES operation on gallbladder process, the surgeon can use top-down method to remove gallbladder, is single base of a fruit tissue thus with gallbladder anatomy, and crucial guide-tube structure is positioned at herein.Based on this, if the surgeon can be clear that choledoch-position, he can be safely with base of a fruit ligation or clamp and finish operation with shorter time and workload still less.Replacedly, choledoch-visual in the NOTES operation on gallbladder of the process of dissecting bile duct and tremulous pulse, will be helpful, this is because present NOTES system is visual and the limitation controlled.In both cases, the choledoch-high-visible NOTES operation on gallbladder that will make is quicker and safer for the patient.
In an embodiment, the bile duct visual system is with the formal operations consistent with above-mentioned laparoscopic use.Fluorescent exciting is introduced into the fibre system of softish endoscope.The beam splitter collar will be used to take fluoroscopic image with the independent fluorescence excitation camera arrangement that is attached to endoscope.Fluoroscopic image with processed and two kinds of images will with: overlapping pattern, picture-in-picture or shoulder to shoulder form (all as mentioned above) be shown to operation team.On fully-integrated NOTES platform, fluorescence excitation source and photographing unit are integrated in the endoscopic apparatus system.In NOTES uses, ICG or other fluorescence or color mark will by the preoperative IV phase inject or perform the operation in direct injection gallbladder be introduced into common bile duct.Direct injection can adopt existing endoscope entry needle conduit, percutaneous acupuncture or the newly-designed equipment or the conduit that are used to inject are finished.
In an embodiment, the image of demonstration is expanded through two-dimentional place.Embodiment shows 3-D view to the surgeon.Surgeon or assistant can use Long-distance Control or use the command facility on peritoneoscope, endoscope, thoracoscope, cystoscope or the like to come image rotating.
5.0 ardware overview
Figure 10 is a block diagram of having described the computer system that embodiment of the present invention can carry out thereon.Computer system 1000 comprises bus 1002 or other communication agency that is used for exchange of information, and the processor that is used for process information 1004 that couples with bus 1002.Computer system 1000 also comprises the main storage 1006 that is coupled to bus 1002, for example random-access memory (ram) or other dynamic memory, the instruction that is used for stored information and will be carried out by processor 1004.Main storage 1006 can also be used in process storage temporary variable or other average information of carrying out the instruction that will be carried out by processor 1004.Computer system 1000 further comprises read only memory (ROM) 1008 or other static storage device that is coupled to bus 1002, is used to store the static information and the instruction that are used for processor 1004.Memory device 1010, for example disk or CD are provided and are coupled to bus 1002, are used for stored information and instruction.
The present invention relates to be used to carry out the use of the computer system 1000 of above-mentioned technology.According to one embodiment of the invention, these technology are carried out by computer system 1000, carry out one or more sequences of the one or more instructions that comprise in the main storage 1006 in response to processor 1004.Such instruction can be read into main storage 1006 from another machine readable media (for example memory device 1010).Make processor 1004 carry out treatment step described herein to the execution that is included in the job sequence in the main storage 1006.In alternative embodiment, hard-wired circuitry can be used for replacing or combination with, software instructions to realize the present invention.Thus, embodiments of the invention are not limited to any particular combinations of hardware circuit and software.
Term used herein " machine readable media " refers to participate in providing any medium of data, and these data make machine operate with particular form.In the embodiment that the system of using a computer 1000 carries out, need multiple different machine readable media for example to be used for providing instruction so that carry out to processor 1004.Such medium can be taked a lot of forms, includes but not limited to storage medium and transmission medium.Storage medium comprises non-volatile media and Volatile media.Non-volatile media for example comprises, CD or disk, and for example memory device 1010.Volatile media comprises dynamic memory, and for example main storage 1006.Transmission medium comprises coaxial cable, copper cash and optical fiber, comprises the cable that contains bus 1002.
The common form of machine readable media comprises, for example diskette, floppy disk, hard disk, tape, or any other magnetic data storage medium, CD/DVD, any other optical medium, card punch, paper tape, or any other physical medium, RAM, PROM and EPROM, FLASH-EPROM, any other storage chip or tape, or any other computer medium that can read with foraminous pattern.
The various ways of machine readable media can participate in one or more sequences of one or more instructions are carried to processor 1004, is used for carrying out.For example instruction can be carried on the disk of remote computer at first.Remote computer can be to its dynamic memory load instructions, and uses modem, sends instruction by telephone wire.The modem of computer system 1000 this locality can receive data on telephone wire, and uses infrared transmitter to transfer data to infrared signal.Infrared Detectors can receive the data that are carried in the infrared signal, and suitable circuit can be placed data on bus 1002.Bus 1002 is transported data to main storage 1006, and from then on processor 1004 obtains and execute instruction.The instruction that is received by main storage 1006 selectively before or after processor 1004 is carried out, is stored on the memory device 1010.
Network linking 1020 typically by one or more networks, provides data communication to other data equipment.For example, network linking 1020 can be passed through local network 1022, provides connection to the data equipment of main frame 1024 or ISP (ISP) 1026 operations.ISP 1026 provides data communication services then by the block data communication net (often being regarded as " the Internet " now) 1028 of global range.Local network 1022 and the Internet 1028 all use electricity, electromagnetism or the optical signal of carrying numerical data stream.
The code that receives can be carried out when it is received by processor 1004, and/or be stored into memory device 1010 or other nonvolatile memory, execution after being used for.Under this mode, computer system 1000 can obtain the application code of carrier format.
In aforementioned specification, embodiments of the invention are described with reference to a plurality of particular contents that change with execution.Thus, the unique and exclusive indication of the content that is intended to protect about content of the present invention and the present patent application people is the disclosed cover claim of the application, in the concrete form of claim issue, comprises arbitrarily corrigendum afterwards.Illustrate especially herein for any definition that is included in the term in such claim, should determine the meaning that these terms use in the claims.So restriction, key element, character, feature, advantage or the attribute that does not have to enumerate especially in the claims should not limit the scope of these claim by any way.Thus, description and accompanying drawing are counted as illustrative and not restrictive meaning.
Claims (39)
1. method that is used for the characteristic imaging of common bile duct (CBD) in patient's body comprises:
At least a fluorescent agent is introduced among patient's the CBD;
From being attached to the visible images data of at least one the visible images pick off reception patient CBD on the peritoneoscope;
From being attached to the fluoroscopic image data of at least one the fluoroscopic image pick off reception patient CBD on the peritoneoscope;
Handle described visible images data and described fluoroscopic image data;
By making up described visible images data and described fluoroscopic image data, produce combined image data;
Send described combined image data to first display.
2. method according to claim 1 is characterized in that: described generation step is got rid of described visible images data or described fluoroscopic image data in response to user command from described combination image.
3. method according to claim 1 is characterized in that: described forwarding step sends described visible images data to second display simultaneously.
4. method according to claim 1 is characterized in that: described forwarding step sends described visible images data with the picture-in-picture form to first display simultaneously.
5. method according to claim 1 is characterized in that: described generation step strengthens the feature of described fluoroscopic image data, thereby emphasizes the imaging in described fluoroscopic image data.
6. method according to claim 1 further comprises:
By inserting patient's peritoneoscope, catch described visible images data and described fluoroscopic image data;
Visible light and fluorescent exciting are entered the patient abdominal cavity by described peritoneoscope transmission;
Allow the user to regulate and be used to catch the described visible light of described visible images data and/or described fluoroscopic image data and the luminescence feature of fluorescent exciting.
7. method according to claim 1 further comprises:
Described combined image data is stored on the memory device.
8. equipment that is used for the characteristic imaging of common bile duct (CBD) in patient's body comprises:
Be used at least a fluorescent agent is introduced the module of patient CBD;
Be used for from the module of the visible images data that are attached at least one the visible images pick off reception patient CBD on the peritoneoscope;
Be used for from the module of the fluoroscopic image data that is attached at least one the fluoroscopic image pick off reception patient CBD on the peritoneoscope;
Be used to handle the module of described visible images data and described fluoroscopic image data;
Be used for producing the module of combined image data by making up described visible images data and described fluoroscopic image data;
Be used for sending the module of described combined image data to first display.
9. equipment according to claim 8 is characterized in that: described generation module is got rid of described visible images data or described fluoroscopic image data in response to user command from described combination image.
10. equipment according to claim 8 is characterized in that: described sending module sends described visible images data to second display simultaneously.
11. equipment according to claim 8 is characterized in that: described sending module sends described visible images data with the picture-in-picture form to first display simultaneously.
12. equipment according to claim 8 is characterized in that: described generation module strengthens the feature of described fluoroscopic image data, thereby emphasizes the imaging in described fluoroscopic image data.
13. equipment according to claim 8 further comprises:
Be used for catching the module of described visible images data and described fluoroscopic image data by inserting patient's peritoneoscope;
Be used for visible light and fluorescent exciting are transmitted the module that enters the patient abdominal cavity by described peritoneoscope;
Be used to allow the user to regulate and be used to catch the module of the luminescence feature of the described visible light of described visible images data and/or described fluoroscopic image data and fluorescent exciting.
14. equipment according to claim 13 further comprises:
Be used for storing described combined image data on the memory device module.
15. a computer-readable medium, carrying is used for the instruction to one or more sequences of the characteristic imaging of common bile duct (CBD) in patient's body, it is characterized in that:
By of the execution of one or more processors, make described one or more processor execution in step to the instruction of one or more sequences:
At least a fluorescent agent is introduced among patient's the CBD;
From being attached to the visible images data of at least one the visible images pick off reception patient CBD on the peritoneoscope;
From being attached to the fluoroscopic image data of at least one the fluoroscopic image pick off reception patient CBD on the peritoneoscope;
Handle described visible images data and described fluoroscopic image data;
By making up described visible images data and described fluoroscopic image data, produce combined image data;
Send described combined image data to first display.
16. computer-readable medium according to claim 15 is characterized in that: described generation step is got rid of described visible images data or described fluoroscopic image data in response to user command from described combination image.
17. computer-readable medium according to claim 15 is characterized in that: described forwarding step sends described visible images data to second display simultaneously.
18. computer-readable medium according to claim 15 is characterized in that: described forwarding step sends described visible images data with the picture-in-picture form to first display simultaneously.
19. computer-readable medium according to claim 15 is characterized in that: described generation step strengthens the feature of described fluoroscopic image data, thereby emphasizes the imaging in described fluoroscopic image data.
20. computer-readable medium according to claim 15 further comprises:
By inserting patient's peritoneoscope, catch described visible images data and described fluoroscopic image data;
Visible light and fluorescent exciting are entered the patient abdominal cavity by described peritoneoscope transmission;
Allow the user to regulate and be used to catch the described visible light of described visible images data and/or described fluoroscopic image data and the luminescence feature of fluorescent exciting.
21. computer-readable medium according to claim 20 further comprises:
Described combined image data is stored on the memory device.
22. one kind be used for operation to patient's body in the system of characteristic imaging of common bile duct (CBD), comprising:
At least one is installed in being used on the peritoneoscope and surveys the pick off of visible images;
At least one is installed in being used on the peritoneoscope and surveys the pick off of fluorescent emission light image;
Receptor, this receptor receives the visible images data and receives the fluorescence emission view data from described at least one pick off that is used to survey the fluorescent emission light image from described at least one pick off that is used to survey visible images;
From the processor of described receptor reception visible images data and fluoroscopic image data, described processor extracts the CBD view data and visible images data and CBD view data is combined into video data from described fluoroscopic image data; And
Communicate to connect the video-stream processor to described processor, described video-stream processor is handled the video data that receives from described processor, is used for showing on the display device that communicates to connect.
23. system according to claim 22 further comprises:
Wireless transmitter, it is installed on the peritoneoscope, and communicate to connect to described at least one be used to survey visible images pick off and described at least one be used to survey the pick off of fluorescent emission light image; And
The emission of wherein said wireless transmitter be received in described at least one be used to survey the visible images data of the pick off of visible images, and emission be received in described at least one be used to survey the fluoroscopic image data of the pick off of fluorescent emission light image.
24. system according to claim 22, it is characterized in that: described receptor is by the combination in any of at least one wire or at least one optical fiber, receives the visible images data and receives fluoroscopic image data from described at least one pick off that is used to survey the fluorescent emission light image from described at least one pick off that is used to survey visible images.
25. system according to claim 23 is characterized in that: described receptor receives visible images data and fluoroscopic image data from described wireless transmitter.
26. system according to claim 22 is characterized in that: described receptor communicate to connect to described at least one be used to survey visible images pick off and described at least one be used to survey the pick off of fluorescent emission light image.
27. system according to claim 22 further comprises:
Storage is received in the memory device of the video data of described processor.
28. system according to claim 22 further comprises:
Light source, this light source enters the patient abdominal cavity with visible light and fluorescent exciting by the peritoneoscope projection.
29. system according to claim 28 is characterized in that: the combination in any of the light that described light source is at least one laser instrument, at least one is filtered, at least one lamp or at least one LED.
30. system according to claim 28 is characterized in that: the visible light in the described light source and/or the feature of fluorescent exciting are that the user is adjustable.
31. system according to claim 22 is characterized in that: described processor is regulated the indicating characteristic of CBD view data, so that CBD view data and visible images data field in the video data are separated.
32. one kind be used for operation to patient's body in the system of characteristic imaging of common bile duct (CBD), comprising:
The fluoroscopic image module comprises at least one that be suitable for being installed on the peritoneoscope and is used to survey the pick off of fluorescent emission light image;
Receptor, this receptor receives fluoroscopic image data from described fluoroscopic image module, and receives the visible images data from being attached to laparoscopically existing visible images pick off;
Receive the processor of visible images data and fluoroscopic image data from described receptor, described processor extracts the CBD view data and the CBD view data is overlapped on the visible images data from described fluoroscopic image data; And
Communicate to connect the video-stream processor to described processor, described video-stream processor is handled the overlapping data that receive from described processor, is used for showing on the display device that communicates to connect.
33. system according to claim 32 further comprises:
Wireless transmitter is installed on the peritoneoscope and communicates to connect to described fluoroscopic image module; And
Wherein said wireless transmitter emission is received in the visible images data of described fluoroscopic image module.
34. system according to claim 32 is characterized in that: described receptor receives the visible images data by the combination in any of at least one wire or at least one optical fiber from described fluoroscopic image module.
35. system according to claim 33 is characterized in that: described receptor receives fluoroscopic image data from described wireless transmitter.
36. system according to claim 32 further comprises:
Storage is received in the memory device of the overlapping data of described processor.
37. system according to claim 32 is characterized in that: described processor is regulated the indicating characteristic of CBD view data, when being overlapped on the visible images data with convenient CBD view data, CBD view data and visible images data field is separated.
38. system according to claim 32 further comprises: the light source that the fluorescence excitation optical projection is entered the patient abdominal cavity by peritoneoscope.
39., it is characterized in that: the combination in any of the light that described light source is at least one laser instrument, at least one is filtered, at least one lamp or at least one LED according to the described system of claim 38.
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| US12/011,490 | 2008-01-24 | ||
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| US12/011,484 US20090192390A1 (en) | 2008-01-24 | 2008-01-24 | Common bile duct surgical imaging system |
| US12/011,484 | 2008-01-24 | ||
| PCT/US2009/031712 WO2009094465A1 (en) | 2008-01-24 | 2009-01-22 | Common bile duct surgical imaging system |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN102949172A (en) * | 2011-08-16 | 2013-03-06 | 富士胶片株式会社 | Image display method and apparatus |
| CN107708518A (en) * | 2015-06-17 | 2018-02-16 | 奥林巴斯株式会社 | Camera device |
| CN107811705A (en) * | 2017-11-27 | 2018-03-20 | 湖北得康科技有限公司 | A kind of new endoscopic system |
| CN109520975A (en) * | 2017-09-20 | 2019-03-26 | 因德斯马特有限公司 | Near-infrared fluorescent detection device and near-infrared fluorescent detection method |
| CN109637622A (en) * | 2013-07-16 | 2019-04-16 | 精工爱普生株式会社 | Information processing unit, information processing method and information processing system |
| CN111481218A (en) * | 2019-01-28 | 2020-08-04 | 麦迪贝肯有限公司 | System and method for home transdermal GFR monitoring |
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| US8706184B2 (en) * | 2009-10-07 | 2014-04-22 | Intuitive Surgical Operations, Inc. | Methods and apparatus for displaying enhanced imaging data on a clinical image |
| US10682198B2 (en) | 2010-07-02 | 2020-06-16 | Intuitive Surgical Operations, Inc. | Method and system for fluorescent imaging with background surgical image composed of selective illumination spectra |
| US9211058B2 (en) * | 2010-07-02 | 2015-12-15 | Intuitive Surgical Operations, Inc. | Method and system for fluorescent imaging with background surgical image composed of selective illumination spectra |
| CN102100542A (en) * | 2010-12-10 | 2011-06-22 | 广州宝胆医疗器械科技有限公司 | Integrated infrared heat-scanning cholecystoscope system |
| CN102100544A (en) * | 2010-12-10 | 2011-06-22 | 广州宝胆医疗器械科技有限公司 | Cholecystoscope system with infrared heat-scanning function |
| US20140051973A1 (en) * | 2012-08-15 | 2014-02-20 | Aspect Imaging Ltd | Mri imaging system for generating a rendered image |
| IL221489A0 (en) * | 2012-08-15 | 2012-12-31 | Aspect Imaging Ltd | Imaging system for generating a rendered image |
| JP2017164007A (en) * | 2016-03-14 | 2017-09-21 | ソニー株式会社 | Medical image processing device, medical image processing method, and program |
| WO2020121373A1 (en) * | 2018-12-10 | 2020-06-18 | オリンパス株式会社 | Image recorder |
| CN109893092B (en) * | 2019-02-20 | 2024-03-29 | 广州乔铁医疗科技有限公司 | Laparoscope external vision mirror device capable of scanning abdominal cavity |
| CN111166276A (en) * | 2020-01-24 | 2020-05-19 | 复旦大学 | Near-infrared fluorescence imaging detection system for ovary through abdominal cavity-laparoscope |
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| US5986271A (en) * | 1997-07-03 | 1999-11-16 | Lazarev; Victor | Fluorescence imaging system |
| AU2003272531A1 (en) * | 2003-09-15 | 2005-04-27 | Beth Israel Deaconess Medical Center | Medical imaging systems |
| JP2009507617A (en) * | 2005-09-14 | 2009-02-26 | ネオガイド システムズ， インコーポレイテッド | Method and apparatus for performing transluminal and other operations |
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- 2009-01-22 CA CA2713113A patent/CA2713113A1/en not_active Abandoned
- 2009-01-22 JP JP2010544420A patent/JP2011510705A/en not_active Withdrawn
- 2009-01-22 EP EP09703731A patent/EP2254456A1/en not_active Withdrawn
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Cited By (7)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN102949172A (en) * | 2011-08-16 | 2013-03-06 | 富士胶片株式会社 | Image display method and apparatus |
| CN102949172B (en) * | 2011-08-16 | 2016-02-10 | 富士胶片株式会社 | Method for displaying image and equipment |
| CN109637622A (en) * | 2013-07-16 | 2019-04-16 | 精工爱普生株式会社 | Information processing unit, information processing method and information processing system |
| CN107708518A (en) * | 2015-06-17 | 2018-02-16 | 奥林巴斯株式会社 | Camera device |
| CN109520975A (en) * | 2017-09-20 | 2019-03-26 | 因德斯马特有限公司 | Near-infrared fluorescent detection device and near-infrared fluorescent detection method |
| CN107811705A (en) * | 2017-11-27 | 2018-03-20 | 湖北得康科技有限公司 | A kind of new endoscopic system |
| CN111481218A (en) * | 2019-01-28 | 2020-08-04 | 麦迪贝肯有限公司 | System and method for home transdermal GFR monitoring |
Also Published As
| Publication number | Publication date |
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| EP2254456A1 (en) | 2010-12-01 |
| WO2009094465A1 (en) | 2009-07-30 |
| JP2011510705A (en) | 2011-04-07 |
| CA2713113A1 (en) | 2009-07-30 |
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Application publication date: 20110406 |