CN112843506B - Surgical system and ultrasonic suction knife system - Google Patents

Surgical system and ultrasonic suction knife system Download PDF

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CN112843506B
CN112843506B CN201911194771.8A CN201911194771A CN112843506B CN 112843506 B CN112843506 B CN 112843506B CN 201911194771 A CN201911194771 A CN 201911194771A CN 112843506 B CN112843506 B CN 112843506B
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blood vessel
operated
ultrasonic suction
ultrasonic
suction knife
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CN112843506A (en
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郭毅军
温兴东
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Chongqing Xishan Science and Technology Co Ltd
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N7/00Ultrasound therapy
    • A61N7/02Localised ultrasound hyperthermia
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046Tracking techniques
    • A61B2034/2065Tracking using image or pattern recognition
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2217/00General characteristics of surgical instruments
    • A61B2217/002Auxiliary appliance
    • A61B2217/005Auxiliary appliance with suction drainage system
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N7/00Ultrasound therapy
    • A61N2007/0004Applications of ultrasound therapy

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  • Surgery (AREA)
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Abstract

The invention discloses a surgical system, an ultrasonic suction knife system and a control method thereof, wherein a three-dimensional model of a target tissue and a blood vessel to be removed is constructed by acquiring imaging data of the target tissue and imaging data of the blood vessel to be removed, the three-dimensional model and positioning data of a part to be operated are subjected to overlapping positioning, the positioning data of the blood vessel are determined, then the relative positions of the ultrasonic suction knife and the target tissue and the blood vessel are determined according to the positioning data of the blood vessel and the positioning data of the ultrasonic suction knife, namely the relative positions of the ultrasonic suction knife and the blood vessel are determined, and corresponding control parameters are obtained by combining the diameters of the blood vessel according to the relative positions. Because the control parameters are determined according to the relative positions of the ultrasonic suction knife and the blood vessel and the diameter of the blood vessel, the tumor can be removed and the blood vessel can be prevented from being damaged.

Description

Surgical system and ultrasonic suction knife system
Technical Field
The invention relates to the field of medical instruments, in particular to a surgical system, an ultrasonic suction knife system and a control method thereof.
Background
The ultrasonic suction knife system is mainly applied to tumor removal surgery, and utilizes cavitation effect and mechanical effect of ultrasonic waves to crush and remove tumor tissues or normal tissues. Because the ultrasonic suction knife system mainly aims at the tissues with more water content and softer tissues, the ultrasonic suction knife system can not damage vascular tissues to a certain extent when smashing and removing tumor tissues or normal soft tissues, but tiny blood vessels can be damaged when the ultrasonic action time is long or the output energy is large. In tumor resection operation, the ultrasonic parameters output by the ultrasonic suction knife system are often required to be regulated to avoid damaging blood vessels, but partial brain tumors have abundant blood supply and different blood vessel thicknesses, and the set ultrasonic parameters are not right due to inaccurate judgment of the blood vessel positions in the operation process, so that the blood vessels are damaged.
Disclosure of Invention
The invention mainly solves the technical problem of how to realize that the ultrasonic suction knife system can not damage blood vessels when removing target tissues.
According to a first aspect, in one embodiment, there is provided a control method of an ultrasonic suction blade system, including:
acquiring a three-dimensional model of a part to be operated, wherein the three-dimensional model at least comprises a blood vessel of the part to be operated and target tissues to be removed;
determining the relative positions of the ultrasonic suction knife and the blood vessel of the to-be-operated position in the three-dimensional model according to the three-dimensional model, the positioning data of the to-be-operated position and the positioning data of the ultrasonic suction knife;
obtaining control parameters of the ultrasonic suction knife system at least according to the relative positions; the control parameters are used for controlling the ultrasonic suction knife system to output corresponding ultrasonic waves and/or generate corresponding negative pressure.
Further, determining a relative position of the ultrasonic suction blade and a blood vessel in the three-dimensional model according to the three-dimensional model, the positioning data of the to-be-operated part and the positioning data of the ultrasonic suction blade, including:
acquiring positioning data of a part to be operated and real-time positioning data of an ultrasonic suction knife;
according to the acquired positioning data of the to-be-operated position, overlapping and positioning the three-dimensional model and the to-be-operated position to obtain positioning data of a blood vessel of the to-be-operated position;
and determining the real-time relative position of the ultrasonic suction knife and the blood vessel according to the positioning data of the blood vessel and the acquired real-time positioning data of the ultrasonic suction knife.
Further, the acquiring the three-dimensional model of the to-be-operated part comprises:
acquiring imaging data of a part to be operated on and imaging data of blood vessels of the part to be operated on;
processing imaging data of the to-be-operated position and imaging data of blood vessels of the to-be-operated position to generate a three-dimensional model of the to-be-operated position.
Further, the obtaining control parameters of the ultrasonic suction blade system at least according to the relative positions comprises:
obtaining the diameter of the blood vessel;
searching control parameters corresponding to the relative position and the diameter in a preset database;
and setting the searched control parameters as the control parameters of the ultrasonic suction knife system.
Further, the control parameters include a gear of the control parameters, and parameters of the gear corresponding to different relative positions, different blood vessel diameters.
According to a second aspect, in one embodiment there is provided a surgical system comprising a neuro-navigation system for generating a three-dimensional model of a site to be operated, the three-dimensional model comprising at least a blood vessel of the site to be operated and a target tissue to be removed; the method comprises the steps of acquiring positioning data of a to-be-operated position and positioning data of an ultrasonic suction knife, and determining the relative positions of the ultrasonic suction knife and blood vessels of the to-be-operated position in the three-dimensional model according to the three-dimensional model, the positioning data of the to-be-operated position and the positioning data of the ultrasonic suction knife;
the ultrasonic suction knife system is used for acquiring the relative position of the ultrasonic suction knife and a blood vessel in a three-dimensional model of the part to be operated, obtaining control parameters of the ultrasonic suction knife system at least according to the relative position, and controlling the ultrasonic suction knife to output corresponding ultrasonic waves and/or generate corresponding negative pressure through the control parameters.
Further, determining a relative position of the ultrasonic suction blade and a blood vessel in the three-dimensional model according to the three-dimensional model, the positioning data of the to-be-operated part and the positioning data of the ultrasonic suction blade, including:
acquiring positioning data of a part to be operated and real-time positioning data of an ultrasonic suction knife;
according to the acquired positioning data of the to-be-operated position, overlapping and positioning the three-dimensional model and the to-be-operated position to obtain positioning data of a blood vessel of the to-be-operated position;
and determining the real-time relative position of the ultrasonic suction knife and the blood vessel according to the positioning data of the blood vessel and the acquired real-time positioning data of the ultrasonic suction knife.
Further, the generating a three-dimensional model of the site to be operated on includes:
acquiring imaging data of a part to be operated on and imaging data of blood vessels of the part to be operated on;
processing imaging data of the to-be-operated position and imaging data of blood vessels of the to-be-operated position to generate a three-dimensional model of the to-be-operated position.
Further, the obtaining control parameters of the ultrasonic suction blade system at least according to the relative positions comprises:
obtaining the diameter of the blood vessel;
searching control parameters corresponding to the relative position and the diameter in a preset database;
and setting the searched control parameters as the control parameters of the ultrasonic suction knife system.
According to a third aspect, in one embodiment, there is provided an ultrasonic suction tool system, including a handle, a tool, and a control device, where the control device is connected to the handle, the handle is connected to the tool, the tool is used to output ultrasonic waves and generate corresponding negative pressure, and the control device is used to obtain a relative position of the ultrasonic suction tool and a blood vessel in a three-dimensional model of a part to be operated, and obtain control parameters of the ultrasonic suction tool system according to at least the relative position, and control the tool to output corresponding ultrasonic waves and/or generate corresponding negative pressure through the control parameters;
the relative position is determined according to a three-dimensional model of the to-be-operated position, positioning data of the to-be-operated position and positioning data of the ultrasonic suction knife, and the three-dimensional model of the to-be-operated position at least comprises a blood vessel of the to-be-operated position and target tissues to be removed.
According to the surgical system, the ultrasonic suction knife system and the control method thereof, the three-dimensional model of the target tissue and the blood vessel to be removed is constructed by acquiring the imaging data of the target tissue and the imaging data of the blood vessel to be removed, the three-dimensional model and the positioning data of the part to be operated are subjected to overlapping positioning, the positioning data of the blood vessel is determined, the relative positions of the ultrasonic suction knife and the target tissue and the blood vessel are determined according to the positioning data of the blood vessel and the positioning data of the ultrasonic suction knife, namely the relative positions of the ultrasonic suction knife and the blood vessel are determined, and the corresponding control parameters are obtained according to the relative positions and the diameters of the blood vessel. Because the control parameters are determined according to the relative positions of the ultrasonic suction knife and the blood vessel and the diameter of the blood vessel, the tumor can be removed and the blood vessel can be prevented from being damaged.
Drawings
FIG. 1 is a schematic structural view of a surgical system according to one embodiment;
FIG. 2 is a flow chart of a method of controlling an ultrasonic suction blade system of an embodiment;
fig. 3 is a flow chart of tumor removal using an ultrasonic aspiration blade system according to one embodiment.
Detailed Description
The invention will be described in further detail below with reference to the drawings by means of specific embodiments. Wherein like elements in different embodiments are numbered alike in association. In the following embodiments, numerous specific details are set forth in order to provide a better understanding of the present application. However, one skilled in the art will readily recognize that some of the features may be omitted, or replaced by other elements, materials, or methods in different situations. In some instances, some operations associated with the present application have not been shown or described in the specification to avoid obscuring the core portions of the present application, and may not be necessary for a person skilled in the art to describe in detail the relevant operations based on the description herein and the general knowledge of one skilled in the art.
Furthermore, the described features, operations, or characteristics of the description may be combined in any suitable manner in various embodiments. Also, various steps or acts in the method descriptions may be interchanged or modified in a manner apparent to those of ordinary skill in the art. Thus, the various orders in the description and drawings are for clarity of description of only certain embodiments, and are not meant to be required orders unless otherwise indicated.
The numbering of the components itself, e.g. "first", "second", etc., is used herein merely to distinguish between the described objects and does not have any sequential or technical meaning. The terms "coupled" and "connected," as used herein, are intended to encompass both direct and indirect coupling (coupling), unless otherwise indicated.
When the ultrasonic suction knife system is used, the efficiency of removing target tissues of a part to be operated can be adjusted by adjusting the amplitude, the pulse and/or the negative pressure, and the higher the amplitude, the pulse and/or the negative pressure is, the higher the efficiency is, and the lower the safety is; the smaller the amplitude, pulse and/or negative pressure, the lower the efficiency and the higher the safety.
In the existing ultrasonic suction knife system, a doctor is required to observe and judge the distance between the suction knife and the blood vessel in the operation process, sometimes, in order not to damage the blood vessel, the ultrasonic suction knife system adopts lower amplitude and/or pulse to crush target tissues, sometimes, in order to avoid the blood vessel from being sucked to the tip of the ultrasonic suction knife, and also adopts lower negative pressure to adsorb the tissues; similarly, sometimes, in order to remove the target tissue faster, the ultrasonic aspiration knife system employs higher amplitude and/or pulse to crush the target tissue or higher negative pressure to adsorb the tissue, but this approach is prone to damaging the blood vessels, causing bleeding, increasing the difficulty of the surgery, and even affecting the physical function or life of the patient.
In an embodiment of the present invention, please refer to fig. 1, fig. 1 is a schematic structural diagram of an operation system according to an embodiment, which includes: the nerve navigation system is used for generating a three-dimensional model of the part to be operated, and the three-dimensional model at least comprises a blood vessel of the part to be operated and target tissues to be removed; the method comprises the steps of acquiring positioning data of a to-be-operated position and positioning data of an ultrasonic suction knife, and determining the relative positions of the ultrasonic suction knife and blood vessels of the to-be-operated position in the three-dimensional model according to the three-dimensional model, the positioning data of the to-be-operated position and the positioning data of the ultrasonic suction knife;
wherein a three-dimensional model of the site to be operated on is generated by an image processing module 2 in the neuronavigation system from the acquired imaging data of the site to be operated on, which includes imaging data of the target tissue to be removed, and imaging data of the blood vessel of the site to be operated on. Imaging data of the site to be operated on is conventional medical image data, such as CT imaging data, magnetic Resonance (MRI) imaging data, and the like. Since it is not clear that normal CT imaging or mri is performed on a blood vessel, imaging data of the blood vessel of the portion to be operated is generally obtained through perfusion imaging (CT perfusion imaging or nuclear magnetic resonance perfusion imaging, etc.), and hemodynamic information of the portion to be operated can also be obtained. For example, imaging data of a blood vessel is obtained by imaging the blood vessel of a surgical site by a CT angiography (CTA) technique, imaging data of a blood vessel is obtained by imaging the blood vessel of a surgical site by a Magnetic Resonance (MRA) vascular imaging technique, or imaging data of a blood vessel is obtained by imaging the blood vessel of a surgical site by a Digital Subtraction (DSA) technique, and of course, any two or three of these three methods may be combined to obtain final vascular imaging data. The imaging data of the to-be-operated part and the imaging data of the blood vessel are mainly two-dimensional imaging data, and the image processing module 2 constructs a three-dimensional model of the to-be-operated part by using the existing image processing technologies such as image synthesis and the like through a plurality of pieces of two-dimensional imaging data of different angles of the to-be-operated part.
The positioning data of the to-be-operated position is the position coordinate data of key points of the to-be-operated position, for example, the brain, the key points can be the positions of eyebrow bows, wing points (forehead, vertex and the like), zygomatic bows and the like, and the position coordinate data can be obtained through the existing infrared positioning technology and the like.
The positioning data of the ultrasonic suction tool is the position coordinate data of the key point (such as the tool tip) of the ultrasonic suction tool, namely the real-time position coordinate data, and can be obtained by the existing infrared positioning technology. In this embodiment, the position detection module 1 of the nerve navigation system acquires the positioning data of the ultrasonic suction blade in real time, and thus the real-time positioning data of the ultrasonic suction blade is obtained. The position detection module 1 outputs the acquired real-time positioning data of the ultrasonic suction knife to the image processing module 2.
The image processing module 2 performs overlapping positioning on the three-dimensional model and the part to be operated according to the acquired positioning data of the part to be operated to obtain the positioning data of the blood vessel of the part to be operated; according to the embodiment, the positioning data of the to-be-operated position is input into the nerve navigation system, and registration operation is carried out, so that the overlapping positioning of the three-dimensional model and the to-be-operated position is realized.
And the nerve navigation system determines the real-time relative position of the ultrasonic suction knife and the blood vessel according to the positioning data of the blood vessel and the acquired real-time positioning data of the ultrasonic suction knife.
The ultrasonic suction knife system is used for acquiring the relative position of the ultrasonic suction knife and a blood vessel in a three-dimensional model of the part to be operated, obtaining control parameters of the ultrasonic suction knife system at least according to the relative position, and controlling the ultrasonic suction knife to output corresponding ultrasonic waves and/or generate corresponding negative pressure through the control parameters.
The ultrasonic suction knife system in the embodiment comprises a handle 5, a knife, a negative pressure generating device and a control device 3, wherein the control device 3 is connected with the handle 5, the handle 5 and the knife are ultrasonic suction knives in a narrow sense.
The handle 5 has an ultrasonic transducer for generating ultrasonic waves.
And the cutter is used for outputting ultrasonic waves and generating corresponding negative pressure.
The negative pressure generating device is used for generating negative pressure and is communicated with the cutter through a pipeline, so that the tip of the cutter generates negative pressure. The negative pressure generating means may be a pump.
The control device 3 is used for acquiring the relative positions of the ultrasonic suction knife and the blood vessels in the three-dimensional model of the part to be operated, and obtaining control parameters of the ultrasonic suction knife system at least according to the relative positions, wherein the control parameters are used for controlling the ultrasonic suction knife to output corresponding ultrasonic waves and/or generate corresponding negative pressure. In other words, the control device 3 controls the ultrasonic transducer through control parameters to adjust the amplitude and pulse of the output ultrasonic wave, and controls the negative pressure generating device through control parameters to adjust the negative pressure of the cutter tip, so that the ultrasonic suction cutter system can efficiently remove the target tissue without damaging the blood vessel.
Because the difference of the thickness of the blood vessel has a certain influence on determining the relative position of the ultrasonic suction knife and the blood vessel, the control device 3 of the ultrasonic suction knife system should also consider the diameter of the blood vessel when determining the control parameter, and specifically comprises the following steps: obtaining the diameter of a blood vessel from the three-dimensional model; the diameter of the blood vessel in this embodiment is the outer diameter of the blood vessel; searching control parameters corresponding to the relative position and the diameter in a preset database; and setting the searched control parameters as the control parameters of the ultrasonic suction knife system.
Based on the above-mentioned surgical system and ultrasonic suction blade system, as shown in fig. 2, a flowchart of a control method for determining control parameters of the ultrasonic suction blade system according to a three-dimensional model of a part to be operated, positioning data of the part to be operated, and positioning data of the ultrasonic suction blade is shown, including:
step 201, obtaining a three-dimensional model of a part to be operated through a nerve navigation system, wherein the three-dimensional model at least comprises a blood vessel of the part to be operated and target tissues to be removed. The three-dimensional model can display the structure, the size and the like of target tissues and blood vessels to be removed in the part to be operated.
Step 202, determining the real-time relative position of the ultrasonic suction knife and a blood vessel of the to-be-operated position in the three-dimensional model by the nerve navigation system according to the three-dimensional model, the positioning data of the to-be-operated position and the real-time positioning data of the ultrasonic suction knife.
The method specifically comprises the following steps:
step 2021, acquiring positioning data of a part to be operated and real-time positioning data of an ultrasonic suction knife; because the position of the ultrasonic suction knife is continuously changed in the operation process, the positioning data of the ultrasonic suction knife needs to be acquired in real time. The positioning data of the to-be-operated part in this embodiment is the coordinate data of the key points of the to-be-operated part in the visual coordinate system, the coordinates of the key points can be obtained by using common positioning methods such as infrared, for example, brain operation, wherein the common key points of the brain are the positions of the eyebrow arch, the wing points (forehead, top, etc.), the cheekbone arch, etc., in one embodiment, the position sensing chip can be attached to the key points, the position sensing chip can be used for obtaining the position data of the key points through the coordinate data output by the position sensing chip, or the head-mounted device with the positioning function can be used for collecting the position coordinate data of the key points through the preset collecting points in the head-mounted device, so that the positioning data of the to-be-operated part can be obtained, and the three-dimensional structure of the to-be-operated part can be constructed in the visual coordinate system through the coordinate data of the key points.
The real-time positioning data of the ultrasonic suction tool in this embodiment refers to coordinate data of the key point (tool tip) of the ultrasonic suction tool in a space coordinate system. In this embodiment, when selecting the key point of the ultrasonic suction blade, in order to facilitate calculation, a point is selected at the end of the ultrasonic suction blade handle 5 as the handle origin position, and then the distance from the handle origin position to the blade tip is measured, so that only the handle origin position needs to be positioned, and then the positioning data of the blade tip of the ultrasonic suction blade is obtained through position conversion, therefore, in this embodiment, the positioning data of the ultrasonic suction blade includes: the ultrasonic suction tool comprises handle origin position coordinate data of the ultrasonic suction tool and distance data from the handle origin to the tool tip.
When the position of the origin of the handle is obtained in the embodiment, the position of the origin of the handle can be obtained by arranging a positioning label on the ultrasonic suction knife, and the position can also be obtained by infrared positioning. As shown in fig. 1, a positioning device 4 is disposed at the origin position of the handle, a chip or a circuit with an infrared receiving and transmitting function can be used as the positioning device, the positioning device 4 can receive and reflect infrared rays, a plurality of infrared rays are emitted by the position detecting device 1 in the nerve navigation system, and the position coordinate data of the origin of the handle can be obtained after being reflected by the positioning device 4.
Step 2022, according to the obtained positioning data of the to-be-operated position, performing overlapping positioning on the three-dimensional model and the to-be-operated position to obtain positioning data of a blood vessel of the to-be-operated position; the three-dimensional model obtained through various image data is under an image coordinate system, so that the three-dimensional model and the three-dimensional structure of the part to be operated are required to be displayed under a visual coordinate system in a coordinate change mode, and the positions of the target tissue and the blood vessel in the three-dimensional model in the visual coordinate system can be obtained. The above-mentioned process can be directly completed by registering in the existing nerve navigation system, as shown in fig. 1, which is output after being processed by the image processing model of the nerve navigation system.
Step 2023, determining the real-time relative position of the ultrasonic suction blade and the blood vessel according to the positioning data of the blood vessel and the acquired real-time positioning data of the ultrasonic suction blade.
In order to determine the real-time relative position of the ultrasonic suction knife and the blood vessel in the three-dimensional model, the position data of the key points under the space coordinate system of the ultrasonic suction knife is firstly introduced into the three-dimensional to-be-operated position structure constructed in the visual coordinate system through coordinate transformation, the three-dimensional to-be-operated position structure comprises target tissues and the blood vessel, and finally the real-time relative position of the ultrasonic suction knife and the blood vessel is calculated under the visual coordinate system.
Step 203, the ultrasonic suction knife system obtains the relative position of the ultrasonic suction knife and a blood vessel in a three-dimensional model of the part to be operated, and obtains the control parameters of the ultrasonic suction knife system at least according to the relative position; the control parameters are used for controlling the ultrasonic suction knife system to output corresponding ultrasonic waves and generating corresponding negative pressure. There may be multiple vessels in the three-dimensional model, with the ultrasonic aspiration blade system acquiring the relative position of the vessel closest to the ultrasonic aspiration blade.
According to the relative position of the ultrasonic suction knife and the blood vessel, the control parameter output by the ultrasonic suction knife can be determined, so that the ultrasonic suction knife can not damage the blood vessel under the control parameter.
Because the thickness of the blood vessel of the human body is larger, for example, the diameter of a capillary vessel is very small, and the diameter of an aortic blood vessel is larger, the relative position of the ultrasonic suction knife and the blood vessel is also influenced to a certain extent by the diameter, if the diameter of the blood vessel is too large, a large point is required to be arranged in the safety range of the relative position, and if the diameter of the blood vessel is small, a small point can be also arranged in the safety range of the relative position. In the case where the relative positions of the ultrasonic-aspiration blade and the blood vessel are the same, the diameters of the blood vessels are different, and thus the control parameters of the ultrasonic-aspiration blade system are also different, the determination of the control parameters of the ultrasonic-aspiration blade system includes:
obtaining the diameter of a blood vessel from the three-dimensional model; the diameter of the blood vessel in this embodiment refers to the outer diameter of the blood vessel.
And searching control parameters corresponding to the relative position and the diameter in a preset database. Therefore, the control parameters of the ultrasonic suction knife system are determined by the relative position and the diameter, manual setting is not needed, the relative position and the diameter can be automatically detected, manual intervention is not needed, errors caused by human factors are avoided, the accuracy of the control parameters is improved, and the damage to blood vessels can be effectively avoided.
And setting the searched control parameters as the control parameters of the ultrasonic suction knife system.
The ultrasonic suction tool system generally adjusts the control parameters by setting parameter gears, so the control parameters include the gear of the control parameters and the parameters of the gear corresponding to different relative positions and different blood vessel diameters.
Because many brain tumors have abundant blood supply and obvious blood vessel thickness difference, in the operation process, doctors are difficult to judge the blood vessel position accurately, and based on the control method of the ultrasonic aspiration knife system, fig. 3 shows a flow chart for eliminating tumors through the ultrasonic aspiration knife system when the part to be operated is the brain and the target tissue to be removed is the tumor, and the flow chart comprises the following steps:
step 101, prior to surgery, performing conventional skull CT or nuclear Magnetic Resonance (MRI) scanning on a to-be-operated part through a CT device or a nuclear magnetic resonance instrument to determine the position, range and type of the tumor and the hemodynamic information of the tumor to be resected.
It should be noted that, in order to obtain the hemodynamic information of the tumor to be resected more accurately, a perfusion imaging mode may be used to better image the tumor to be resected.
Step 102, according to the tumor type to be resected, a command corresponding to the tumor type is input through a human-computer interaction system to query a tumor database, and according to the control parameter corresponding to the tumor of the type to be resected in the past, the control parameter is used as a first control parameter, and the first control parameter is configured for an ultrasonic suction knife system through an ultrasonic suction knife system control device.
Step 103, after the cranium bone formation window is opened, detecting the tumor outside the dura mater by an ultrasonic probe to obtain the preliminary range and size of the tumor so as to determine the range and size of the dura mater incision, detecting the brain tissue surface by the ultrasonic probe after the dura mater is incised, further obtaining the accurate range, size and position of the tumor, the depth of the tumor from the dura mater, lesion echo, tumor boundary and tumor and peripheral relationship, and tumor internal and peripheral blood flow information, judging whether the first control parameter needs to be finely adjusted by a control device of the ultrasonic suction knife system or judging whether an instruction for finely adjusting the first control parameter input by a user is received by the control device of the ultrasonic suction knife system according to the information; if the fine adjustment is needed, fine adjustment is performed on the first control parameter according to a fine adjustment instruction input by a user so as to obtain a second control parameter, for example, the second control parameter is obtained according to a preset empirical formula based on the first control parameter; otherwise, the control device of the ultrasonic suction knife system continues to control the ultrasonic suction knife to output by the first control parameter.
Step 104, in the process of performing the operation, determining whether to automatically adjust the control parameters thereof by the control device of the ultrasonic suction knife system according to the change of the tumor or the surrounding situation, if the control device is required to automatically adjust, the control device of the ultrasonic suction knife system automatically adjusts the control parameters according to the received control instruction, specifically, step 105; if the automatic adjustment of the control device is not needed, the output of the ultrasonic suction knife system is continuously controlled by the current control parameters.
Step 105, the control device of the ultrasonic suction knife system acquires the real-time relative position of the ultrasonic suction knife and the blood vessel from the nerve navigation system.
The specific implementation process of determining the real-time relative position of the ultrasonic suction tool and the blood vessel by the nerve guidance system is described in detail above, and will not be repeated here.
And 106, determining corresponding control parameters by the control device of the ultrasonic suction knife system according to the acquired relative position of the ultrasonic suction knife and the blood vessel, the diameter parameters of the blood vessel and the preset safety range.
Judging the relative position between the ultrasonic suction knife and the blood vessel according to the control device, and if the relative position is smaller than the safety range, combining the blood vessel diameter parameters (such as the blood vessel outer diameter), and selecting corresponding control parameters in a preset database to control the output of the ultrasonic suction knife system; if the relative position is greater than the safety range, the output of the ultrasonic suction knife system is continuously controlled by the current control parameters.
The specific implementation process of determining the corresponding control parameters by the control device of the ultrasonic suction tool system according to the obtained relative position of the ultrasonic suction tool and the blood vessel, the diameter parameters of the blood vessel and the preset safety range is described in detail in the foregoing, and is not repeated here.
And 107, configuring the determined control parameters to the ultrasonic suction knife system through a control device of the ultrasonic suction knife system so that the ultrasonic suction knife outputs corresponding ultrasonic waves and/or corresponding negative pressure to clear the tumor.
According to the embodiment, probability data of vascular injuries with different diameters under different control parameters are obtained through experiments, and a safe control parameter database of the vascular injuries with different diameters is obtained by combining clinical experiments and clinical experience data. The database can be built in the ultrasonic suction knife system or can be used for inquiring by the control device through communication connection with the ultrasonic suction knife system. Table 1 is the control parameters which are determined to be suitable for different types of tumors according to clinical trial and clinical experience data, and table 2 is the control parameters and the vascular injury probability which are obtained after the automatic adjustment according to the control device.
Tumor type Amplitude of vibration Negative pressure Pulse
Glioma A5 B3 C5
Meningioma A3 B3 C5
TABLE 1
Amplitude of vibration Negative pressure Pulse Diameter of blood vessel Probability of vascular injury
A5.1 B3.1 C5.1 D1 X1
A3.1 B3.1 C5.1 D2 X2
TABLE 2
In table 1, glioma and meningioma are taken as examples respectively, according to the types of the two tumors, the first control parameters (amplitude, negative pressure and pulse) of the ultrasonic suction knife are obtained by inquiring a tumor type and ultrasonic suction knife control parameter database, and in table 2, the control parameters obtained after the first control parameters are adjusted by the control device are used, and the damage probability of the blood vessel can be obtained by combining the diameters of the blood vessel. The database is obtained according to clinical tests, so that the more proper corresponding relation between different relative positions, different blood vessel diameters and different control parameters can be obtained.
The foregoing description of the invention has been presented for purposes of illustration and description, and is not intended to be limiting. Several simple deductions, modifications or substitutions may also be made by a person skilled in the art to which the invention pertains, based on the idea of the invention.

Claims (4)

1. The surgical system is characterized by comprising a nerve navigation system and an ultrasonic suction knife system, wherein the nerve navigation system is used for generating a three-dimensional model of a part to be operated, and the three-dimensional model at least comprises a blood vessel of the part to be operated and target tissues to be removed; the three-dimensional model is overlapped with the to-be-operated position according to the acquired positioning data of the to-be-operated position, so as to obtain the positioning data of the blood vessel of the to-be-operated position; determining the real-time relative position of the ultrasonic suction knife and the blood vessel according to the positioning data of the blood vessel and the acquired real-time positioning data of the ultrasonic suction knife; the positioning data of the to-be-operated position are position coordinate data of key points of the to-be-operated position;
the ultrasonic suction knife system is used for acquiring the relative position of the ultrasonic suction knife and a blood vessel in a three-dimensional model of the part to be operated, obtaining control parameters of the ultrasonic suction knife system at least according to the relative position, and controlling the ultrasonic suction knife to output corresponding ultrasonic waves and/or generate corresponding negative pressure through the control parameters.
2. The surgical system of claim 1, wherein the neuro-navigation system generates a three-dimensional model of the site to be operated on, comprising:
acquiring imaging data of a part to be operated on and imaging data of blood vessels of the part to be operated on;
processing imaging data of the to-be-operated position and imaging data of blood vessels of the to-be-operated position to generate a three-dimensional model of the to-be-operated position.
3. The surgical system of claim 1, wherein the ultrasonic-aspiration-blade-system-based at least on the relative positions, deriving control parameters of the ultrasonic-aspiration-blade-system comprises:
obtaining the diameter of the blood vessel;
searching control parameters corresponding to the relative position and the diameter in a preset database;
and setting the searched control parameters as the control parameters of the ultrasonic suction knife system.
4. The ultrasonic suction knife system comprises a handle, a knife and a control device, wherein the control device is connected with the handle, the handle is connected with the knife, and the knife is used for outputting ultrasonic waves and generating corresponding negative pressure;
the relative position is determined according to the three-dimensional model of the to-be-operated position, the positioning data of the to-be-operated position and the positioning data of the ultrasonic suction knife, and the three-dimensional model and the to-be-operated position are subjected to overlapped positioning to obtain the positioning data of the blood vessel of the to-be-operated position; determining the real-time relative position of the ultrasonic suction knife and the blood vessel according to the positioning data of the blood vessel and the acquired real-time positioning data of the ultrasonic suction knife; the positioning data of the to-be-operated position are position coordinate data of key points of the to-be-operated position; the three-dimensional model of the to-be-operated position at least comprises a blood vessel of the to-be-operated position and target tissues to be removed.
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