CN201578365U - Surgical oncology intraoperative fluorescent navigation system - Google Patents
Surgical oncology intraoperative fluorescent navigation system Download PDFInfo
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- CN201578365U CN201578365U CN2009203502926U CN200920350292U CN201578365U CN 201578365 U CN201578365 U CN 201578365U CN 2009203502926 U CN2009203502926 U CN 2009203502926U CN 200920350292 U CN200920350292 U CN 200920350292U CN 201578365 U CN201578365 U CN 201578365U
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Abstract
The utility model belongs to clinical medicine surgery, in particular to a surgical oncology intraoperative fluorescent navigation system, which aims to resolve problems that recognition of residual tumor tissues and tracking of lymphatic metastasis are difficult in tumor margin discrimination during surgical tumor excision operations. The surgical oncology intraoperative fluorescent navigation system is characterized by comprising a bioluminescence excitation source, a guide system, a fluorescent material with specificity target marks, a camera device and an image displaying and processing device connected with the camera device. Compared with the prior art, on the basis of the conception of surgical oncology intraoperative fluorescent navigation, doctors can discriminate tumor margins, recognize residual tumor tissues, track tumor lymphatic metastasis and then complete through excision of tumor tissues by aid of a fluorescent observation mirror or camera display system, thereby effectively increasing surgical treatment effect, reducing mortality of tumor patients and improving surgical oncology development greatly.
Description
Technical field
This utility model belongs to the clinical medicine surgery, is specifically related to fluorescence navigation system in a kind of surgical oncology art.
Background technology
According to World Health Organization's investigation, had 7,600,000 to allow the people die from cancer in 2005, account for 13% of all dead person's 58,000,000 ratios.For example there is 1,300,000 non-skin carcinoma patients every year in the U.S., has half to cure by excision, has 5% approximately by chemotherapy and/or radiotherapy healing, and all the other patients can not cure.Wherein incurable main cause is that surgical operation can not thoroughly excise tumor, such as can not correctly discerning the tumor scope in the art, can not clear and definite micro metastasis etc.
And image check in the existing art, because its application of multiple effects limit.Such as, the iodized oil angiography can be seen blood vessel structure clearly, but patient and medical personnel will be exposed under the X ray, and the iodized oil of millimolar concentration all has nephrotoxicity to patient; Ultrasonic being widely used, but ultrasonic specificity and sensitivity to tumor is too low; Magnetic resonance can provide structural information clearly, but up to the present matching type is insensitive, almost do not have the contrast medium of targeting, and the equipment heaviness also influences its application in some surgical procedures.Radioscintigraphy uses more, does not also meet the space structure of Surgical Operating Room.Secondly one of impracticable reason of imaging is to lack the tumour-specific contrast medium in the art.So need to inquire into imaging pattern in a kind of new art.
Summary of the invention
This utility model is in order to solve in the existing surgery tumor resection process, carrying out tumor boundaries differentiates, the problem of the tracking difficulty of tumors remaining tissue identification and neoplasm metastasis lymph node provides fluorescence navigation system in a kind of surgical oncology art, realizes imaging pattern in a kind of new art.
This utility model adopts following technical scheme to realize:
Fluorescence navigation system in the surgical oncology art is characterized in that comprising fluorescent material and the picture pick-up device and pictorial display that is connected with picture pick-up device and blood processor of bioluminescence excitation source, light-conducting system, selectively targeted labelling;
The bioluminescence excitation source comprises lamp source and filter system, the lamp source (and light of the arbitrary wave band that in theory need) of lamp source for sending incandescence, 365-405nm, 445-490nm, 500-555nm, 615-665nm and 710-760nm wave-length coverage, the exciter filter that filter system comprises rotating filter wheel and is installed on 365-405nm, 445-490nm, 500-555nm, 615-665nm and 710-760nm wavelength on the filter wheel;
The detachable installation edge filter of the camera lens front end of picture pick-up device, edge filter is removal or replacing at any time.
Described light source is xenon lamp, metal halid lamp, mercury lamp or LASER Light Source.
Fluorescent material comprises green fluorescence dyestuff, red fluorescence dyestuff, far red light dyestuff or near infrared light dyestuff, if do not need to use fluorescent material when exciting autofluorescence.
Picture pick-up device comprises single anti-digital camera, ccd video camera, refrigeration CCD or wear-type Fluirescence observation mirror.
Single anti-digital camera, ccd video camera, refrigeration CCD or wear-type Fluirescence observation mirror all are applicable to various open surgery, but wear-type Fluirescence observation mirror more adapts to and operation, and the doctor wears flexible operation.The sensitivity difference of single anti-digital camera, ccd video camera, refrigeration CCD fluorescence imaging, the CCD imaging effect that wherein freezes is best, endoscope's tumor operation fluorescence navigation system is applicable to non-refrigeration ccd video camera, and the surgical microscope fluorescence navigation system adopts ccd video camera, refrigeration CCD can.
Light-conducting system adopts liquid light pipe or optical fibers.
This utility model can be used for fluorescence navigation system in the open surgery art, surgical microscope fluorescence navigation system or endoscope's fluorescence navigation system.The bioluminescence excitation source is launched the exciting light of certain section specific wavelength, can make the histiocyte that indicates the specificity fluorescent label behind the exciting light that absorbs certain section specific wavelength, make the fluorescent material molecule absorption that is in the ground state lowest energy level have the light of same characteristic features frequency with it, and transit to each vibration level of higher excited electronic state, be in the molecule of each vibration level of higher excited electronic state, in turning back to each different vibration level processes of ground state, can launch corresponding light quantum, produce fluorescence, see through edge filter and picture pick-up device and observe fluoroscopic image, instruct doctor's treatment that undergos surgery.
Relative prior art, the utility model proposes the notion of fluorescence navigation in the surgical oncology art, the fluorescence navigation is meant the biological living of suffering from tumor disease in the surgical oncology art, behind vein or the selectively targeted fluorescent dye of local injection, the body surgical field of view is under the irradiation of specific wavelength light wave, tumor tissues and tumor cell can be launched the fluorescence of certain wavelength, the doctor is under fluorescence observation mirror or shooting display system, carry out tumor boundaries and differentiate, the tumors remaining tissue identification, the neoplasm metastasis lymph node is followed the trail of, thorough tumor resection tissue, effectively improve surgical result, reduce the tumor patient mortality rate, will make surgical oncology produce qualitative leap.
Description of drawings
Fig. 1 is the sketch map of fluorescence navigation system in the open surgery art
Fig. 2 is the internal structure sketch map in biological fluorescent exciting source
Among the figure: 1-bioluminescence excitation source, 2-light-conducting system, 3-tumor, 4-picture pick-up device, 5-image processing equipment, 6-image display;
1.1-fan, 1.2-fan board, 1.3-light source, 1.4-lamp bracket, 1.5-insulation board, 1.6-base plate, 1.7-diathermic reflector, 1.8-filter wheel, 1.9-leaded light seat, 1.10-light pipe.
The specific embodiment
Fluorescence navigation system in the surgical oncology art comprises fluorescent material and the picture pick-up device 4 and the pictorial display and the blood processor that are connected with picture pick-up device 4 of bioluminescence excitation source 1, light-conducting system 2, selectively targeted labelling.Function of the present utility model is to carry out tumor boundaries to differentiate the tracking of tumors remaining tissue identification and neoplasm metastasis lymph node in surgery tumor resection process.The biological living of suffering from tumor disease, behind vein or the selectively targeted fluorescent dye of local injection, the body surgical field of view is under the irradiation of specific wavelength light wave, tumor tissues and tumor cell can be launched the fluorescence of certain wavelength, the doctor is the spike tumor tissues under picture pick-up devices such as fluorescence observation mirror or CCD shooting display, the thorough tumor resection tissue of guiding surgeon.
1, bioluminescence excitation source concrete structure is as follows:
1.1, the lamp source
The lamp source is one of most important parts of bioluminescence excitation source alternative light source, its lamp source (and light of the arbitrary wave band that needs in theory) for sending incandescence, 365-405nm, 445-490nm, 500-555nm, 615-665nm and 710-760nm wave-length coverage, as: xenon lamp, metal halid lamp, mercury lamp or LASER Light Source, especially with xenon lamp (symbol of element is Xe), luminous efficiency height.The lamp source is installed on the base plate by lamp bracket and insulation board, and the light source front end is provided with diathermic reflector.In order to improve power factor, reduce circuit loss, the configurable starting drive circuit of forming by booster transformer, pulse transformer, bypass capacitor etc. in addition.In addition, the lamp source, especially the operating temperature of xenon lamp is very high, and dispose air-cooled, to prolong bulb life.
The main uses of each wave band of alternative light source is:
1), LIF 365-405nm, be mainly used in exciting of autofluorescence,
Autofluorescence is that some materials do not need the external source fluorescent dyeing to be stimulated to send the phenomenon of fluorescence in the organism.Medically, there is the utilization electricity to penetrate and causes the intravital autofluorescence of people, in order to the mode of diseases such as cancer diagnosis.
Such as: under the fluorescence colposcope: the cervix uteri surface fluorescence shows that purple, atropurpureus are the primary fluorescence positive, and prompting has pathological changes, and it is negative blue and white to occur, points out no malignant change, and the demonstration withered yellow is an inflammation.
2), Green 445-490nm, the exciting of green fluorescence
445-490nm is green fluorescent protein (GFP), enhanced green fluorescence protein (EGFP), and (Fluorescein isothiocynate, exciting light FITC) are used for the research of live body green fluorescences such as living cells and animal to Fluorescein isothiocyanate.
3), Red 500-550nm, the red fluorescent labeling of live body
500-550nm is DsRed, PKH26 fluorescent tracer (PKH26), and the exciting light of Qdot605 is used for the red fluorescently-labeled research of live bodies such as living cells and animal.
4)、Far-red?615-665nm
Cy5.5，Alexa?Fluor，Qdot705
5)、NIR?710-760nm
710-760nm is indocyanine green (ICG), and the exciting light of Qdot800 near infrared light excites near-infrared fluorescent group to produce fluorescence, carries out navigating in the art of surgical oncology.
1.2, filter system
Filter system mainly refer in the bioluminescence excitation source casing filter wheel before the lamp source with and go up the optical filter of installation, the high-quality band general formula interferometric filters that adopt more, this utility model is installed incandescence (also promptly blank) altogether, 365-405nm, 445-490nm, 500-555nm, 615-665nm and 710-760nm, Deng 5 exciter filters, when the light time of selecting a wave band, filter wheel just forwards corresponding exciter filter to front, lamp source, the light that the lamp source is sent filters, the light that allowing needs passes through, unwanted light ends, and can send the light of our needed any one wave band in theory.
1.3, casing
For the casing main requirement is light leak, firm, rational in infrastructure not.
1.4, control, display system
For waveband selection, generally on casing, all there is a wave band adjusting knob to be connected, the output light intensity in a light intensity adjusting knob control lamp source, and the LCDs that shows the work at present wave band with filter wheel.
2, light-conducting system
Light pipe comprises light pipe, can be liquid light pipe or fiber optics.Usually adopt the liquid light pipe, liquid light pipe cost is higher, but higher transmittance is arranged.
The delivery outlet of light pipe has the multiple interfaces mode, can be connected with endoscope light guide bundles, living imaging instrument, fluorescence microscope etc.
3, the fluorescent material of selectively targeted labelling
Organism can be induced the photo emissions of biosystem under the of short duration irradiation of extraneous high light.The intensity of this weak in time induced luminescence is much larger than organism self-luminous intensity.Can be used for the detection of medical diagnosis on disease and food quality.Because tumor patient and healthy physiognomy ratio, the luminous photon intensity of its blood and diseased organ and tissue raises, and in that good application is arranged aspect the diagnosis of cancer, can find out its location in early days in tumor, realizes the early diagnosis and therapy of tumor.
Fluorescent material and tumor group are woven with good affinity, allow fluorescent materials such as patient's intravenous injection or oral photosensitizer, accept illumination again, can launch bright more fluorescence, determine knub position.
As Fluorescein isothiocyanate be and protein bound, the absorption maximum optical wavelength is 490～495nm, and the emission maximum optical wavelength is 520～530nm, presents bright yellow-green fluorescence; Tetramethylrhodamine isothiocyanate, absorption maximum optical wavelength are 550nm, and the emission maximum optical wavelength is 620nm, presents fluorescent red-orange.
The tumor of green fluorescent protein (GFP) labelling is transplanted to the large intestine of mice or subcutaneous, the whole body imaging under blue light, can Real Time Observation intravital mouse body in fluorescently-labeled tumor.
In addition, multiple fluorescence imaging material combines with advanced person's optical image technology, for dynamically monitor in real time in the cell and biological living in molecular events strong laboratory facilities are provided, for generation, diagnosis, the treatment that discloses vital movement rule and study of disease provides new technologies, greatly promoted development of life science.Deep day by day along with the fluorescent labeling research field will produce far-reaching influence to surgical oncology.
System described in the utility model can excite and absorb autofluorescence, green fluorescence, red fluorescence, far red light and the near infrared light of living organism and the generation of living body fluorescent dyestuff thereof, and corresponding fluorescence imaging.System carries out the fluorescence navigation behind the different fluorescent dyes of live body intravenous injection: the 1st class is the green fluorescence dyestuff, as green fluorescent protein, fluorescein sodium, the 2nd class are red fluorescence dyestuff, as red fluorescent protein, photofrin, the 3rd class are that far red light dyestuff, the 4th class are the near infrared light dyestuff, as quantum dot, wait the dyestuff that produces different wave length.
4, picture pick-up device
Picture pick-up device generally includes the 1st class and is single anti-digital camera; The 2nd class is highly sensitive CCD; The 3rd class is refrigeration CCD; The 4th class is for wearing spectacle.Picture pick-up device is connected with image processing equipment with pictorial display, as computer etc.
The detachable front end of the camera lens of picture pick-up device is installed edge filter.
Rely on this utility model can form four kinds of model systems, the 1st kind of model is endoscope's tumor operation fluorescence navigation system, mainly is applicable to various endoscopic surgerys, as bladder tumors electric resection; The 2nd kind of model is the surgical microscope fluorescence navigation system, is mainly used in the navigation of neurosurgery tumor resection; The 3rd kind of model is the open surgery fluorescence navigation system; The 4th kind of model surgical doctor wear-type Fluirescence observation mirror.As shown in Figure 1: fluorescence navigation system in the open surgery art, light source: be the light source that to export the 710-760nm light wave; Optical fibers: near infrared light is by near-infrared optical fibers irradiation tumor Suspected Area; Video camera: adopt the near-infrared video camera or wear the highly sensitive camera of near infrared filter; Image shows by computer and display.
Embodiment 1:
Adopt the gene transfection method of liposome 2000 mediations, mice bladder cancer BTT739 cell line is arrived in chicken β-actin-DsRed-Neo carrier transfection; The G418 screening obtains the monoclonal cell strain (BTT739-DsRed) of stably express red fluorescent protein (DsRed); Set up the transplanted tumor model; Fluorescence navigation record tumor growth shifts relevant fluoroscopic image and fluorescence intensity in the surgical oncology art.The result shows that the BTT-739 cell line of DsRed labelling is red fluorescence under fluorescence microscope, this cell seeding is subcutaneous mice, set up behind the mice bladder cancer transplanted tumor model the 7th, fluorescence navigation in the surgical oncology art, excitation wavelength 560～580nm, wavelength of transmitted light are 590～610nm, tumor is rubescent color fluorescence, the tumor fluorescence intensity strengthens gradually, observes the local lymphatic metastasis, does not see metastasis in 28th; The tumor size is linear positive correlation with fluorescence intensity.
Organism can be induced the photo emissions of biosystem under the of short duration irradiation of extraneous high light.The intensity of this weak in time induced luminescence is much larger than organism self-luminous intensity.Can be used for the detection of medical diagnosis on disease and food quality.Because tumor patient and healthy physiognomy ratio, the luminous photon intensity of its blood and diseased organ and tissue raises, and in that good application is arranged aspect the diagnosis of cancer, can find out its location in early days in tumor, realizes the early diagnosis and therapy of tumor.
Embodiment 2:
Fluorescent material and tumor group are woven with good affinity, allow (48～72 hours) behind patient's intravenous injection or the oral photosensitizer, accept illumination again, and record fluorescence spectrum characteristic curve can be determined knub position.Also have the autofluorescence spectroscopic diagnostics not need to add photosensitive agents, the fluorescence that utilizes tissue to produce under laser carries out spectrum analysis and differentiates tumor.Need not oral or the injection photosensitizer, is a kind of do not have invasive, quick diagnostic techniques.
Embodiment 3:
In the fluorescence molecule imaging, for interested biomolecule process is distinguished, need observe and quantitative analysis by means of fluorescent molecular probe, in addition, also have the fluorescein of traget antibody, Fluorescein isothiocyanate is and protein bound that the absorption maximum optical wavelength is 490～495nm, the emission maximum optical wavelength is 520～530nm, presents bright yellow-green fluorescence; Tetramethylrhodamine isothiocyanate, absorption maximum optical wavelength are 550nm, and the emission maximum optical wavelength is 620nm, presents fluorescent red-orange.
Embodiment 4:
The tumor of green fluorescent protein (GFP) labelling is transplanted to the large intestine of mice or subcutaneous, the whole body imaging under blue light, can Real Time Observation intravital mouse body in fluorescent labeling growth of tumor and shifting and realtime imaging.GFP whole body imaging technology is at the animal manipulation in vitro, to the animal noinvasive, can the continuous monitoring tumor in the situation of intravital malignancy of intact animal and transfer.
In addition, also have fluorescence light groups such as red fluorescent protein and quantum dot, be employed and the living cells imaging, and be used for component in cell intrinsic protein, epidermal protein, the cell, and the research of the inside and outside receptor transport pathway of cell.
Embodiment 5:
Use fluorescein sodium to carry out fluorescence guiding glioblast TRS as photosensitizer, the zone of demonstration hyperfluorescence shows as and is rich in tumor cell and the stronger vascular reaction of tool in the discovery pathological examination.Necrotic zone does not have fluorescence, the visible a small amount of tumor cell in the zone of hypofluorescence.
Biomedical Photonics is at the early-stage at present, surgical microscope, endoscope etc. also only rest on the level of traditional biological research, so need carry out basic change to this kind equipment, and this utility model will remedy the deficiency of these equipment, to further expand its function, expand the fluorescence navigation function, promote the fast development of Wicresoft's medical career.
Claims (5)
1. fluorescence navigation system in the surgical oncology art is characterized in that comprising fluorescent material and the picture pick-up device (4) and the pictorial display and the blood processor that are connected with picture pick-up device (4) of bioluminescence excitation source (1), light-conducting system (2), selectively targeted labelling;
Bioluminescence excitation source (1) comprises light source and filter system, light source is for sending the light source of incandescence, 365-405nm, 445-490nm, 500-555nm, 615-665nm and 710-760nm wave-length coverage, the exciter filter that filter system comprises rotating filter wheel (1.8) and is installed on 365-405nm, 445-490nm, 500-555nm, 615-665nm and 710-760nm wavelength on the filter wheel (1.8);
The detachable installation edge filter of the camera lens front end of picture pick-up device (4).
2. fluorescence navigation system in the surgical oncology art according to claim 1 is characterized in that described light source is xenon lamp, metal halid lamp, mercury lamp or LASER Light Source.
3. fluorescence navigation system in the surgical oncology art according to claim 1 and 2 is characterized in that fluorescent dye comprises green fluorescent material, red fluorescence material, far red light dyestuff or near infrared light dyestuff.
4. fluorescence navigation system in the surgical oncology art according to claim 3 is characterized in that picture pick-up device (4) comprises single anti-digital camera, ccd video camera or wear-type Fluirescence observation mirror.
5. fluorescence navigation system in the surgical oncology art according to claim 4 is characterized in that conduit system (2) comprises that light pipe is liquid light pipe or optical fibers.
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| CN2009203502926U CN201578365U (en) | 2009-12-31 | 2009-12-31 | Surgical oncology intraoperative fluorescent navigation system |
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| CN2009203502926U CN201578365U (en) | 2009-12-31 | 2009-12-31 | Surgical oncology intraoperative fluorescent navigation system |
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Cited By (11)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN101770141B (en) * | 2009-12-31 | 2011-11-09 | 山西医科大学 | Fluorescence navigation system used in tumor surgery |
| CN102721469A (en) * | 2012-06-14 | 2012-10-10 | 中国科学院自动化研究所 | Multispectral imaging system and method based on two cameras |
| CN103027751A (en) * | 2011-10-09 | 2013-04-10 | 汤维波 | Fluorophor positioning device for jointly positioning and excising diseased region by gastrointestinal endoscope and peritoneoscope |
| CN103249359A (en) * | 2010-12-02 | 2013-08-14 | 国立大学法人高知大学 | Medical tool that emits near infrared fluorescence and medical tool position-confirming system |
| CN106937884A (en) * | 2017-04-14 | 2017-07-11 | 苏州影睿光学科技有限公司 | Operation guiding system based near infrared imaging |
| CN107260137A (en) * | 2017-07-31 | 2017-10-20 | 济南显微智能科技有限公司 | It is a kind of to detect ICG and double Tracing detection device and methods of methylenum careuleum simultaneously |
| CN109480770A (en) * | 2017-12-26 | 2019-03-19 | 深圳先进技术研究院 | Tumor resection recognition methods and device based on NIR-Ib window fluorescence |
| CN111557676A (en) * | 2020-05-13 | 2020-08-21 | 山东省肿瘤防治研究院（山东省肿瘤医院） | System and equipment for dynamically adjusting target area position according to change of tumor in radiotherapy process |
| CN112263331A (en) * | 2020-10-30 | 2021-01-26 | 上海初云开锐管理咨询有限公司 | System and method for presenting medical instrument vision in vivo |
| CN113892932A (en) * | 2021-10-09 | 2022-01-07 | 安徽医科大学 | Tissue real-time in-vivo identification equipment in tumor resection and matched identification method thereof |
| CN114469344A (en) * | 2022-01-27 | 2022-05-13 | 上海安翰医疗技术有限公司 | Navigation head and surgical navigation equipment |
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2009
- 2009-12-31 CN CN2009203502926U patent/CN201578365U/en not_active Expired - Lifetime
Cited By (13)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN101770141B (en) * | 2009-12-31 | 2011-11-09 | 山西医科大学 | Fluorescence navigation system used in tumor surgery |
| CN103249359A (en) * | 2010-12-02 | 2013-08-14 | 国立大学法人高知大学 | Medical tool that emits near infrared fluorescence and medical tool position-confirming system |
| CN103027751A (en) * | 2011-10-09 | 2013-04-10 | 汤维波 | Fluorophor positioning device for jointly positioning and excising diseased region by gastrointestinal endoscope and peritoneoscope |
| CN102721469A (en) * | 2012-06-14 | 2012-10-10 | 中国科学院自动化研究所 | Multispectral imaging system and method based on two cameras |
| CN106937884A (en) * | 2017-04-14 | 2017-07-11 | 苏州影睿光学科技有限公司 | Operation guiding system based near infrared imaging |
| CN107260137A (en) * | 2017-07-31 | 2017-10-20 | 济南显微智能科技有限公司 | It is a kind of to detect ICG and double Tracing detection device and methods of methylenum careuleum simultaneously |
| CN109480770A (en) * | 2017-12-26 | 2019-03-19 | 深圳先进技术研究院 | Tumor resection recognition methods and device based on NIR-Ib window fluorescence |
| CN111557676A (en) * | 2020-05-13 | 2020-08-21 | 山东省肿瘤防治研究院（山东省肿瘤医院） | System and equipment for dynamically adjusting target area position according to change of tumor in radiotherapy process |
| CN111557676B (en) * | 2020-05-13 | 2023-12-19 | 山东省肿瘤防治研究院（山东省肿瘤医院） | System and equipment for dynamically adjusting target area position by tumor change in radiotherapy process |
| CN112263331A (en) * | 2020-10-30 | 2021-01-26 | 上海初云开锐管理咨询有限公司 | System and method for presenting medical instrument vision in vivo |
| CN113892932A (en) * | 2021-10-09 | 2022-01-07 | 安徽医科大学 | Tissue real-time in-vivo identification equipment in tumor resection and matched identification method thereof |
| CN114469344A (en) * | 2022-01-27 | 2022-05-13 | 上海安翰医疗技术有限公司 | Navigation head and surgical navigation equipment |
| CN114469344B (en) * | 2022-01-27 | 2024-01-09 | 上海安翰医疗技术有限公司 | Navigation head and operation navigation equipment |
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