CN111445754B - Auxiliary training system for simulating laser surgery - Google Patents
Auxiliary training system for simulating laser surgeryDownload PDFInfo
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- CN111445754B CN111445754BCN202010365708.2ACN202010365708ACN111445754BCN 111445754 BCN111445754 BCN 111445754BCN 202010365708 ACN202010365708 ACN 202010365708ACN 111445754 BCN111445754 BCN 111445754B
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Abstract
Description
Technical Field
The invention relates to the field of laser surgery, in particular to an auxiliary training system for simulating laser surgery.
Background
The theoretical basis of laser surgery is to utilize the thermal effect generated by the absorption of strong laser by biological tissues to generate coagulation, vaporization, carbonization, melting and other effects on the tissues. Laser surgery has the advantages of non-contact, less bleeding, high control precision and the like, and is widely applied and popularized in clinic at present. However, inIn laser surgery, the thermal effect generated by laser irradiation on tissues also brings about side effects such as thermal injury, and the like, and parameters such as laser wavelength, working mode, power density, energy density and the like are not properly selected, or the laser is operated to irradiate a non-focus area or damage normal tissues such as muscles and nerves near the focus during the operation, so that the side effects such as thermal injury and the like and even serious medical accidents are possibly generated. To minimize the side effects of thermal injury from laser surgery, there are two solutions: 1. the laser technology is improved, energy is efficiently absorbed in a focus area as much as possible under the condition that the laser energy density is the same, instantaneous thermal effects such as erosion and the like on a minimum area are generated, and heat is not transmitted to tissues outside the focus; 2. the operation experience of doctors is improved, so that more reasonable laser parameters can be selected according to clinical focuses, and more reasonable operation can be performed. In the former case, anderson, proc. Massachusetts, mass.C.of Harvard, USA, equal to 1983, proposed the theory of selective photothermolysis, which states that the use of light of appropriate wavelength (usually higher absorption at these tissues, cells and organelles), energy density and pulse width can cause selective damage to specific tissues, cells and organelles of the body, while causing less damage to other surrounding tissues. Precise laser microsurgery can be performed through this selective absorption of pulsed laser light. Accordingly, the series of CO at 532nm and 1064nm for the hemoglobin absorption peak in the tissue and for the water absorption peak in the tissue2 Lasers (10600nm, 9340nm), erYAG (2940 nm), er: hoYAG (2870 nm) and the like are rapidly applied to clinical surgical operations on blood vessels, skin, tumors, bone tissues, hard tissues of teeth and the like. Meanwhile, the pulse width is improved from microsecond to femtosecond, so that the laser can generate extremely small thermal effects such as ablation and the like, and the novel effect of excellent precise blasting and cutting effects on tissues is realized. The femtosecond laser technology developer, asia se, astru, thus won the nobel prize of 2018. However, the promotion of laser theory and technology has certainly produced a great push to the clinical application, but the actual laser operation is performed by a doctor, and the operation experience of the laser operation of the clinician is an important factor for determining the operation effect. Such as laser surgery by cliniciansThe probability of side effects such as thermal injury and even medical accidents in laser surgery is relatively high due to inexperience. This may further lead to a fear of medical accidents and the selection of other surgical techniques. Therefore, the lack of clinical operation experience may cause medical accidents, and limit the application and popularization of laser surgery. Aiming at the improvement of the operation experience of doctors, currently, laser medical teaching and training are mainly carried out by professors with abundant use experience, the laser medical academic organization makes clinical specifications and doctors carry out simulation experiments in corresponding tissues of animals (such as a pig mandible simulation oral cavity and a cockscomb tissue simulation blood vessel) to improve the operation experience, and a technical solution which can simulate and carry out real-time quantitative analysis on the actual operation effect of the clinicians is not available.
In order to solve the problems, the invention creates a laser surgery in-vitro phantom photothermal dynamic parameter inspection technology based on a multi-mode sensor network, based on the technology, an expert library consisting of experts with abundant clinical operation experience is established, and by using an intelligent algorithm, each operation of a clinician on the in-vitro phantom can be analyzed in real time, so that the laser operation experience can be rapidly improved by the clinician, the generation of thermal injury side effects is reduced and even avoided, and the laser surgery clinical popularization and application are assisted.
Disclosure of Invention
The invention aims to provide an assistant training system for simulating laser surgery, which is used for intelligently assisting in training the laser surgery.
In order to achieve the purpose, the invention provides the following scheme:
an assisted training system for simulating laser surgery, the system comprising:
simulating a focus;
a normal tissue phantom located on both sides and/or below the lesion phantom;
the laser handle is positioned above the focus imitation body;
the multimode sensor network is distributed between the focus imitation body and the normal tissue imitation body and is used for acquiring temperature change data of the focus imitation body irradiated by the laser handle and transmitted light energy of laser after the laser penetrates through the focus imitation body and/or the normal tissue imitation body in real time;
the data acquisition module is connected with the multi-mode sensor network and is used for acquiring the temperature change data and the light energy;
the camera/infrared thermal imaging head is positioned above the focus imitation body and the normal tissue imitation body in an inclined manner and is used for detecting the surface temperature and the image change condition of the focus imitation body in real time;
and the upper computer is connected with the data acquisition module and the camera/infrared thermal imaging head, and is used for receiving the temperature change data, the light energy and the surface temperature and image change data of the focus imitation and/or the normal tissue imitation and processing the temperature change data, the light energy and the surface temperature and image change data of the focus imitation and/or the normal tissue imitation.
Optionally, the system further includes:
a lens hood for preventing reflection laser gets into operator's eye, causes simulation operation accident, the lens hood is upper and lower open-ended cylindric, and the bottom opening is used for covering the imitative body of focus with the imitative body of normal tissue, the open-top is used for stretching into of laser handle.
Optionally, the light shield is made of transparent glass.
Optionally, the transparent glass adopts a coating technology to realize absorption of laser with a specific wavelength.
Optionally, the camera/thermal infrared imager is located on the outer surface of the light shield.
Optionally, the multi-modal sensor network specifically includes: a plurality of micro temperature sensors and energy/power detection probes;
the plurality of micro temperature sensors are accurately positioned at specific positions of the focus imitation body and the normal tissue imitation body and are used for collecting the time-space data of the temperature change of the focus and the normal tissue imitation body after being irradiated by the laser handle in real time;
the energy/power detection probe is used for dynamically detecting the transmitted light energy of the laser after the laser penetrates through the focus imitation body and/or the normal tissue imitation body in real time;
the plurality of micro temperature sensors and the energy/power detection probe are connected with the data acquisition module.
Optionally, the processing of the temperature change data, the light energy, and the surface temperature and image change data of the lesion mimic and/or the normal tissue mimic specifically includes:
and comparing the temperature change data, the light energy and the surface temperature and image change data of the focus imitation and/or the normal tissue imitation with pre-stored standard data, judging whether the temperature change data, the light energy and the surface temperature and image change data of the focus imitation and/or the normal tissue imitation are abnormal or not, and giving a score.
According to the specific embodiment provided by the invention, the invention discloses the following technical effects:
the system can analyze each operation of a clinician on the focus phantom and/or the normal tissue phantom in real time, and assist the clinician to rapidly improve the laser operation experience, thereby reducing or even avoiding the generation of thermal injury side effects and assisting the clinical popularization and application of laser surgery.
Drawings
In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings needed to be used in the embodiments will be briefly described below, and it is obvious that the drawings in the following description are only some embodiments of the present invention, and it is obvious for those skilled in the art to obtain other drawings without inventive exercise.
Fig. 1 is a schematic structural diagram of an assistant training system for simulating laser surgery according to an embodiment of the present invention.
Description of the symbols:
the focus simulator comprises afocus simulator 1, anormal tissue simulator 2, alaser handle 3, amicro temperature sensor 401, an energy/power detection probe 402, adata acquisition module 5, a camera/infraredthermal imaging head 6, anupper computer 7 and alight shield 8.
Detailed Description
The technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are only a part of the embodiments of the present invention, and not all of the embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.
The invention aims to provide an assistant training system for simulating laser surgery, which is used for intelligently assisting in training the laser surgery.
In order to make the aforementioned objects, features and advantages of the present invention comprehensible, embodiments accompanied with figures are described in further detail below.
Fig. 1 is a schematic structural diagram of an assisted training system for simulating laser surgery according to an embodiment of the present invention, and as shown in fig. 1, the system includes: the system comprises afocus imitation 1, anormal tissue imitation 2, alaser handle 3, a multi-mode sensor network, adata acquisition module 5, a camera/infraredthermal imaging head 6, anupper computer 7 and alight shield 8.
Wherein, thenormal tissue imitations 2 are positioned at two sides of the focus imitations and can be positioned below the focus imitations under specific conditions. Sometimes, some normal tissue imitation needs to be added below the focus imitation, sometimes, only the focus tissue imitation needs to be carried out, and according to specific use conditions, a user can adjust the positions of the focus imitation and the normal tissue imitation.
Thelaser handle 3 is positioned above the focus imitation.
The multi-modal sensor network is distributed between the focus imitation body and the normal tissue imitation body and is used for collecting temperature change data of the focus imitation body irradiated by the laser handle and transmitted light energy of laser after the laser penetrates through the focus imitation body or the normal tissue imitation body in real time.
Specifically, the multimodal sensor network specifically includes: a plurality of micro temperature sensors and energy/power detection probes;
the plurality of micro temperature sensors are accurately positioned at specific positions of the focus imitation body and the normal tissue imitation body and are used for collecting the time-space data of the temperature change of the focus and the normal tissue imitation body after being irradiated by the laser handle in real time;
specifically, the experiment according to concrete operation is different, and the position that the sensor was placed is also different, and according to the demand, the sensor can be located laser beam under, perhaps regard laser facula center as the origin, place the sensor in reasonable within range, for example: the sensor can be placed 10mm away from the laser spot by 5mm of the diameter of the laser spot.
For example, the first case: knowing the temperature distribution in the focus tissue, taking the central point of a light spot on the surface of the tissue irradiated by laser as an origin, and descending the part right below (z axis) according to the step length of 0.1 mm; meanwhile, the temperature distribution on the surface can be measured by taking the central point of a light spot on the surface of the tissue irradiated by laser as the original point and taking r as the radius on the surface, and the value of r is 0-2 times of the radius of the light spot, so that the method is suitable for detecting the temperature distribution in the simulated body of the lesion tissue and using the simulated body of the normal tissue only;
in the second situation, the light damage of laser irradiation to normal tissues is known, and the boundary between the focus tissue and the normal tissues is selected at the temperature measuring point, so that the method is a method for simulating and clinically measuring the side effect of tissue damage.
The energy/power detection probe is used for dynamically detecting the transmitted light energy of the laser after the laser penetrates through the focus imitation body or the normal tissue imitation body in real time;
the plurality of micro temperature sensors and the energy/power detection probe are connected with the data acquisition module.
Thedata acquisition module 5 is connected with the multi-mode sensor network and is used for acquiring the temperature change data and the light energy;
the camera/thermalinfrared imager 6 is positioned above the focus imitation and the normal tissue imitation and is used for detecting the surface temperature and the image change condition of the focus imitation in real time;
theupper computer 7 is connected with the data acquisition module and the camera/infrared thermal imaging head, and is used for receiving the temperature change data, the light energy and the surface temperature and image change data of the focus imitation and processing the temperature change data, the light energy and the surface temperature and image change data of the focus imitation.
Specifically, the host computer compares the curve of the change of the light energy of each laser pulse transmitted light with the time (the time domain change of the light energy field) with the curve of the change of the light energy with the time recorded by the expert in the database after the simulation operation; meanwhile, the temperature change curve (temperature field time domain change) uploaded to the upper computer by the micro temperature measuring sensor is also uploaded to the upper computer and compared with the temperature change curve over time recorded by the micro temperature measuring sensor at the same measuring site and recorded by an expert in a simulation operation. If the laser operator selects improper parameters or the operation method is careless, the change of the light energy and the temperature along with the time will be abnormal, so that the upper computer judges that the operation is not in accordance with the standard through an algorithm, and simultaneously, quantitative scores are given according to the comparison with the operation simulation result of an expert.
Thelight shield 8 is of a cylindrical shape with an upper opening and a lower opening, the bottom opening is used for shielding the focus imitation body and the normal tissue imitation body, and the top opening is used for the laser handle to stretch into.
The lens hood is specifically a cone with a top opening smaller than a bottom opening, so that simulated irradiation of a doctor on a focus imitation is not influenced, the main body material of the lens hood is transparent glass, and specific absorption of laser with specific wavelength (such as 1064 nm) is realized by adopting a coating technology. The camera/infrared thermal camera is arranged on the light shield, and the shooting area of the camera/infrared thermal camera is the focus imitation and the periphery.
In actual use, a laser operator selects laser parameters according to clinical characteristics such as the size and the shape of a lesion mimic in a target area, and then performs irradiation operation by holding a laser handle. The multi-mode sensor network records the light transmission condition and the temperature distribution condition of the whole operation process in real time, the light transmission condition and the temperature distribution condition are sent to the upper computer through the data acquisition module, the light transmission condition and the temperature distribution condition of expert database experts performing treatment aiming at the same typical focus imitation on the upper computer are compared through an intelligent algorithm, whether the laser parameter selection and the operation of an actual laser operator are correct or not is judged, whether the treatment effect is achieved or not is judged, whether irreversible thermal damage is generated or not is judged, and finally the actual operation score of the laser operator is output. The camera or the online thermal infrared imager records the image change or temperature distribution of the lesion surface in the whole process of the simulated treatment and uploads the image change or temperature distribution to the upper computer in real time. The method is used for displaying the surface treatment effect in real time in the simulation treatment, and displaying the surface image change or temperature distribution simultaneously when the method is operated by an expert database expert after the score is given, so that a doctor can more accurately find the self deficiency and standardize the laser clinical operation. The selective light shield can play a role in laser safety protection, and can absorb stray light refracted and scattered from the surface of the imitation body, so that the stray light is prevented from being emitted into human eyes. Because the light shield only absorbs specific wavelength of laser, the visible light can still normally propagate, thereby facilitating the real-time observation of the treatment effect by laser operators and other observers.
The system consists of a detection probe penetrating light energy and a plurality of temperature measuring points at specified depth and position, the used focus imitation body is manufactured by adopting a 3D printing technology, and the focus imitation body can be produced in batch and has the same size and shape (taking hemangioma as an example, a 3D printing blood vessel cavity is filled with venous blood). The expert database is a database in which experts (national or international standards) in the field of laser therapy for a specific lesion are selected, and the experts actually operate the phantom and record information on transmitted light and temperature at each point throughout the operation as evaluation criteria. In the field of laser selective photothermal coagulation, there are thermal damage threshold (43 ℃), protein temperature denaturation threshold (60 ℃), pain threshold (43 ℃,52 ℃) and the like which can be used as references. If the light energy is abnormally changed or the temperature curve of each temperature measuring point breaks through the damage threshold in the whole operation process of an actual operator, the light energy can be compared with the light-heat dynamic change curve of the same imitation focus operated by the expert, and the temperature of each temperature measuring point can be judged to break through the threshold such as tissue damage, so that the quantifiable score can be made. The intelligent evaluation algorithm for evaluation can be simple and direct comparison of whether the threshold is broken through or not, statistical analysis performed by using a multiple linear regression analysis model, a deep learning algorithm based on artificial intelligence and the like.
The detection and intelligent algorithm of the system is based on the dynamic change rule of the absorption coefficient in the photothermal coagulation process caused by the laser irradiation on the tissue under the clinical treatment condition, and for blood and vascular lesions, the detection and intelligent algorithm is the umbrella effect of the laser absorbed by the tissue under the clinical treatment condition: when laser irradiation is started, the surface light absorption rate is low, and the laser can be directly irradiated to the deep part of the tissue just like a sunshade umbrella is not opened, so that the temperature of the surface layer and the deep layer is sharply increased. After that, the irradiation causes an increase in the superficial light absorption rate, as if a sun shade were opened on the surface of the irradiated area, thereby protecting the deep tissue from the influence of the laser irradiation. When the irradiation time is continuously increased, the further increase of the surface temperature leads to the continuous carbonization and deflagration of the surface, takes away the laser heat, and continuously protects the deep tissue from the influence of laser illumination like a protective umbrella. The turning point of the change can be determined by the change of the transmitted light intensity and the time when the temperature of the tissue exceeds the temperature threshold of physical and chemical changes such as cell deformation, protein denaturation, evaporation, boiling, carbonization, explosion and the like in the photothermal coagulation process measured by each temperature measuring point. Therefore, the quality and the irreversible damage degree of the simulated laser surgery can be judged through the space-time change of the temperature and the transmitted light intensity of the simulated body fed back by the multi-mode sensor network.
The system can be used for intelligent assistant training of laser surgery, can also be used for detecting whether the energy output of the laser is stable or not and detecting the dynamic photo-thermal parameters of interaction of the laser and biological tissues, and has wide application value in clinic and scientific research.
The embodiments in the present description are described in a progressive manner, each embodiment focuses on differences from other embodiments, and the same and similar parts among the embodiments are referred to each other.
The principles and embodiments of the present invention have been described herein using specific examples, which are provided only to help understand the method and the core concept of the present invention; meanwhile, for a person skilled in the art, according to the idea of the present invention, the specific embodiments and the application range may be changed. In view of the above, the present disclosure should not be construed as limiting the invention.
Claims (3)
1. An assisted training system for simulating laser surgery, the system comprising:
simulating the focus;
a normal tissue phantom located on both sides and/or below the lesion phantom;
the laser handle is positioned above the focus imitation body;
the multimode sensor network is distributed between the focus imitation body and the normal tissue imitation body and is used for acquiring temperature change data of the focus imitation body irradiated by the laser handle and transmitted light energy of laser after the laser penetrates through the focus imitation body and/or the normal tissue imitation body in real time;
the multimodal sensor network comprises in particular: a plurality of micro temperature sensors and energy/power detection probes;
the energy/power detection probe is used for dynamically detecting the transmitted light energy of the laser after the laser penetrates through the focus imitation and/or the normal tissue imitation in real time;
the plurality of micro temperature sensors and the energy/power detection probe are connected with a data acquisition module;
the data acquisition module is connected with the multi-mode sensor network and used for acquiring the temperature change data and the light energy;
the camera/infrared thermal imaging head is positioned above the focus imitation and the normal tissue imitation in an inclined mode and is used for detecting the surface temperature and the image change condition of the focus imitation and/or the normal tissue imitation in real time;
the camera or the online thermal infrared imager records the image change or temperature distribution of the lesion surface in the whole process of the simulated treatment and uploads the image change or temperature distribution to the upper computer in real time; the system is used for displaying the surface treatment effect in real time in the simulation treatment, and displaying the surface image change or temperature distribution simultaneously when the system is operated by an expert database expert after giving a score;
the upper computer is connected with the data acquisition module and the camera/infrared thermal imaging head and is used for receiving the temperature change data, the light energy and the surface temperature and image change data of the focus phantom and/or the normal tissue phantom and processing the temperature change data, the light energy and the surface temperature and image change data of the focus phantom; specifically, the upper computer compares the curve of the change of the light energy of the transmitted light of each laser pulse along with the time with the data curve of the change of the light energy along with the time recorded by the expert who performs the simulation operation and recorded in the database; meanwhile, the temperature change curve of the micro temperature measuring sensor uploaded to the upper computer along with time is also uploaded to the upper computer and is compared with the temperature change curve of the micro temperature measuring sensor at the same measuring site recorded by the expert in the simulation operation along with time; if the laser operator selects improper parameters or the operation method is sparse, the change of the light energy and the temperature along with the time will be abnormal, so that the upper computer judges that the operation is not in accordance with the standard through an algorithm, and simultaneously, quantitative scores are given according to the comparison with the operation simulation result of an expert; the intelligent evaluation algorithm for evaluation adopts simple direct comparison to judge whether the threshold is broken through; or statistical analysis using a multiple linear regression analysis model; or a deep learning algorithm based on artificial intelligence;
the plurality of micro temperature sensors are accurately positioned at specific positions of the focus imitation body and the normal tissue imitation body and are used for acquiring temperature change space-time data of the focus and the normal tissue imitation body after being irradiated by the laser handle in real time; according to different experiments of specific operations, the positions where the sensors are placed are different;
in the first case: knowing the temperature distribution in the focal tissue, selecting a temperature measuring point by taking the central point of a light spot on the surface of the tissue irradiated by laser as an original point, and descending in the z-axis direction right below according to the step length of 0.1 mm; meanwhile, the central point of a light spot on the surface of the tissue irradiated by the laser is taken as the origin, the temperature distribution on the surface is measured by taking r as the radius on the surface, and the value of r is 0-2 times of the radius of the light spot;
the second condition is that the light damage of the laser irradiation to the normal tissue is known, the temperature measuring point selects the boundary of the focus tissue and the normal tissue, and the method is a method for simulating the clinical determination of the side effect of the tissue damage;
the system further comprises: the light shield is cylindrical with an upper opening and a lower opening, specifically is conical with a top opening smaller than a bottom opening, the bottom opening is used for covering the focus imitation body and the normal tissue imitation body, and the top opening is used for the laser handle to extend into; the light shield is made of transparent glass; the transparent glass adopts a coating technology to realize the absorption of the laser with the specific wavelength.
2. The assisted training system for simulated laser surgery of claim 1, wherein said camera/thermographic camera is located on an outer surface of said light shield.
3. The system of claim 1, wherein the processing of the temperature change data, the light energy, and the surface temperature and image change data of the lesion mimic comprises:
and comparing the temperature change data, the light energy, the surface temperature of the focus imitation and the image change data with pre-stored standard data, judging whether the temperature change data, the light energy, the surface temperature of the focus imitation and the image change data are abnormal or not, and giving a score.
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