WO2010136092A1 - Lampe opératoire, système de formation d'image et utilisation d'une lampe opératoire - Google Patents
Lampe opératoire, système de formation d'image et utilisation d'une lampe opératoire Download PDFInfo
- Publication number
- WO2010136092A1 WO2010136092A1 PCT/EP2010/001883 EP2010001883W WO2010136092A1 WO 2010136092 A1 WO2010136092 A1 WO 2010136092A1 EP 2010001883 W EP2010001883 W EP 2010001883W WO 2010136092 A1 WO2010136092 A1 WO 2010136092A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- light
- operating
- fluorescence
- recording device
- surgical
- Prior art date
Links
- 238000003384 imaging method Methods 0.000 title claims abstract description 23
- 230000010412 perfusion Effects 0.000 claims abstract description 20
- 238000012545 processing Methods 0.000 claims description 18
- 230000005284 excitation Effects 0.000 claims description 12
- 238000001356 surgical procedure Methods 0.000 claims description 7
- 230000003287 optical effect Effects 0.000 claims description 5
- 238000002156 mixing Methods 0.000 claims description 2
- 238000012632 fluorescent imaging Methods 0.000 claims 1
- 238000001228 spectrum Methods 0.000 description 15
- 238000000695 excitation spectrum Methods 0.000 description 14
- MOFVSTNWEDAEEK-UHFFFAOYSA-M indocyanine green Chemical compound [Na+].[O-]S(=O)(=O)CCCCN1C2=CC=C3C=CC=CC3=C2C(C)(C)C1=CC=CC=CC=CC1=[N+](CCCCS([O-])(=O)=O)C2=CC=C(C=CC=C3)C3=C2C1(C)C MOFVSTNWEDAEEK-UHFFFAOYSA-M 0.000 description 13
- 229960004657 indocyanine green Drugs 0.000 description 13
- 230000005855 radiation Effects 0.000 description 10
- 238000011156 evaluation Methods 0.000 description 5
- 230000001954 sterilising effect Effects 0.000 description 5
- 238000004659 sterilization and disinfection Methods 0.000 description 5
- 239000003086 colorant Substances 0.000 description 4
- 238000005286 illumination Methods 0.000 description 4
- 238000011161 development Methods 0.000 description 3
- GNBHRKFJIUUOQI-UHFFFAOYSA-N fluorescein Chemical compound O1C(=O)C2=CC=CC=C2C21C1=CC=C(O)C=C1OC1=CC(O)=CC=C21 GNBHRKFJIUUOQI-UHFFFAOYSA-N 0.000 description 3
- 238000002073 fluorescence micrograph Methods 0.000 description 3
- 230000010354 integration Effects 0.000 description 3
- 238000000034 method Methods 0.000 description 3
- 238000010521 absorption reaction Methods 0.000 description 2
- 229910052736 halogen Inorganic materials 0.000 description 2
- 150000002367 halogens Chemical class 0.000 description 2
- QSHDDOUJBYECFT-UHFFFAOYSA-N mercury Chemical compound [Hg] QSHDDOUJBYECFT-UHFFFAOYSA-N 0.000 description 2
- 238000003556 assay Methods 0.000 description 1
- 239000008280 blood Substances 0.000 description 1
- 210000004369 blood Anatomy 0.000 description 1
- 230000008081 blood perfusion Effects 0.000 description 1
- 238000004140 cleaning Methods 0.000 description 1
- 239000002131 composite material Substances 0.000 description 1
- 230000001143 conditioned effect Effects 0.000 description 1
- 238000001816 cooling Methods 0.000 description 1
- 239000000428 dust Substances 0.000 description 1
- 238000002189 fluorescence spectrum Methods 0.000 description 1
- 230000004927 fusion Effects 0.000 description 1
- 238000005259 measurement Methods 0.000 description 1
- 238000002324 minimally invasive surgery Methods 0.000 description 1
- 239000000203 mixture Substances 0.000 description 1
- 210000000056 organ Anatomy 0.000 description 1
- 238000002360 preparation method Methods 0.000 description 1
- 102000004169 proteins and genes Human genes 0.000 description 1
- 108090000623 proteins and genes Proteins 0.000 description 1
- 238000009877 rendering Methods 0.000 description 1
- 230000003595 spectral effect Effects 0.000 description 1
- 230000001360 synchronised effect Effects 0.000 description 1
- 238000002211 ultraviolet spectrum Methods 0.000 description 1
- 238000011144 upstream manufacturing Methods 0.000 description 1
- 238000001429 visible spectrum Methods 0.000 description 1
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 description 1
- 229910052724 xenon Inorganic materials 0.000 description 1
- FHNFHKCVQCLJFQ-UHFFFAOYSA-N xenon atom Chemical compound [Xe] FHNFHKCVQCLJFQ-UHFFFAOYSA-N 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/026—Measuring blood flow
- A61B5/0275—Measuring blood flow using tracers, e.g. dye dilution
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/30—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/026—Measuring blood flow
- A61B5/0261—Measuring blood flow using optical means, e.g. infrared light
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/30—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
- A61B2090/308—Lamp handles
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
- A61B2090/364—Correlation of different images or relation of image positions in respect to the body
Definitions
- ICG indocyanine green
- chromophore A commonly used chromophore for tissue perfusion studies is indocyanine green (ICG), which binds well to proteins in the blood and fluoresces in the near infrared region.
- ICG indocyanine green
- the peak of the excitation spectrum for ICG lies between 785 nm and 815 nm, the de-excitation spectrum approximately between 820 nm and 840 nm. Further absorption maxima are exhibited by ICG in the UV range.
- Tissue perfusion studies with ICG as the chromophore are often performed in the near infrared region.
- the emitted fluorescence radiation is detected by a recording device, such as a CCD camera or an intensified CCD.
- a device known from EP 1 210 906 B1 comprises a near-infrared laser for exciting indocyanine green, an expansion optics for the generated laser beam, a safety housing, an electronic camera with an optical filter and an electronic image evaluation system.
- the optical filter is transmissive to emitted light of the excited indocyanine green and impermeable to the wavelength range of the generated beam.
- the image evaluation system is equipped to determine the brightness of the pixels in selected image areas, wherein the light source and the expansion optics are integrated into the security housing so that only a harmless, expanded beam can emerge from the security housing.
- the expansion optics allow the illumination of a sufficiently large surgical field, even for non-microinvasive procedures.
- an operating doctor such as a surgeon, cardiologist, dentist or ophthalmologist u. a., one
- an operating light comprising at least a first light source for illuminating an operating field with visible, in particular white, light for an operator, which is further developed in that for determining a tissue perfusion during surgery, an operation field aligned or alignable imaging fluorescence sensing device sensitive to emitted fluorescent light of a chromophore.
- an insertable filter In the case of a fixed filter, only fluorescent light enters the fluorescence acquisition device.
- an insertable filter it is possible to switch the mode of operation of the fluorescence acquisition device back and forth between fluorescence acquisition and conventional imaging.
- an insertable filter is advantageously designed as a filter wheel with a plurality of positions, of which one position is equipped with the corresponding emission or fluorescence filter and another position is left free. It is also possible to use different filter positions of a corresponding filter wheel be equipped with bandpass filters or preferably low-pass filters for different wavelengths, which are each adapted to different emission frequencies of one or different chromophores, such as indocyanine green and fluorescein.
- the surgical light comprises two pick-up devices, one of which is a fluorescence pick-up device and another is a conventional pick-up device.
- Fluorescence recording device and the recording device are aligned or alignable by means of a common optics on the surgical field, wherein an optical element for splitting received light on the fluorescence recording device and the recording device, in particular a prism and / or a semitransparent mirror is provided.
- the two recording devices have an identical perspective, so that the images generated by the two recording devices are ideally compatible and superimposed on each other.
- the fluorescence acquisition device and / or the acquisition device are or are in a central hand position. handle the surgical light arranged.
- the receiving device or receiving devices are preferably encapsulated in the central handle or in the surgical light, which facilitates or eliminates the need for cleaning and sterilization.
- an imaging system for determining a tissue perfusion during an operation comprising an operating light according to the invention, as described above, and an image data processing device, in particular with an image display device, wherein the image data processing device for receiving and processing image data from the Fluorescence recording device is formed.
- an imaging system allows the simultaneous and conditioned rendering of the fluorescence image data from an optimal acquisition position during surgery, thus providing an ideal tool to aid in an operation requiring tissue perfusion to be examined or considered.
- This measure is particularly useful to the surgeon as he simultaneously has at his disposal during the surgery or in the follow-up of the surgery, image data with all the relevant data for tissue perfusion directly superimposed on such reference images, that of his own natural view of the surgical field with the body, organ or tissue to be operated. Thus, the surgeon immediately and without thinking the perfusion state of each part of the affected tissue in the surgical field.
- the images of the recording device can also be processed by means of intensified colors and contrasts or contain further information.
- the perfusion data can be displayed in spatial distribution, for example in false colors. This immediately indicates to the surgeon which tissue parts in the surgical field are insufficiently perfused, for example. With this data, he can immediately plan and execute his next operation steps.
- a corresponding integrated surgical system is known, for example, under the name Advanced EndoAlpha (AEA) of the Applicant.
- a corresponding integrated surgical system provides a uniform interface for different applications in an operating room or operating environment, via which the various applications or devices can be operated and whose status can be retrieved and monitored.
- An operating light according to the invention with integrated fluorescence acquisition device and optionally an inte- The integrated visible light imaging device in the entire visible spectrum is ideal and easy to insert into such an integrated surgical system.
- False color representation for example, for the infrared image or the fluorescence image is superimposed.
- the surgical light according to the invention and the fluorescence recording device included therein can also be remotely configured or activated.
- FIG. 1 is a schematic representation of a surgical light according to the invention in a first embodiment
- FIG. 2 is a schematic representation of a surgical light according to the invention in a second embodiment
- FIG. 3 is a schematic representation of a connection of an operating light according to the invention to a Schmda ten kaus- and control device.
- Fig. 1 shows a surgical light 1 according to the invention in a schematic representation.
- a central handle 8 Arranged around a central handle 8 are first light sources 2, 3 which illuminate a surgical field 5 on a surgical underlay 4. For reasons of clarity, no surgeon and no patient in the surgical field 5 or on the surgical pad 4 are shown.
- the light fields 6, 7 or light cone of the first light sources 2, 3 are indicated by dashed lines.
- the first light sources 2, 3 ensure uniform illumination of the surgical field 5 in the visible, in particular white light. This is the light that a human surgeon needs to perform an operation.
- a recording device 1 for example, a CCD camera with a lens 12 and a rotatable fluorescence filter 14 are shown, the field of view 5 detects the operating field.
- the recording device 1 1 is sensitive, for example, in the near-infrared region in order to detect the radiation of a chromophore, for example indocyanine green, whose fluorescence excitation spectrum lies in the near-infrared region.
- the fluorescence filter 14 is shown schematically as a filter wheel with four positions. The positions can filter for different
- indocyanine green both part of the excitation spectrum and the de-excitation spectrum are in the near-infrared range.
- the excitation spectrum of indocyanine green continues to extend beyond the visible light to the ultraviolet spectrum.
- the two recording devices 21, 21 ' have a common lens 22, which is the field of view of the recording devices
- the further beam path to the lens 22 is provided with reference numeral 25.
- a beam splitter 23 in the present case, a semi-transparent mirror.
- the beam path 25 splits, wherein a portion of the beams impinges on the recording device 21 'and another beam of the beam path 25 strikes the recording device 21 through a rotatable fluorescence filter 24.
- both recorders 21, 21 ' have the same perspective so that their images representing different frequency spectra can readily be superimposed to give a composite representation of natural representation and false color representation of fluorescence image data.
- FIG. 3 shows a control unit 31 within the operating light 1, which serves for controlling and powering the first light sources 2, 3 and the receiving devices 11, 21, 21 'via control and data lines 32, 33, 34.
- the control line 34 for the first light sources 2, 3 is divided. These first light sources 2, 3 are driven together. Not shown is another control line for the second light source 16.
- a further control and data line 35 leads to an image data processing and control device 36, here represented in the form of a data processing system, with a screen 37 and a keyboard 38.
- the image data processing and control device 36 takes the image data of the recording devices 1 1, 21, 21 'and processes them, superimposes them if necessary and presents them separately or together.
- the image data processing and control device 36 is also designed to record the image data during an operation for later evaluation and to control the operating light 1 and the components arranged therein, for example the brightness of the first light sources 2, 3 and the second light source 16 and optionally their coordination, ie the illumination of the surgical field 5.
- the rotatable fluorescence filters 14, 24 are controllable by means of the image data processing and control device 36.
- the image data processing and control device 36 may also be part of an integrated operation system such as the patent applicant's Active EndoAlpha system.
- Manner also light-tight veneers can be produced, so that the receiving devices 1 1, 21, 21 'exclusively absorb light that has been reflected from the surgical field 5.
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Molecular Biology (AREA)
- General Health & Medical Sciences (AREA)
- Veterinary Medicine (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Public Health (AREA)
- Animal Behavior & Ethology (AREA)
- Pathology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Hematology (AREA)
- Cardiology (AREA)
- Physiology (AREA)
- Physics & Mathematics (AREA)
- Biophysics (AREA)
- Investigating, Analyzing Materials By Fluorescence Or Luminescence (AREA)
Abstract
L'invention concerne une lampe opératoire (1) qui comprend au moins une première source de lumière (2, 3) pour éclairer un champ opératoire (5) par de la lumière visible, en particulier de la lumière blanche, au bénéfice d'un opérateur, ainsi qu'un système de formation d'image pour déterminer une transfusion de tissu pendant une opération et qui comprend une lampe opératoire (1) correspondante, et des utilisations d'une lampe opératoire correspondante (1). La lampe opératoire (1) selon l'invention est transformée en y incluant un dispositif (11; 21) d'enregistrement de fluorescence formant des images, qui est orienté ou peut être orienté sur le champ opératoire (5) pendant une opération pour déterminer une transfusion de tissu, et qui est sensible à la lumière fluorescente émise par un chromophore.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| DE102009022497.1 | 2009-05-25 | ||
| DE102009022497A DE102009022497A1 (de) | 2009-05-25 | 2009-05-25 | Operationsleuchte, Bildgebungssystem und Verwendung einer Operationsleuchte |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| WO2010136092A1 true WO2010136092A1 (fr) | 2010-12-02 |
Family
ID=42269631
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| PCT/EP2010/001883 WO2010136092A1 (fr) | 2009-05-25 | 2010-03-25 | Lampe opératoire, système de formation d'image et utilisation d'une lampe opératoire |
Country Status (2)
| Country | Link |
|---|---|
| DE (1) | DE102009022497A1 (fr) |
| WO (1) | WO2010136092A1 (fr) |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20210106237A1 (en) * | 2013-09-20 | 2021-04-15 | National University Corporation Asahikawa Medical University | Method and system for image processing of intravascular hemodynamics |
Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| EP1210906B1 (fr) | 2000-11-28 | 2006-06-07 | Pulsion Medical Systems AG | Dispositif pour déterminer l'état de perfusion tissulaire |
| US20060173358A1 (en) * | 2005-01-11 | 2006-08-03 | Olympus Corporation | Fluorescence observation endoscope apparatus and fluorescence observation method |
| DE102005019143A1 (de) * | 2005-04-20 | 2006-11-02 | Karl Storz Gmbh & Co. Kg | Kombiniertes diagnose- und therapieunterstützendes System |
| DE102005036275A1 (de) * | 2005-08-02 | 2007-02-08 | Berchtold Holding Gmbh | Operationsleuchte |
| US20090127433A1 (en) * | 2007-11-13 | 2009-05-21 | Trumpf Medizin Systeme Gmbh + Co. Kg | Illuminating a Surgical Site |
Family Cites Families (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JP3417795B2 (ja) * | 1997-04-30 | 2003-06-16 | ペンタックス株式会社 | 蛍光診断装置 |
-
2009
- 2009-05-25 DE DE102009022497A patent/DE102009022497A1/de not_active Withdrawn
-
2010
- 2010-03-25 WO PCT/EP2010/001883 patent/WO2010136092A1/fr active Application Filing
Patent Citations (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| EP1210906B1 (fr) | 2000-11-28 | 2006-06-07 | Pulsion Medical Systems AG | Dispositif pour déterminer l'état de perfusion tissulaire |
| US20060173358A1 (en) * | 2005-01-11 | 2006-08-03 | Olympus Corporation | Fluorescence observation endoscope apparatus and fluorescence observation method |
| DE102005019143A1 (de) * | 2005-04-20 | 2006-11-02 | Karl Storz Gmbh & Co. Kg | Kombiniertes diagnose- und therapieunterstützendes System |
| DE102005036275A1 (de) * | 2005-08-02 | 2007-02-08 | Berchtold Holding Gmbh | Operationsleuchte |
| US20090127433A1 (en) * | 2007-11-13 | 2009-05-21 | Trumpf Medizin Systeme Gmbh + Co. Kg | Illuminating a Surgical Site |
| EP2063309A1 (fr) * | 2007-11-13 | 2009-05-27 | TRUMPF Medizin Systeme GmbH + Co. KG | Lumière d'opération et procédé d'illumination d'un poste d'opération |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20210106237A1 (en) * | 2013-09-20 | 2021-04-15 | National University Corporation Asahikawa Medical University | Method and system for image processing of intravascular hemodynamics |
Also Published As
| Publication number | Publication date |
|---|---|
| DE102009022497A1 (de) | 2010-12-02 |
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