WO2017171252A1 - Instrument électrochirurgical intelligent avec poursuite de tumeur - Google Patents

Instrument électrochirurgical intelligent avec poursuite de tumeur Download PDF

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Publication number
WO2017171252A1
WO2017171252A1 PCT/KR2017/002230 KR2017002230W WO2017171252A1 WO 2017171252 A1 WO2017171252 A1 WO 2017171252A1 KR 2017002230 W KR2017002230 W KR 2017002230W WO 2017171252 A1 WO2017171252 A1 WO 2017171252A1
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Prior art keywords
tumor
gamma
tracking
gamma ray
unit
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PCT/KR2017/002230
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English (en)
Korean (ko)
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하효은
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하효은
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/08—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/12—Arrangements for detecting or locating foreign bodies

Definitions

  • the present invention relates to a real-time tumor tracking electrosurgical device, and in particular, a gamma probe capable of detecting gamma rays emitted from a tumor in a conventional electrosurgical unit (ESU) capable of invading a tumor and bleeding the incision site.
  • ESU electrosurgical unit
  • the present invention relates to a new concept fusion surgical device capable of simultaneously identifying and removing residual cancer and real-time tumor tracking and removal during cancer surgery.
  • Electrosurgical instruments are widely used for surgical operations such as cancer resection.
  • the electrosurgical device is a surgical device that applies a high-frequency power to the incision tip to generate an electric discharge or high heat, and incision the surgical site by using the same, and at the same time hemostatic the incision site, bleeding compared to the conventional incision method using a scalpel It has a small hemostatic effect and is widely used in the field of surgery.
  • Patent Document 1 Korean Patent Registration No. 10-0500395 (Patent Document 1), when a surgical operation is required, the tissue is cut and coagulated by applying heat to the tissue as needed. It is used, and describes the electric cutter for surgery to shorten the operation time and increase the convenience of use by adjusting the strength of the cutting, the strength of the weak and coagulation heat, the drug as needed.
  • fine cancer cells may remain around even after the incision of the affected area, and these fine cancer cells cannot be accurately identified with the naked eye, and recently, they have been confirmed using molecular imaging equipment.
  • Molecular imaging is an imaging of gene phenomena occurring in vivo or biochemical and physiological levels of life phenomena.F-18 FDG PET / CT is actively used in clinical diagnosis for cancer diagnosis. Compared with conventional imaging, the sensitivity and specificity of cancer diagnosis are known to be higher.
  • Patent Document 2 Korean Patent Laid-Open Publication No. 10-2016-0012391
  • a radiation induction capable of detecting a radiation dose irradiated to a radiation surgery unit by incorporating a radiation detector and a wireless communication control unit.
  • a surgical wireless probe is described.
  • the conventional gamma probe is used as a separate device from the electrosurgical operation, it is inconvenient to use the electrosurgical device and the gamma probe device alternately at the time of surgery, and the senile lymph node biopsy using Tc-99m pertechnetate is performed. It is difficult to track cancer tissue accurately in real time because it is mainly used in city.
  • the present invention has been made to solve the above problems of the conventional gamma probe and electrosurgical operation, the problem to be solved in the present invention by miniaturizing the gamma probe integrated into the electrosurgical operation, while tracking the tumor in real time, the electrical removal surgery At the same time it is to provide a possible smart tumor tracking electrosurgical device.
  • the smart tumor tracking electrosurgery device is a smart tumor tracking electrosurgery device capable of real-time tumor tracking and removal and confirmation and removal of residual cancer at the same time. It comprises an electrosurgical unit for incision, hemostatic incision, and a gamma probe unit formed integrally with the electrosurgical unit and detecting a gamma ray radiated from the tumor to track the tumor.
  • the electrosurgical unit includes a power supply unit for generating a high frequency signal and an incision tip for generating an electric discharge or high heat by receiving a high frequency signal from the power supply unit.
  • the gamma probe unit may include a gamma ray detector for detecting gamma rays radiated from a tumor, a signal processor for converting and outputting the gamma rays detected by the gamma ray detector into digital signals, and counting digital signals from the signal processor as gamma ray information. And a display unit for displaying gamma ray information from the controller to the outside.
  • the gamma ray detector may include a scintillator that receives gamma rays and emits light, an aiming unit that blocks gamma rays coming from an undesired direction, and a detection sensor that detects light generated from the scintillator, wherein the detection sensor is a CdZnTe (CZT) semiconductor. It is preferable that it is a sensor.
  • CZT CdZnTe
  • the signal processor may include an amplifier for amplifying the signal detected by the detection sensor, and an analog / digital converter for filtering the signal amplified by the amplifier and outputting the digital signal from which the noise is removed.
  • the gamma ray detector is installed concentrically along the outer circumferential surface of the incision tip, and is installed to move forward and backward of the incision tip, or is installed in four directions along the outer circumference of the incision tip, and is movable to the front and rear of the incision tip. Can be installed.
  • a gamma probe for tumor detection and an electrosurgical device for incision are integrally formed, surgery such as incision can be performed while tracking a tumor in real time. Therefore, by improving the accuracy and promptness of tumor tracking during surgery and reducing the operation time and anesthesia time, it is possible to simultaneously achieve the results of cancer surgery and the reduction of surgical complications and side effects of patients.
  • FIG. 1 is a cross-sectional view functionally showing a tumor tracking electrosurgical device according to an embodiment of the present invention, showing a state in which a gamma ray detector is protruded.
  • FIG. 2 is a cross-sectional view illustrating a form in which the sliding button is not positioned on the same line as the operation button in the electrosurgical apparatus of FIG. 1.
  • FIG. 3 is a cross-sectional view showing a state in which the incision tip protrudes in the electrosurgical instrument of FIG.
  • FIG. 4 is a cross-sectional view functionally showing a tumor tracking electrosurgical device according to another embodiment of the present invention, showing a state in which a gamma ray detector is protruded.
  • FIG. 5 is a block diagram functionally showing the configuration of a gamma probe unit in a tumor tracking electrosurgical operation device according to the present invention.
  • Figure 6 is a perspective view showing the overall appearance of the tumor tracking electrosurgical operation according to an embodiment of the present invention.
  • FIG. 1 to 6 schematically show a smart tumor tracking electrosurgical device according to an embodiment of the present invention.
  • the electrosurgical device is a smart tumor tracking electrosurgical device capable of tracking the location of a tumor and simultaneously dissecting the tumor and bleeding the incision, and is mainly composed of an electrosurgical unit and a gamma probe unit.
  • the electrosurgical unit is to incise or bleed the affected area by generating an electric discharge or high heat, and generates an electric discharge or high heat by receiving a high frequency signal from the power supply unit 110 and the power supply unit 110 generating a high frequency signal. It consists of a cutting tip 120 to.
  • the power supply unit 110 generates a high frequency signal and applies it to the incision tip 120.
  • the power supply 110 supplies operating power to each component of the gamma probe unit or the electrosurgical unit.
  • the cutting tip 120 is a kind of heat generating member that receives high frequency power from the power supply 110 and generates heat by electric resistance.
  • the high fever generated in the incision tip 120 is applied to the affected part to enable incision or hemostasis of the affected part.
  • the gamma probe unit detects gamma rays radiated from the tumor and tracks the tumor, and injects cancer-specific radiopharmaceuticals for molecular imaging and detects gamma rays generated from the tumor.
  • the gamma probe unit includes a gamma ray detector 210, a signal processor 220, a controller 230, and a display 240, and is integrally formed with an electrosurgical unit and one handpiece.
  • the gamma ray detector 210 is provided in a concentric shape along the outer peripheral surface of the cutting tip 120.
  • the gamma ray detector 210 may be fixed to the rear side of the incision tip 120, but is preferably slidably moved forward and backward of the incision tip 120. By the sliding movement, the state in which the gamma ray detector 210 protrudes is shown in FIG. 1, and the state in which the incision tip 120 protrudes is shown in FIG. 3.
  • the end of the gamma-ray detector 210 is operated by the patient rather than the state where the gamma-ray detector 210 shown in FIG. 3 slides backward. Since it can be located closer to the site has the effect of increasing the sensitivity of cancer cells, that is, the detection of gamma rays.
  • the gamma ray detector 210 may be less affected by the heat generated by the cutting tip 120.
  • the sliding button 310 for manipulating the sliding movement is installed on the body surface of the electrosurgical instrument.
  • the sliding button 310 may be installed on the same line as the operation button 320 of the electrosurgical instrument.
  • the sliding button 310 and the operation button 320 of the electrosurgical instrument may be circled. It may be installed 90 degrees apart.
  • the operation button 320 may be located on the operator's index finger
  • the sliding button 310 may be located on the operator's thumb.
  • the sliding button 310 may be installed so as to be spaced about 90 degrees from the opposite side of the operation button 320, unlike the case of FIGS. This will provide an optimal environment for the operator who mainly uses his left hand.
  • the gamma ray detector 210 may be installed at a predetermined interval in four directions of the outer circumferential surface of the cutting tip 120.
  • the gamma ray detector 210 of this type is shown in FIG. 4.
  • FIG. 4 In the present exemplary embodiment, only the two types of gamma ray detectors 210 of FIGS. 1 and 4 are illustrated, but the present invention is not limited thereto, and various other forms installed adjacent to the incision tip 120 may be considered. .
  • the gamma ray detector 210 detects the gamma rays radiated from the tumor
  • the signal processor 220 converts the gamma rays detected by the gamma ray detector 210 to a digital signal and outputs the digital signal
  • 230 counts and outputs the digital signal from the signal processor 220 as gamma ray information.
  • the display unit 240 serves to display gamma ray information from the controller 230 to the outside, and also displays information related to the electrosurgical unit if necessary.
  • the gamma ray detector 210 includes a scintillator 211, a detection sensor 212, and a collimator 213.
  • the scintillator 211 is an element that emits light by gamma rays from a tumor of a patient, and may include a reflector for preventing leakage of light.
  • the detection sensor 212 is for detecting the emitted light and may be configured as a semiconductor sensor or a photodiode.
  • the semiconductor sensor uses CdZnTe (CZT), which shows good signal characteristics even at room temperature, and can achieve both miniaturization and excellent energy resolution.
  • the aimer 213 is a mechanical focusing device that blocks high energy gamma rays, such as gamma rays, from entering in an undesired direction, and tungsten is mainly used.
  • the signal processor 220 may include a shaping amplifier 221 for amplifying a signal detected by the detection sensor 212, and an analog / digital converter (A / D) for noise filtering of the amplified signal. converter 222.
  • the A / D converter 222 filters the noise to remove the noise. To this end, the A / D converter 222 includes a noise filter.
  • the signal output from the A / D converter 222 is input to the controller 230, and the controller 230 counts and quantifies the gamma dose.
  • the quantified gamma dose is displayed on the display unit 240.
  • the numerical value may be displayed by a number, may be displayed in the form of a graph, may be displayed by color, or in some cases, a separate acoustic speaker may be built in, so that a signal sound may be generated according to gamma dose. This beep allows the operator to determine the site to be excised without looking at the display 240.
  • an operation button 320 for operating a gamma probe unit and an electrosurgical unit is installed on the body surface of the electrosurgical device, and the operation button 320 is used to select hemostasis of the incision of the tumor and the incision site. Selection buttons, detection buttons of the gamma probe unit, and the like may be included.
  • FIG. 6 shows a schematic appearance of a tumor tracking electrosurgical apparatus according to an embodiment of the present invention, wherein the power controller 400, together with the power supply 110 described above, measures the magnitude of the high frequency signal applied to the electrosurgical unit. It may further include a control device that can be adjusted.
  • the smart tumor tracking electrosurgical device can track the tumor in real time by the gamma probe unit, and hemostasis of the incision and the incision site of the tumor tracked by the electrosurgical unit. In addition, by scanning the entire surgical site to check the remaining cancer tissue without biopsy enables accurate tumor removal surgery.
  • the tumor tracking electrosurgical device of the present invention utilizes a variety of cancer-specific radiopharmaceuticals to enable real-time tumor tracking and removal and identification and removal of residual cancer at the time of cancer surgery, thereby improving the results of cancer surgery and reducing the occurrence of surgical complications and side effects. Will be achieved.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Surgery (AREA)
  • Medical Informatics (AREA)
  • Veterinary Medicine (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Physics & Mathematics (AREA)
  • Otolaryngology (AREA)
  • Plasma & Fusion (AREA)
  • Biophysics (AREA)
  • High Energy & Nuclear Physics (AREA)
  • Optics & Photonics (AREA)
  • Pathology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Surgical Instruments (AREA)
  • Measurement Of Radiation (AREA)

Abstract

La présente invention concerne un instrument électrochirurgical intelligent avec poursuite de tumeur, qui peut effectuer simultanément la poursuite et le retrait d'une tumeur et l'identification et le retrait d'un cancer résiduel en temps réel, l'instrument électrochirurgical comprenant : une unité électrochirurgicale pour générer une décharge électrique ou une chaleur élevée de façon à découper une tumeur et arrêter le saignement du site excisé ; et une unité de sonde gamma pour poursuivre une tumeur par détection de rayons gamma émis depuis la tumeur, l'unité de sonde gamma étant formée de façon intégrée avec l'unité électrochirurgicale. Par conséquent, l'instrument électrochirurgical intelligent peut effectuer une opération telle qu'une résection tout en poursuivant simultanément une tumeur en temps réel, améliorer la précision et la vitesse de suivi de tumeur pendant l'opération, et réduire le temps nécessaire pour l'opération et l'anesthésie.
PCT/KR2017/002230 2016-04-01 2017-02-28 Instrument électrochirurgical intelligent avec poursuite de tumeur WO2017171252A1 (fr)

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KR1020160040473A KR101714310B1 (ko) 2016-04-01 2016-04-01 스마트 종양추적 전기 수술기
KR10-2016-0040473 2016-04-01

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2024090612A1 (fr) * 2022-10-27 2024-05-02 주식회사 브라이토닉스이미징 Dispositif de fusion d'images pour intervention chirurgicale laparoscopique

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6484050B1 (en) * 1997-11-18 2002-11-19 Care Wise Medical Products Corporation Minimally invasive surgical instrument for tissue identification, dislodgment and retrieval and methods of use
US6771802B1 (en) * 2000-04-13 2004-08-03 Photon Imaging, Inc. Method and apparatus for imaging and localizing radiation
KR100500395B1 (ko) * 2002-05-15 2005-07-14 고홍 수술용 전기 컷터와 그 제어방법
WO2011104664A1 (fr) * 2010-02-26 2011-09-01 Koninklijke Philips Electronics N.V. Dispositif chirurgical d'ablation capable de différencier les tissus
KR20160012391A (ko) * 2014-07-24 2016-02-03 명지대학교 산학협력단 방사유도 수술용 무선 프로브 및 그 제어 방법

Family Cites Families (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9554866B2 (en) * 2011-08-09 2017-01-31 Covidien Lp Apparatus and method for using a remote control system in surgical procedures

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6484050B1 (en) * 1997-11-18 2002-11-19 Care Wise Medical Products Corporation Minimally invasive surgical instrument for tissue identification, dislodgment and retrieval and methods of use
US6771802B1 (en) * 2000-04-13 2004-08-03 Photon Imaging, Inc. Method and apparatus for imaging and localizing radiation
KR100500395B1 (ko) * 2002-05-15 2005-07-14 고홍 수술용 전기 컷터와 그 제어방법
WO2011104664A1 (fr) * 2010-02-26 2011-09-01 Koninklijke Philips Electronics N.V. Dispositif chirurgical d'ablation capable de différencier les tissus
KR20160012391A (ko) * 2014-07-24 2016-02-03 명지대학교 산학협력단 방사유도 수술용 무선 프로브 및 그 제어 방법

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2024090612A1 (fr) * 2022-10-27 2024-05-02 주식회사 브라이토닉스이미징 Dispositif de fusion d'images pour intervention chirurgicale laparoscopique

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