CN117481753B

CN117481753B - Method and device for monitoring movement track of water jet knife based on endoscope

Info

Publication number: CN117481753B
Application number: CN202311841041.9A
Authority: CN
Inventors: 赵静; 史策; 陈文波; 史轶伦
Original assignee: Beijing Zhiyu Medical Technology Co ltd
Current assignee: Beijing Zhiyu Medical Technology Co ltd
Priority date: 2023-12-29
Filing date: 2023-12-29
Publication date: 2024-04-05
Anticipated expiration: 2043-12-29
Also published as: CN117481753A

Abstract

A monitoring method based on the water knife movement position track parameter of the endoscope, the water knife can carry out linear movement and rotary movement according to the planned movement track, and jet water jet to carry out tissue excision; the planned movement track is defined by water jet movement position track parameters; the endoscope has a following motion mode, and the endoscope can at least linearly move along the water knife according to a following motion track in the following motion mode; the following motion track is defined by a following motion position track parameter; determining a following movement position track parameter of the endoscope based on the planned movement position track parameter of the water jet; the endoscope monitors the movement position track parameters of the water jet knife in real time in a following movement mode. The method and the device can effectively, accurately and timely monitor the execution condition in the water jet operation process.

Description

Method and device for monitoring movement track of water jet knife based on endoscope

Technical Field

The application relates to a monitoring method and a device of operation execution equipment, in particular to a monitoring method and a device for a movement track of a water knife in an actual operation process based on an endoscope.

Background

In recent years, with the progress of medical technology, minimally invasive surgery using image-guided surgery performing equipment such as a water jet scalpel has been increasingly popular. For example, in a water jet minimally invasive surgery, an ablation or excision track can be planned in advance based on medical images, so that the water jet performs a surgical action according to the planned ablation or excision track, and ablation or excision of tissue is completed.

However, the medical image used for planning is usually an image before tissue ablation, and even if planning is performed based on a real-time ultrasound image, only the state before the tissue is ablated may be reflected, and during the operation, the state of the tissue to be ablated and the surrounding tissue may have been changed along with the progress of the ablation action, and this change may cause the actual operation execution trajectory to be different from the previously planned operation execution trajectory, resulting in deviation. Deviations are sometimes caused by equipment malfunctions, for example when the water knife is loose but the driving part is not aware that this is still performing the moving driving of the water knife. More may be independent of equipment failure or trajectory planning, but due to, for example, a surgical environment or a patient's special physique. Deviations are undesirable for any reason, since, on the one hand, deviations are taken to mean deviations of the execution trajectory from the planned target trajectory, so that the surgery that should have been performed in accordance with the planned trajectory is not precisely controlled, and, on the other hand, deviations may lead to unnecessary damage to the patient. Therefore, it is necessary to monitor the actual operation execution track in real time, on the one hand, it can be ensured that the operation is performed according to the planned target track based on the closed loop feedback mechanism, and when the deviation is detected, the actual operation execution track is timely adjusted, and more importantly, the real time monitoring of the actual operation execution track can further ensure the operation safety, especially, the additional protection of sensitive positions such as the vernix and the like when the prostatoplasia excision operation is performed is particularly important, and even if the operation is performed according to the planned track, the operation may cause damage; the accurate real-time operation execution track monitoring is realized, so that the accurate control of the operation process based on planning can be ensured to the greatest extent, and the operation damage can be avoided to the greatest extent.

However, there are many difficulties in real-time monitoring of the actual surgical execution trajectory of the water jet, mainly because: because the water jet needs to be sprayed with high-pressure water jet in the operation process to form a water column region, a large amount of artifacts and noise exist in the ultrasonic image, the real-time ultrasonic image can only be used for rough observation, and can not be used for accurately calculating specific parameters related to the actual operation execution track of the water jet, so that the real-time monitoring of the actual operation execution track of the water jet can not be realized.

Some researchers also propose monitoring methods based on endoscopes, but because the water knife is in a motion state in the operation process, a manual operation or image tracking control mode is generally adopted to enable the endoscope to observe the water knife, but manual operation of the endoscope is time-consuming and labor-consuming; the image tracking algorithm is usually complex in program implementation, real-time effective tracking of an operation area is difficult to realize, and the real-time calculation of specific parameters related to the actual operation execution track of the water jet scalpel is more difficult to realize due to the fact that the overall operation amount is large and the calculation speed is low by combining with the monitoring calculation of track parameters. In addition, the water jet sprayed during the water jet operation can cause the blurring phenomenon to be very easy to occur in the image observed through the endoscope, so that the definition of the water jet observed through the endoscope is reduced. In addition, when the water jet scalpel is used in a surgical scene for hyperplasia and excision of the prostate, the problem of insufficient view through the endoscope is caused because surrounding tissues are squeezed to collapse during the insertion of the endoscope, so that the view of the endoscope is blocked.

Disclosure of Invention

In order to solve the technical problems, the application provides a monitoring method of a water knife movement position track parameter based on an endoscope, which is characterized in that,

the water knife can perform linear motion and rotary motion according to the planned motion track, and jet water jet to perform tissue excision; the planned movement track is defined by water jet movement position track parameters, and the water jet movement position track parameters comprise linear movement position track parameters, rotary movement position track parameters and/or jet length track parameters;

the endoscope has a following motion mode, and the endoscope can at least linearly move along the water knife according to a following motion track in the following motion mode; the following motion track is defined by following motion position track parameters, and the following motion position track parameters at least comprise linear following motion position track parameters;

determining a following movement position track parameter of the endoscope based on the planned movement position track parameter of the water jet;

the endoscope monitors the movement position track parameters of the water jet knife in real time in a following movement mode.

Further, the endoscope also has an autonomous movement mode.

Further, the endoscope and the water jet blade share a sheath or the sheath of the endoscope and the sheath of the water jet blade are integrally formed.

Further, the linear motion directions of the endoscope and the water jet are parallel to each other, the endoscope is positioned behind the water jet, and a preset distance is reserved between an observation lens of the endoscope and the water jet injection part.

Further, the movement track of the water jet is an array combination of water jet movement position track parameters of a plurality of step sizes, and the following movement track is determined according to the water jet movement position track parameters contained in the array of each step size.

Further, the following motion position track parameter is determined according to the tissue collapse visual distance and/or the optimal working distance of the endoscope.

Further, image segmentation processing is carried out on the endoscope image of the water jet movement acquired by the endoscope in real time, and the jet length track parameters are determined.

Further, based on a comparison result of a rotation angle range in a preset track of the water jet and a tissue collapse visible angle range, the value of the waterjet_visible is determined, and the rotation movement position track parameters of the water jet are monitored by adopting different algorithms based on different values of the waterjet_visible.

Further, the endoscope obtains an actual measurement value of the track parameter of the rotary motion position by monitoring the swing angle and/or the swing frequency of the water jet in real time; and/or the endoscope obtains the actual measurement value of the jet length track parameter by monitoring the length of the water jet in real time.

Further, when the water jet is within the view field of the endoscope, the oscillation frequency of the water jet is calculated based on the water jet image of the same endoscope observation angle with an even number of steps in the monitoring image of the endoscope, and when the water jet is not within the view field of the endoscope, the oscillation frequency of the water jet is calculated based on the water jet feature point image of the same endoscope observation angle with an even number of steps in the monitoring image of the endoscope.

Further, the endoscope acquires a real-time monitoring image, identifies a sensitive part through an image segmentation algorithm, determines a non-removal area, and determines the safety risk of the planned motion trail based on overlapping comparison of the non-removal area and the planned removal area.

Further, detecting a sensitive part in the organism tissue from the monitoring image of the endoscope, calculating the safe excision depth for the sensitive part based on the actual position and the removal safety distance of the sensitive part in the monitoring image of the endoscope, and determining the safety risk of planning the movement track based on the comparison of the safe excision depth and the planned jet length track parameter.

Further, the endoscope has a lens with an adjustable tilt angle, and the following motion trajectory parameters of the endoscope include rotation following motion position trajectory parameters.

The application also provides a monitoring devices of water sword motion position orbit parameter based on endoscope, including water sword, endoscope, water sword drive division, endoscope drive division, control division, its characterized in that:

the water knife can perform linear motion and rotary motion according to the planned motion track under the drive of the water knife driving part, and jet water jet to perform tissue excision; the planned movement track is defined by water jet movement position track parameters, and the water jet movement position track parameters comprise linear movement position track parameters, rotary movement position track parameters and/or jet length position track parameters;

the endoscope moves under the drive of the endoscope driving part and has a following movement mode, and the endoscope can move at least linearly along the water knife according to the following movement track in the following movement mode; the following motion track is defined by following motion position track parameters, and the following motion position track parameters at least comprise linear following motion position track parameters;

The control part determines a following movement position track parameter of the endoscope based on the planned movement position track parameter of the water jet and sends the following movement position track parameter to the endoscope driving part;

The application also provides a monitoring devices of water sword motion position orbit parameter based on endoscope, including water sword, endoscope, water sword drive division, endoscope drive division, control division, its characterized in that: the apparatus is capable of performing the aforementioned method.

According to the scheme provided by the application, the technical problem in the background technology can be effectively solved, the effective, accurate and real-time monitoring and calculation are carried out aiming at the specific parameters related to the actual operation execution track of the water jet knife in the actual operation process, the method is particularly suitable for an automatic water jet knife system, and when the water jet knife moves according to the planned operation execution track to execute tissue ablation or excision operation, the scheme can carry out real-time monitoring on the actual movement position track parameters of the water jet knife, and is beneficial to realizing adjustment on the planned movement position track parameters based on real-time monitoring results; the method and the device can monitor the working area of the water knife, particularly the area related to the sensitive part, evaluate and determine the safety risk of the pre-planned movement track based on the real-time monitoring result, pre-trigger an alarm mechanism or modify a planning scheme to reduce damage before the water knife executes ablation or excision according to the safety risk evaluation result, and correct the pre-planned movement position track parameter according to the real-time monitoring result so as to fully ensure the safety of the actual operation process.

Drawings

Fig. 1 is a schematic structural view of a surgical execution apparatus according to an embodiment of the present application.

Fig. 2 is a schematic cross-sectional view of a surgical execution device according to an embodiment of the present application.

Fig. 3 is a view schematically showing the field of view of the endoscope.

Fig. 4 is a diagram schematically illustrating a sensitive site within a patient lumen.

Fig. 5 is a diagram schematically showing a method of measuring the excision depth of a water jet.

Fig. 6 is a view showing a tiltable endoscope.

FIG. 7 is a diagram of a surgical procedure for a tissue ablation instrument in accordance with an embodiment of the present application.

Detailed Description

Various exemplary embodiments of the present application are described in detail below with reference to the accompanying drawings. The description of the exemplary embodiments is merely illustrative, and is in no way intended to limit the application, uses, or uses of the invention. This application may be embodied in many different forms and is not limited to the embodiments described herein. These embodiments are provided so that this disclosure will be thorough and complete, and will fully convey the scope of the disclosure to those skilled in the art. It should be noted that: the relative arrangement of parts and steps, numerical expressions and values, etc. set forth in these embodiments are to be construed as illustrative only and not as limiting unless otherwise stated. All terms (including technical or scientific terms) used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this application belongs unless specifically defined otherwise. It will be further understood that terms, such as those defined in commonly used dictionaries, should be interpreted as having a meaning that is consistent with their meaning in the context of the relevant art and will not be interpreted in an idealized or overly formal sense unless expressly so defined herein. Parameters of, and interrelationships between, components, and control circuitry for, components, specific models of components, etc., which are not described in detail in this section, can be considered as techniques, methods, and apparatus known to one of ordinary skill in the relevant art, but are considered as part of the specification where appropriate.

As used in this application, the word "comprising" or "comprises" and the like means that elements preceding the word encompass the elements recited after the word, and that no other elements are excluded from the possible coverage.

And, in this application, "front" or "distal" or "tip" means the orientation of the surgical instrument (water knife or endoscope) closer to the tissue or surgical area, and "rear" or "proximal" means the orientation of the surgical instrument (water knife or endoscope) closer to the operator.

Fig. 1 is a schematic structural view of a surgical execution apparatus according to an embodiment of the present application. Typically, the surgical performance device includes a water knife and a monitoring device for its trajectory. As shown in fig. 1, the surgical instrument includes a water jet and an endoscope at the distal end thereof, and a water jet drive unit, an endoscope drive unit 4, and a control unit at the distal end thereof. The control part is electrically connected with the water knife driving part, the water knife driving part is in driving connection with the water knife, the control part is also electrically connected with the endoscope driving part, and the endoscope driving part is in driving connection with the endoscope.

The water jet knife comprises a sheath and a movable high-pressure-resistant pipeline arranged in the sheath, and the front end of the high-pressure-resistant pipeline can jet high-pressure water jet to ablate or cut tissues. In this application, the water jet blade refers to a front end portion (also referred to as a water jet injection portion or a nozzle) of the water jet of the high pressure resistant pipe, and a portion of the high pressure resistant pipe other than the blade is also referred to as a blade. In addition, in this application, no strict distinction is made between "ablation" or "excision", both of which are similar in meaning, also referred to as "ablation" in some contexts; the water jet or the water column is not strictly distinguished, and refers to high-pressure water jet sprayed from a water knife head.

The control part is electrically connected with the water knife driving part, and the water knife enters a target tissue area (can enter through the urethra or the perineum in the prostate hyperplasia excision operation environment) under the driving of the water knife driving part and performs ablation or excision by injecting high-pressure water jet.

The water jet moves according to a planned path, which may be a path pre-designed by a doctor or a processor based on image information. And taking the track formed by the movement of the planned path as a planned movement track, wherein the planned movement track can be a movement control position track generated by an image planning module according to the fitting of the continuous boundary position track planned in advance on the navigation image.

The water knife can perform linear motion and/or rotary motion under the drive of the water knife driving part, the linear motion of the water knife refers to the motion process that the water knife advances or retreats along the linear direction defined by the water knife sheath channel, the rotary motion of the water knife is that the water knife rotates relative to the axis direction of the water knife body, and the water jet is sprayed by the knife head while rotating, so that ablation or removal of target tissues is performed in a scanning mode.

In addition to the linear motion and/or the rotary motion of the water jet, the water jet also sprays high-pressure water jet from the water jet head, the length of the water jet represents the distance of the action point of the water jet, and the length of the water jet is also an important parameter for describing the motion track of the water jet because the length of the water jet is controllable through a pipeline and a hydraulic power module.

In order to characterize the above-mentioned motion process of the water jet, in this application, the motion locus of the water jet is defined by the motion locus parameter of the water jet, the motion locus parameter of the water jet represents the position of the water jet action point of the water jet under the water jet coordinate system, the motion control module can make the water jet move according to the preset motion locus parameter through the water jet motion control motor, the pipeline and the hydraulic pump of the hydraulic power module, and the preset motion locus parameter can be determined based on the planned motion locus.

Preferably, the linear motion position track parameter for representing the linear motion of the water jet blade can be the long axis position of the jet flow of the action point and/or the long axis speed of the jet flow of the action point under the coordinate system of the water jet blade; the track parameter of the rotary motion position for representing the rotary motion of the water jet knife can be an included angle of the cross section of the action point and/or the rotary speed of the cross section; the jet length trajectory parameter representing the length of the water jet (i.e., the distance between the water jet injection portion and the point of action) injected by the water jet cutter head can be the point of action jet length.

In the present application, the endoscope is provided with a follow-up movement mode, and for this purpose, the endoscope is disposed in the vicinity of the water blade, the axis of the endoscope and the axis of the water blade are parallel to each other, and the directions of linear movement of the endoscope and the water blade are also parallel to each other.

The endoscope may be disposed near the water jet in various fixed mounting manners, for example, the endoscope and the water jet share one sheath, the endoscope and the water jet are respectively disposed in two parallel channels defined by the sheath, or the endoscope and the water jet are respectively provided with independent sheaths, but the sheath provided with the endoscope and the sheath provided with the water jet are integrally formed, or both are fixedly mounted with respect to the same base. The endoscope and the water knife are arranged to share the sheath or the sheath of the two is integrally formed, so that the fixation of the relative motion path of the endoscope and the water knife is facilitated, the correspondence consistency of the relation between the following motion track of the endoscope and the motion track of the water knife is ensured, and the stability of the following motion of the endoscope is facilitated.

The control unit is also electrically connected to the endoscope driving unit, and the endoscope is driven by the endoscope driving unit to enter the target tissue region. The endoscope captures images of the water jet blade and the tissue environment in the vicinity thereof, acquires images in the field of view of the endoscope in real time, and transmits the acquired endoscopic image data to the control unit.

The endoscope is driven by the endoscope driving section to perform a linear motion and/or a rotational motion, wherein the linear motion is a motion process in which the endoscope advances or retreats in a linear direction defined by the endoscope sheath channel, and the rotational motion is selectable, for example, the endoscope is rotated relative to the endoscope in an axial direction in order to adjust the view of the endoscope.

In the application, the endoscope has a following motion mode, and in the following motion mode, the endoscope can follow the water knife to perform at least linear motion according to a following motion track, and the linear motion of the endoscope is synchronous with the linear motion of the water knife.

In the following motion mode in some embodiments, the endoscope is configured to move only linearly with the water blade, but not rotationally with the water blade, to facilitate the endoscope to observe the linear and rotational movement of the water blade at a fixed viewing angle.

In other embodiments, the endoscope is arranged to move linearly along with the water knife and also to move rotationally along with the water knife in a follow-up mode, so that the water knife and the water column which move rotationally are in the observation field of the endoscope.

In order to realize the following motion mode of the endoscope, the control part generates the following motion track of the endoscope based on the planned motion track of the water jet and sends the generated following motion track of the endoscope to the endoscope driving part for controlling the endoscope to move according to the following motion track.

The following motion track of the endoscope is defined by a following motion position track parameter, and the following motion position track parameter at least comprises a linear following motion position track parameter. The linear following movement position track parameter is determined based on the linear movement position track parameter of the water knife.

The endoscope may also have an autonomous mode of motion in which the endoscope independently performs linear and/or rotational movement within the endoscope sheath channel independent of the linear and/or rotational movement of the water blade.

The user can select the movement mode of the endoscope through the control part or the similar mechanism to meet the requirements of different scenes, for example, in the stage of debugging the preoperative equipment, the endoscope can be selected to enter an autonomous movement mode, the endoscope is manually controlled or driven by a motor to move in a sheath channel of the endoscope, related parameters are collected, and the track parameters of the following movement position are set or updated based on the collected parameters. When the water knife is in place and is ready to start the elimination or ablation operation on the tissues, the endoscope is selected to enter a following movement mode, and the motor is used for driving the endoscope to move, so that real-time monitoring of actual movement position track parameters in the working process of the water knife can be realized.

Preferably, the image acquisition unit of the endoscope acquires an image and transmits the image to the control part, and the control part analyzes the image data after acquiring the image data and adjusts the planned movement track of the water jet and the following movement track of the endoscope based on the analysis result of the image data.

The control part can convert the planned motion track or parameter into a motion position track parameter, for example, convert the motion track or parameter planned and set by a doctor in an image coordinate system into a motion control position track or parameter and further convert the motion control position track or parameter into a motion position track parameter under a water jet coordinate system; or directly converting the received planned motion track or parameter or motion control position track or parameter into the motion position track parameter under the water jet coordinate system.

The control part can directly acquire the water jet movement position track parameters, the water jet movement position track parameters are determined based on the pre-planned movement track, and the control part sends the water jet movement position track parameters determined based on the pre-planned movement track to the water jet driving part so as to drive the water jet to move according to the water jet movement position track parameters.

The motion position track parameters comprise: linear motion position trajectory parameters, rotational motion position trajectory parameters, and jet length trajectory parameters.

The linear motion position track parameters can be the long axis position z and/or the long axis speed Vz of the jet of the action point under the water jet coordinate system, and the rotation motion position track parameters can be the cross section included angle theta and/or the cross section rotation speed V of the action point under the water jet coordinate system _θ The jet length position track parameter can be the jet length R of an action point under a water jet coordinate system.

Further, the linear motion position trajectory parameters may include a linear velocity Vz, a linear start position z_start, a linear end position z_stop, and the like; the rotational movement position trajectory parameter may include a rotational speed V _θ A rotation start angle θ_start, a rotation end angle θ_stop, and the like; jet length trajectory parameters may include jet length R, ablation depth D, and the like.

The overall motion track of the water jet can be divided into a plurality of step sizes, and motion position track parameters in the step sizes are given on the basis of each step size. The motion position trajectory parameters for each step may be represented by an array, for example: [ { stepNO, z_start, z_stop, vz, θ_start, θ_stop, V _θ , R}]Wherein stepNO is the step number of the water knife movement, z_start is the linear starting position of the water knife in the step, z_stop is the linear ending position of the water knife in the step, vz is the linear speed of the water knife movement in the step, θ_start is the rotation starting angle of the water knife in the step, and θ_stop is the rotation ending of the water knife in the stepAngle V _θ For the rotation speed of the water jet in the step length, R is the jet length of the water jet in the step length, alternatively, the jet length track parameter in the step length can be expressed by the cutting depth D of the water jet in the step length, and in the application, the cutting depth D and the jet length R are regarded as approximately equal parameters.

By representing the motion position track parameters of the water jet by the array of each step, the motion track of part or whole of the water jet can be expressed by the combination of the motion position track parameter arrays of each step.

The length of each step may be appropriately set according to the surgical scene and the surgical target. For example, in the case of a hyperplasia excision or ablation operation, the length of each step length of the movement track of the water jet knife is set to be in the order of magnitude of mm, so that the control precision requirement of the operation process can be basically met, and precise and controllable excision control is realized. For scenes with low requirements on surgical accuracy, the length of each step can be set to a larger value.

In order to monitor actual movement position track parameters in the working process of the water knife by using the endoscope, the endoscope is provided with a following movement mode, and in the following movement mode, the endoscope moves along the water knife according to the following movement track. Therefore, the control unit needs to determine the following motion trajectory of the endoscope in advance based on the planned motion trajectory of the water jet. Specifically, the following motion position track parameter of the endoscope is determined based on the planned motion position track parameter of the water jet.

For the situation that the overall motion track of the water jet is divided into a plurality of step sizes and motion position track parameters in the step sizes are given on the basis of each step size, the following motion track of the endoscope is also divided into a plurality of step sizes, the following motion position track parameters in each step size of the endoscope are generated on the basis of the motion position track parameters in each step size of the water jet, and the following motion track of the endoscope is expressed by the combination of the following motion position track parameter arrays of the respective step sizes of the endoscope.

Specifically, the motion position trajectory parameter of each step of the water jet is expressed as [ { stepNO, z_start, z_stop, vz, θ_start, θ_stop, V _θ , R}]The following motion position trajectory parameter for each step of the endoscope is expressed as [ { CtepNO, cz_start, cz_stop, CVz }]Determining a step number CtepNO of the corresponding follow-up movement of the endoscope based on the step number stepNO in the planned movement position track parameter of the water jet; determining a linear starting position Cz_start of the endoscope in the step length based on the linear starting position z_start of the water knife in the step length; determining the linear ending position Cz_stop of the endoscope in the step length based on the linear ending position z_stop of the water knife in the step length; the linear movement speed CVz of the endoscope is determined based on the linear movement speed Vz of the water jet.

Preferably, the endoscope has a step length consistent with that of the water jet and a linear motion speed consistent with that of the water jet, and cstepno=stepno, cvz=vz can be set. Further, it is preferable to set the linear movement time in each step of the endoscope and the linear movement time in each step of the water jet to coincide, so that the linear movement speed CVz of the endoscope is calculated by CVz =vz× (cz_stop-cz_start)/(z_stop-z_start).

Because the water jet injection part of the water jet continuously injects water jet to form a water column (gas-liquid mixture generally containing cavitation air clusters) in a radial state in a working state, the observation lens of the endoscope cannot realize clear observation if the observation lens is inevitably interfered by visual interference of water column radiation under the water jet injection part, and if the observation lens of the endoscope is arranged at the front end of the water jet injection part, the movement area of the endoscope exceeds the movement area of the water jet, so that the movement area of the water jet is limited under the same insertion depth. In order to realize clear observation of the endoscope on the water knife, the endoscope is arranged behind the water knife, and a preset distance S is arranged between an observation lens of the endoscope and the water jet injection part. In this way, endoscopic viewing can be made to avoid both interference caused by the injected water jet and to help provide an improved viewing field and viewing effect with an unrestricted surgical field. Further, after the step S is determined, the linear start position cz_start of each step in the track parameter of the following movement position of the endoscope can be determined according to the linear start position z_start of each step in the track parameter of the planning movement position of the water jet, and the linear end position cz_stop of each step in the track parameter of the following movement position of the endoscope can be determined according to the linear end position z_stop of each step in the track parameter of the planning movement position of the water jet. Specifically, in performing the prostatectomy, the water jet and the endoscope are moved to the most distal position (starting from the position) in synchronization, and then the endoscope is driven to retreat to the rear of the water jet injection part, and the endoscope is set at a position at a distance S behind the water jet, and accordingly, a straight line start position cz_start=z_start+s and a straight line end position cz_stop=z_stop+s of the endoscope among the following movement track parameters of the endoscope are set.

After the endoscope and the water knife are staggered backwards by a certain distance in the axial direction, the water knife can spray water jet without shielding, the endoscope can not shield the water jet sprayed by the water knife, and the effective shooting of the endoscope on the water jet of the water knife is possible. However, it is not sufficient to provide only the endoscope behind the water jet by a predetermined distance, the manner of determination of S is an important factor in achieving clear observation,

fig. 3 is a view of a view range visible region of an endoscope, where C is a substantial center of the endoscope, a is imaging of a water knife in the view of the endoscope, and E is a water jet, i.e., a water column, ejected from a water jet ejection unit. When the track parameters of the following movement position of the endoscope are determined, the view of the endoscope needs to be ensured to be clearly observed, so that the image information of the water jet A and the water jet E is utilized for calculation processing.

Because of the differences in shooting capabilities of different endoscopes, the present application introduces the parameter endoscope optimal working distance L when determining the distance between the endoscope lens and the water jet blade head in order to ensure clear imaging. The optimal working distance L of the endoscope, which represents the distance that an object can be clearly imaged from the lens of the endoscope, is generally related to the focal length of the endoscope, and in this application represents the optimal working distance between the lens of the endoscope and the water jet blade, within which the water jet blade a and the water jet E in the field of view can be clearly imaged by the endoscope. L can be determined beforehand by experiments. For example, in the autonomous movement mode, the water jet is driven to enter the target tissue region, then the movement is stopped, the endoscope is driven to advance to the vicinity of the water jet head in the sheath channel of the endoscope and reciprocate until the region where the images of the water jet head A and the water column E can be clearly observed through the endoscope, the positions of the region where the images of the water jet head A and the water column E can be clearly observed are recorded, and the optimal working distance L of the endoscope is determined according to the recorded positions.

The optimal working distance L of the endoscope can be a numerical range or a group of numerical values which are related to the water knife position and dynamically change, namely, different optimal working distances L of the endoscope can be determined according to different water knife fixing positions P, and the group corresponding to the optimal working distance L of the endoscope and the water knife position P is stored.

The following movement position locus parameter of the endoscope may be determined based on the endoscope optimum working distance L, for example, a straight line start position cz_start=z_start+l and a straight line end position cz_stop=z_stop+l of the endoscope among the straight line following movement position locus parameters of the endoscope are set.

When the water jet is inserted into human tissue, tissue collapse is formed around the water jet, and in particular, the water jet is inserted through the urethra in a hyperplasia and resection operation, surrounding hyperplasia tissue of the prostate is extruded to generate shrinkage collapse, and the tissue is enclosed around the water jet, as shown in fig. 3, B, D, F represents the tissue which appears in the view of an endoscope due to extrusion deformation of surrounding tissue caused by the insertion of the water jet.

The inventor finds through repeated experiments that, because the extruded tissue is soft and deformable, the formed shielding of the view of the lens of the endoscope occurs in the movement process of the surgical instrument, and the shielding degree is related to the volume and the texture of the tissue and the distance between the endoscope and the water jet scalpel head. For example, when the endoscope is next to the water knife blade, little or no tissue collapse effect will occur in the endoscope field of view or less will affect the view as the previously inserted water knife blade provides some bracing and expanding action to the surrounding tissue; when the distance between the endoscope and the water knife head is far, the expansion effect of the water knife head inserted in front on the surrounding tissues is eliminated, the collapsing effect of the tissue around the knife body is obvious, and the serious situation almost causes the shielding of the whole view of the endoscope.

In order to solve the problem, the method introduces a parameter tissue collapse visual distance T, wherein the parameter tissue collapse visual distance T is a distance value between an endoscope and a water knife tool bit and is used for representing the influence of a tissue collapse effect on the view of the endoscope. The visual distance T of tissue collapse of different tissue parts in an ultrasonic image when the water knife is inserted is obtained in advance through experiments. For example, in the autonomous movement mode, the water knife is driven to enter the target tissue region and then stops moving, and then the endoscope is driven to advance in the sheath channel of the endoscope to be right below the water knife head and gradually away from the water knife head, so that a water column E can be observed in the visual field of the endoscope within the visual tissue collapse distance T, and the visual field of the endoscope is blocked due to the influence of tissue shrinkage, extrusion and wrapping after the water column E exceeds the visual field of the endoscope. The distance between the endoscope and the water jet scalpel head corresponding to the position is recorded as the tissue collapse visible distance T, taking the limit that the endoscope view is not blocked to the position of the small part of the blocked or blocked area. In other words, the visual distance T of tissue collapse refers to a distance near the water jet blade head that has not been or is less affected by occlusion of tissue compression deformation.

The tissue collapse visual distance T can be a numerical range or a group of numerical values of dynamic change related to the water knife position, namely different tissue collapse visual distances T can be determined according to different water knife fixing positions P, and the tissue collapse visual distance T is stored in an array corresponding to the water knife position P.

Further, the following movement position trajectory parameter of the endoscope may be determined based on the tissue collapse visual distance T, and a straight line start position cz_start=z_start+t of the endoscope among the straight line following movement position trajectory parameters of the endoscope may be set, and a straight line end position cz_stop=z_stop+t. In this way, it can be ensured that the field of view of the endoscope in the follow-up mode is not affected by the tissue collapse effect.

More preferably, the present application can determine the following motion trajectory parameters of the endoscope based on both the tissue collapse visual distance T and the endoscope optimal working distance L. For example, cz_start=z_start+min (L, T) is set; and setting cz_stop=z_stop+min (L, T). In this way, it is possible to ensure that the field of view of the endoscope in the follow-up mode is not affected by the tissue collapse effect, and a better imaging effect can be obtained.

Furthermore, the method can also set and adjust the depth of field delta of the endoscope, and properly adjust the distance between the lens of the endoscope and the water knife head within the allowable range of the depth of field delta of the endoscope so as to ensure that the water knife and the water jet sprayed by the water knife fall into the visual field range of the endoscope as far as possible. The endoscope depth of field delta is the working range of the endoscope in front of and behind the aforesaid endoscope optimal working distance L, i.e. the depth of field of the endoscope at the most clear focal length.

Through the arrangement, when the water knife actually works, the endoscope can start the following movement mode to drive the endoscope to move according to the following movement position track, and because the following movement position track parameter of the endoscope is determined based on the planning movement position track parameter of the water knife, the linear movement of the endoscope moving according to the following movement position track parameter and the linear movement of the water knife moving according to the planning movement position track parameter can be always synchronous, so that the head of the water knife and the water column sprayed by the head of the water knife and the surrounding tissue area can be clearly observed under the condition that the influence of water column spraying and surrounding tissue collapse is considered by the endoscope. In addition, as the following movement mode of the endoscope is preset, the following movement position track parameter of the endoscope is also determined based on the planning movement position track parameter of the water knife in advance, so that a large amount of image data calculation such as tracking and the like is not needed when the endoscope executes the following movement, the calculated amount of a control part or a processor in the movement process of the endoscope is greatly reduced, the control part or the processor can calculate and analyze the actual movement position track parameter in the working process of the water knife based on the endoscope image with sufficient calculation residual force, and the technical effect of almost real-time monitoring is realized. The specific monitoring mode is described in detail below.

The endoscope in the following motion mode can acquire the endoscope images of the water knife head and the injected water column in real time, and as described above, the images of the water knife head and the water column can be clearly identified based on the acquired endoscope images based on the following motion track determining mode of the present application. As shown in fig. 5, the control unit or the processor determines the water column region in each image by using an image segmentation algorithm for the obtained endoscope image, calculates the length of the water column, and the obtained length of the water column is the jet length track parameter R in the track parameters of the actual movement position of the water jet. Since the image is sharp and the image segmentation algorithm is already very mature, the calculation of the jet length trajectory parameter R is obtained almost in real time.

For example, the water column region E and the outer peripheral polygonal region thereof may be obtained by dividing the water column region E in the endoscopic image. The application range w and the length h of the actual water jet can be determined for monitoring through measurement of the outer surrounding polygonal area, such as image detection of the height h and the width w of the minimum outer surrounding rectangle, the length h is the measured jet length track parameter, and whether the measured jet length track parameter of the water jet in the step length is consistent with the planned jet length track parameter can be estimated through comparison of the measured length h and the planned jet length track parameter R.

Further, the control part or the processor can analyze the endoscope images acquired in the following motion mode, and calculate the rotational motion position track parameters in the actual motion position track parameters of the water jet. According to the method, the swing angle of the water column and/or the swing frequency of the water column are measured, the track parameters of the rotary movement position of the water knife are monitored, and further, different monitoring methods of the track parameters of the rotary movement position of the water knife can be adopted based on the comparison result of the range of the rotation angle in the preset track of the water knife and the range of the tissue collapse visible angle.

Measuring and calculating swing angle for evaluating actual rotary motion position track parameter of water jet knife

When all water columns can be observed through the endoscope, the rotation angle track parameters of the water knife can be directly obtained through a mode of measuring and calculating the swing angle range of the water columns, for example, a series of endoscope image frames can be obtained, and the swing angle of the water columns is calculated by dividing the water column image of each frame.

Specifically, in the motion process of a step, the split water column images of all frames from the beginning to the end of the step motion can be recorded, angles of long axis lines and vertical directions of water columns in all the water column images are calculated, and the angles of the long axis lines and the vertical directions of the water columns in all the water column images are 0 degrees from the water knife head, so that the minimum swing angle RotateStartreal and the maximum swing angle RotatepReal of the long axis lines of the water columns in all the water column images in the motion process of the step are obtained, and (RotateStartReal, rotatestopReal) is taken as a swing angle range, namely the actually measured rotation angle range of the water column motion in the step. By comparing the actually measured rotation angle range (RotateStartReal, rotatestopReal) of the water column movement in the step length with the planned angle range (theta_start, theta_stop) determined by the rotation movement track parameter of the step length, whether the actually measured rotation movement position track parameter of the water knife in the step length is consistent with the planned rotation movement position track parameter can be evaluated.

However, the foregoing is merely an ideal case, and it is found in the actual observation that, although the visual distance of tissue collapse is considered in the determination of the following movement position trajectory parameter, there is still more or less tissue extrusion shielding in the actual observation, in which case the angle of the water jet swing may be beyond the view range of the endoscope, that is, the full angle range in which the water jet swing cannot be observed from the view of the endoscope alone. As shown in fig. 2, a schematic cross-sectional view of the water jet knife of the present application is shown, W represents the center of the water jet knife, C represents the center of the endoscope, the solid line circle represents the radiation range of the water jet, and the dotted line circle represents the field of view of the endoscope. Due to the structural limitations of the water jet and the endoscope, the radiation range of the water jet and the field of view of the endoscope are typically not 360 degrees, but a fan-shaped region of less than 360 degrees. As shown in fig. 2, the radiation range of the water jet is a sector area PWQ, and the field of view of the endoscope is a sector area PCQ; and referring to fig. 3, there is a possibility that a portion of the radiation range of the water jet does not fall within the view range of the endoscope due to the shielding of the structure of the water jet itself (e.g., the upper sheath) and the influence of the collapse of surrounding tissues, which results in a problem of insufficient photographing due to the shielding of the water jet and the water jet ejected therefrom based on the observation of the water jet by the endoscope.

In this case, if the foregoing manner of calculating the swing angle of the water jet blade is still adopted, there is a problem that the monitoring result is inaccurate due to data loss.

In order to solve the problems, the application firstly defines the tissue collapse visual angle, and selects different rotary motion position track parameter monitoring methods according to different tissue collapse visual angle ranges.

Specifically, the tissue collapse viewing angle is defined by tθ_start and tθ_stop. The manner in which tθ_start and tθ_stop are determined is as follows: and under the visual distance T of tissue collapse, taking the water knife bit as a center of a circle, and taking the planned jet length R as a radius, the starting angle and the ending angle of a tangent line tangent with the boundary of surrounding collapsed tissue. The region A, B, C, D, E, F in fig. 3 and the like can be obtained from a real-time image of the endoscope by using an image segmentation algorithm, and a tissue collapse visual angle (tθ_start, tθ_stop) of the tissue collapse visual distance T can be determined.

The present application also defines a waterjet_visual parameter that is used to indicate whether a water jet can be captured by an endoscope. The planned angle range (theta_start, theta_stop) of the water jet is compared with the tissue collapse visual angle (T theta_start, T theta_stop) determined based on the endoscopic image segmentation, and assignment of the waterjet_visual parameter is determined according to the comparison result. For example, when tθ_start is equal to or less than θ_start and tθ_stop is equal to or greater than θ_stop at an angle of 0 degrees vertically downward from the water jet head, meaning that water column in the range of rotational movement of the step is observable through the endoscope, waterjet_visual=2 is set; when tθ_stop is less than or equal to θ_start, or tθ_start is more than or equal to θ_stop, meaning that any water column in the rotational movement range of the step cannot be observed through the endoscope, setting waterjet_visible=0; when θ_start < tθ_stop < θ_stop, or θ_start < tθ_start < θ_stop, it means that a portion of the water column in the rotational movement range of the step can be observed through the endoscope, waterjet_visible=1 is set.

Measuring and calculating water column swing frequency for evaluating actual rotary motion position track parameter of water knife

When waterjet_visible=1, the oscillation frequency of the water column can be measured and calculated to evaluate the actual rotational movement position track parameter of the water jet, namely, to evaluate whether the water jet executes the operation according to the planned movement track.

An observation angle position, cameraobserve_gap, is defined as the angle position of the oscillation position of the water column observed in the selected endoscopic image, which is used to observe and calculate the actual oscillation frequency of the water column, cameraobserve_gap is a vector with a direction, which contains both the angle value of the oscillation of the water column to that position and the direction or trend of the change of the angle value of the oscillation of the water column to that position.

The water jet is used for cutting in a mode of sweeping one fan at each step length, and after entering the next step length, the water jet is used for cutting in a mode of sweeping one fan again. Thus, when cutting in successive steps, the water column behaves like a spiral, and the rotation (oscillation) in each step has a pitch similar to that of V _θ θ_start, θ_stop related period (frequency). The wobble frequency of the water column referred to herein is calculated as the reciprocal of the sum of the two step movement times. When no abrupt change in motion between adjacent steps occurs, then the frequency of the water-jet oscillation through the observation angle position may be approximately 1/2 of the reciprocal of the time of motion of one of the steps (the time required to move from θ_start to θ_stop). Since the image acquisition frequency of the endoscope is much greater than the wobble frequency of the water column. Therefore, by observing the angular position and collecting and calculating the swing frequency of the water knife, whether the water knife executes the operation according to the planned rotating motion track can be judged.

Firstly, acquiring rotation motion track parameters in a planning motion track of a water jet at a current step length, wherein the rotation motion track parameters comprise a rotation start angle theta_start of the water jet in the step length, a rotation end angle theta_stop of the water jet in the step length and a rotation speed V of the water jet in the step length _θ The method comprises the steps of carrying out a first treatment on the surface of the Calculating the planned swing frequency theta_f of the water column in the step length based on the planned rotation movement track parameter: θ_f=0.5×v _θ /(θ_stop-θ_start)。

And recording the segmented water column images of all frames in the process from the beginning to the end of the step movement, and obtaining the time interval of the water column reaching the adjacent observation angle position (CameraObserv_depth) by segmenting the water column image of each frame, namely, determining the time interval of two adjacent CameraObserv_depth positions with the same water column angle value and the same water column angle value change direction, wherein the reciprocal of the time interval is the actual swing frequency theta_freal of the water knife.

Due to the periodical movement of the water jet, two observation angle positions (cameraobserve_gap) in which the angle value of the water jet and the direction of change of the angle value are the same usually occur with an odd number of steps. Theoretically, any two cameraobserve_gap values having the same angle value and angle value change direction with an odd number of steps therebetween can be used to calculate the wobble frequency. However, in view of the continuity of the ablation channel, it is preferable to calculate the wobble frequency by two observation angle positions (cameraobserve_gap) in which the angle value and the change direction of the angle value are the same at intervals of one step. Here, two observation angle positions (camerabserve_gap) with the same angle value and angle value change direction appearing at an interval are called adjacent observation angle positions, and the time interval of the adjacent observation angle positions is calculated, wherein the reciprocal of the time interval is the actual swing frequency θ_freal of the water knife in the step.

The deviation of the actual swing frequency theta_freal of the water column movement in the step length and the planned swing frequency theta_f determined by the rotational movement track parameter of the step length can be judged by comparing the actual swing frequency theta_freal of the water column movement in the step length with the planned swing frequency theta_f, so that whether the actual rotational movement position track parameter of the water knife in the step length is consistent with the planned rotational movement position track parameter is estimated.

Measuring and calculating the swing frequency of key points of the cutter body for evaluating the actual rotary movement position track parameters of the water cutter

For the extreme case, when waterjet_visible=0, that is, when any water column in the rotational movement range of the step cannot be observed through the endoscope, a value determined by a method for measuring and calculating the oscillation frequency of the key point of the monitoring blade can be used as the oscillation frequency of the water column, so as to evaluate the actual rotational movement position track parameter of the water knife.

Specifically, as shown in fig. 3, the area a is a water knife area, the key points are identified and marked by using a key point detection algorithm such as SIFT key points, and the time interval when the identified key point angle reaches an adjacent observation angle position (cameraobserve_degree) with the same observation angle value and angle value change direction is determined by sampling the endoscope image, and the reciprocal of the time interval is taken as the actual oscillation frequency θ_freal of the water column. Further, by comparing the actually measured oscillation frequency θ_freal of the water column movement in the step length with the planned oscillation frequency θ_f determined by the rotational movement locus parameter of the step length, the deviation between the actual oscillation frequency of the water column and the planned oscillation frequency can be judged, and whether the actually measured rotational movement locus parameter of the water knife in the step length is consistent with the planned rotational movement locus parameter is further evaluated.

In the method for estimating the actual rotary motion trajectory parameters of the water jet by calculation, the calculation method based on the blade key point swing frequency can also be used in the situation of water jet_visible=1 or 2, the calculation method based on the water column swing frequency can also be used in the situation of water jet_visible=2, but in order to achieve better calculation speed and accuracy, different water jet rotary motion position trajectory parameter monitoring methods are selected based on the comparison result of the rotation angle range and the tissue collapse visible angle range in the preset trajectory of the water jet, namely, for different water jet_visible assignments, when water jet_visible=2, the calculation method based on the swing angle is selected, when water jet_visible=1, the calculation method based on the water column swing frequency is selected, and when water jet_visible=0, the calculation method based on the blade key point swing frequency is selected.

Rotational movement of an endoscope

In most cases, the lens of the endoscope is parallel to the axial direction of the water knife (i.e. facing straight ahead), however, in determining the optimal working distance L of the endoscope, the water column E used for testing is usually directly downward or only tested within a certain angle range, and the rotation range of the water column may exceed the visual field of the endoscope during actual working.

For example, as illustrated in the left view of fig. 6, when the lens of the endoscope is parallel to the axial direction of the water knife (i.e., toward the front), the angle of view of the endoscope is +.s2-C-S1, and when the rotation range of the water column exceeds the view of the endoscope during actual operation, the water column is not observed through the lens of the endoscope, i.e., waterjet_visual=0. When the endoscope lens cannot observe the water column, although the foregoing alternative measurement and calculation manner may be adopted, the accuracy may have a defect, and for this purpose, an alternative scheme may be adopted, namely, increasing the rotation motion of the endoscope, adopting the rotatable endoscope lens, as shown in the right diagram in fig. 6, using the endoscope lens with a certain inclination angle, and adjusting the inclination angle of the endoscope lens along with the rotation of the endoscope, so that the rotated endoscope can meet the requirement of the visibility angle of the endoscope within the limited distance determined based on min (L, T).

For the case that the inclination angle of the lens of the endoscope is adjustable, the following movement of the endoscope can be set to comprise rotary movement, namely, the following movement mode of the endoscope is set to not only follow the linear movement of the water knife but also follow the rotary movement of the water knife, correspondingly, the following movement position track parameter also comprises Ctheta_start which represents the rotation starting angle of the endoscope in the step length, the rotation ending angle Ctheta_stop in the step length and the rotation speed CV in the step length _θ . The following movement of the endoscope aims at adjusting the view area of the endoscope and ensuring that the view of the water knife and the jet water column is observed as much as possible. At this time, θ_start, θ_stop, V based on the water jet are also required _θ Determining Cθ_start, Cθ_stop, CV of an endoscope _θ 。

Through the steps, the actual rotary motion position track parameter and jet length track parameter in the working process of the water jet knife can be calculated based on the endoscope image, whether deviation exists between the actual rotary motion position track parameter and the jet length track parameter is judged, and when the deviation exists, an alarm mechanism can be started or the deviation is fed back to the control part, and the planned track of the water jet knife is compensated and adjusted according to the feedback result.

Safety monitoring for sensitive sites

Referring to fig. 4, fig. 4 schematically illustrates a sensitive site within a patient lumen. In the figure, C represents the approximate center of the endoscope, a represents imaging of the water jet in the field of view of the endoscope, B, D, F represents the tissue deformed by the water jet or other tissue in the lumen, and E represents the water jet. In the context of prostate surgery, F is the tissue of a sensitive site in the lumen, such as the ureteral orifice or the mons of the hand, which is to be protected from surgical excision in order to avoid injury to the patient.

In general, ablation avoidance of sensitive sites has been considered when determining planned motion trajectories of a water jet based on pre-operative images or based on ultrasound images. However, due to the accuracy of the ultrasound image or the movement of the living body, etc., there may be a deviation in the actual position of the sensitive part of the living body compared to the recognition result of the preoperative image or the ultrasound image during the actual execution of the operation, resulting in the risk of damage based on the planning scheme.

In the application, the endoscope following the movement mode can acquire clear real-time images of the water knife and the water column, and based on the acquired real-time images, the safety protection function of the sensitive part is added, and the implementation thought comprises the safety monitoring of the sensitive part based on the jet length track parameters or the safety monitoring of the sensitive part based on the rotational movement position track parameters.

Sensitive part safety monitoring based on jet length track parameters

Firstly, acquiring a real-time clear image through an endoscope following a motion mode, identifying a sensitive part F in the endoscope image by using an image segmentation algorithm, and measuring the shortest distance S1 between the outline boundary of the identified sensitive part F and a water jet cutter head.

Then, a safe cutting depth for the sensitive part F is determined based on the shortest distance between the contour boundary of the sensitive part F and the water jet cutter head. Preferably, the safe resection depth is also determined based on a preset removal safe distance. The removal safety distance is determined in advance through experiments or is preset based on experience, operation requirements and other factors. The provision of the removal safety distance helps to give a greater margin to ensure safety without the water jet touching the sensitive site F. For example, in the case where the removal safety distance is set to S2, the cutting depth of the water jet should stop at the contour S2 of the distance sensitive portion F. Further, in the case where the shortest distance between the contour boundary of the sensitive part F and the water jet blade head is S1 and the removal safety distance is S2, the safe cutting depth of the sensitive part F is determined to be S1-S2.

Further, the planned movement track of the water jet is traversed, if the planned jet length track parameter with a certain step length is calculated to be larger than the safe cutting depth of the water jet, the risk that the water jet is cut to the sensitive part F later is indicated. In this case, the surgical execution device 100 issues an alarm, halting the resection. At this time, the water jet planning can be readjusted, the sensitive part is avoided or the removing safety distance S2 of the sensitive part is adjusted, and the problems of safety, operation failure and the like caused by cutting the sensitive part are avoided. For example, according to the monitoring result, the distance that the length of the jet in the water jet planning step of the endoscope is required to be reduced is obtained, and then the dynamic adjustment of the water jet planning track is realized by adjusting the jet length track parameter R in the track parameters of the actual movement position in the water jet planning step.

Sensitive part safety monitoring based on rotary motion position track parameters

According to another embodiment, non-removed areas may be provided for sensitive sites. Taking fig. 4 as an example, F is a sensitive part, E to E' are planned removal areas, and D is a target removal object. The non-removing area C is defined as a sector area which takes the water jet A as the center of the radiation and contains the sensitive part F, the non-removing area C can be expressed by (S theta_start, S theta_stop), S theta_start represents the starting angle of the contour tangent of the sensitive part taking the water jet A as the center of the circle, and S theta_stop represents the ending angle of the contour tangent of the sensitive part taking the water jet A as the center of the circle. In this case, no water jet is emitted when the water jet is directed towards the sensitive site F, i.e. no ablation or excision is performed at all for the tissue in the non-removed area C, i.e. (sθ_start, sθ_stop). For the scheme, the safety monitoring of the sensitive part can be realized based on the track parameters of the rotary motion position, and the specific realization steps are as follows:

Firstly, acquiring a real-time clear image through an endoscope following a motion mode, identifying a sensitive part F in the endoscope image by using an image segmentation algorithm, and calculating an actual non-removal area (Sθ_start, Sθ_stop).

Then, whether the non-removed area C overlaps with the planned removed area EE' is compared, that is, whether (S theta_start, S theta_stop) overlaps with (theta_start, theta_stop), and a safety strategy is executed according to whether the overlapping or the overlapping degree exists, and the planning is alarmed, suspended, or planned.

Preferably, a safe overlap range U may be set, where the safe overlap range U may be an area size, that is, when the overlap area of the non-removed area C and the planned removed area EE' is greater than a certain threshold, a risk is considered to exist. The safe overlap range U may be a size of an overlap ratio, for example, when a ratio of an overlap area of the non-removed region C and the planned removed region EE' to the non-removed region C is greater than a certain threshold, a risk is considered.

When the risk is judged to exist, the water jet planning can be adjusted again, the sensitive part F is avoided or the safety overlapping range U of the sensitive part F is adjusted, and the problems of safety, operation failure and the like caused by cutting the sensitive part F are avoided. Meanwhile, according to the non-removal area C area obtained in real time in the endoscope image, the relation of C and EE' in the following water jet planning step can be calculated in advance and used as the real-time feedback of the cutting range of the water jet planning movement track, the cutting range of the planning movement track of the water jet in the following step length can be automatically adjusted, and the dynamic adjustment of the water jet cutting planning track is realized.

In the foregoing solution, the alarm mechanism may be triggered based on the monitoring of the actual movement position trajectory parameter of the water jet and/or based on the monitoring of the actual sensitive part. Particularly, the alarm mechanism is set based on real-time monitoring of the endoscope in the following motion mode, in an actual operation scene, the linear motion track of the water knife head is the motion direction from front to back, and the tissue area (comprising the cutting range, the sensitive part and the like) observed by the endoscope behind the water knife head comprises the area where the water knife head is about to cut, so that deviation and risk can be prejudged, an early warning function is realized, and better planning scheme and safety guarantee are facilitated.

Next, one of the procedures of performing the excision operation by the operation performing device of the present application will be described with reference to fig. 7. It will be appreciated by those skilled in the art that the flow described below is only one application of the present application, and the order and details of the steps may be appropriately set according to the actual scenario.

Step S1, acquiring a planned movement track of the water jet, and calculating a following movement track of the endoscope.

Step S2, calculating an initial monitoring position of the endoscope, and moving the endoscope to the initial monitoring position.

Step S3, detecting a sensitive part of the organism tissue based on the monitoring image of the endoscope and adjusting the subsequent excision planning based on the sensitive part in the operation.

And S4, in the operation, monitoring the actual movement position track parameter of the water jet based on the monitoring image of the endoscope, and adjusting the follow-up excision planning based on the deviation of the actual movement position track parameter and the planned movement position track parameter.

Step S5, in operation, monitoring a dangerous scene and alarming. Here, the dangerous scene means that, for example, the time for simultaneously losing the water jet and the water column in the view field of the endoscope exceeds a predetermined threshold, and the swing frequency or the ablation depth of the water jet exceeds a safety threshold with respect to the planned frequency or the ablation depth.

Through the embodiment of the application, the technical problem in the background technology can be effectively solved, the effective, accurate and real-time monitoring is carried out aiming at the execution condition in the water jet operation process, the application is particularly suitable for an automatic water jet system, and when the water jet moves and works according to the planned movement position track parameter, the scheme of the application can carry out real-time monitoring on the actual movement position track parameter of the water jet, thereby being beneficial to realizing the real-time adjustment of the movement position track parameter; the water jet knife real-time monitoring system can also monitor the actual working scene of the water jet knife, particularly the area related to the sensitive part in real time, determine the safety risk of planning the motion track based on the real-time monitoring result, and timely trigger an alarm mechanism to take emergency measures.

Claims

1. The monitoring device based on the water jet movement track of the endoscope comprises a water jet, the endoscope, a water jet driving part, an endoscope driving part and a control part, and is characterized in that,

the water knife can move according to the planned movement track under the drive of the water knife driving part and jet water jet to cut or ablate tissues; the movement track of the water jet is defined by movement position track parameters of the water jet, and the movement position track parameters of the water jet comprise linear movement position track parameters, rotation movement position track parameters and/or jet length track parameters;

the endoscope moves under the drive of the endoscope driving part, the endoscope has an autonomous movement mode and a following movement mode, and the endoscope can move at least linearly along the following movement track along the water knife in the following movement mode; the following motion track is defined by following motion position track parameters, and the following motion position track parameters at least comprise linear following motion position track parameters;

The endoscope monitors the actual movement position track parameters of the water jet under the following movement mode.

2. The device for monitoring a movement trace of a water jet according to claim 1, wherein the endoscope and the water jet share a sheath or the sheath of the endoscope and the sheath of the water jet are integrally formed, the linear movement directions of the endoscope and the water jet are parallel to each other, the endoscope is positioned behind the water jet, and a predetermined distance is provided between an observation lens of the endoscope and the water jet injection part.

3. The water jet movement track monitoring device according to claim 1, wherein the movement track of the water jet is an array combination of water jet movement position track parameters with a plurality of step sizes, and the following movement track is determined according to the water jet movement position track parameters contained in the array of each step size.

4. The water jet scalpel moving locus monitoring device according to claim 1, wherein the control unit determines the following moving position locus parameter according to a tissue collapse visual distance and/or an endoscope optimal working distance.

5. The device for monitoring a water jet movement locus according to claim 1, wherein the control unit performs image segmentation processing on an endoscopic image of a water jet movement acquired by the endoscope in real time, and monitors the jet length locus parameter.

6. The water jet movement locus monitoring device according to claim 1, wherein the control unit monitors the rotational movement locus parameter of the water jet by measuring and calculating the oscillation angle of the water column and/or the oscillation frequency of the water column.

7. The device for monitoring a movement track of a water jet according to claim 6, wherein the control part adopts different monitoring methods for the movement track parameters of the water jet rotation based on the comparison result of the rotation angle range and the tissue collapse visible angle range in the preset track of the water jet.

8. The water jet scalpel motion profile monitoring device according to claim 1, wherein the endoscope is provided with a lens with an adjustable dip angle, and the following motion profile parameters of the endoscope comprise rotation following motion position profile parameters.

9. The water jet blade movement trace monitoring device according to claim 1, wherein the endoscope further performs safety monitoring for sensitive sites in a follow-up movement mode.

10. The monitoring device for the water jet movement track according to claim 9, wherein the control part performs sensitive part safety monitoring based on the jet length track parameter, determines a safety excision depth according to an image acquired by the endoscope, and judges the risk according to a comparison result of the planned jet length track parameter and the safety excision depth.

11. The monitoring device for the water jet movement track according to claim 9, wherein the control part performs sensitive part safety monitoring based on the rotational movement position track parameter, determines a non-removal area according to an image acquired by the endoscope, and judges the risk according to a comparison result of the planned rotational movement position track parameter with the non-removal area.