技术领域Technical Field
本申请是针对申请号为 2023118410419，申请日为 2023 年 12 月29 日， 名称为“一种基于内窥镜的水刀运动轨迹的监测方法和装置”的发明专利申请的分案申请。This application is a divisional application for the invention patent application with application number 2023118410419, application date December 29, 2023, and name “A method and device for monitoring the motion trajectory of a water jet based on an endoscope”.
本申请涉及手术执行设备的监测装置，尤其涉及一种基于内窥镜的针对水刀实际手术过程中运动轨迹的监测装置。The present application relates to a monitoring device for surgical execution equipment, and in particular to an endoscope-based monitoring device for the motion trajectory of a water jet during an actual surgical procedure.
背景技术Background technique
近年来，随着医疗技术的进步，利用影像引导手术执行设备譬如水刀的微创手术逐渐普及。例如，在水刀微创手术中，可基于医学图像预先规划出消融或切除轨迹，使水刀按照规划的消融或切除轨迹执行手术动作，完成对组织的消融或切除。In recent years, with the advancement of medical technology, minimally invasive surgeries using image-guided surgical equipment such as water jets have become increasingly popular. For example, in water jet minimally invasive surgeries, the ablation or resection trajectory can be pre-planned based on medical images, so that the water jet performs the surgical action according to the planned ablation or resection trajectory to complete the ablation or resection of the tissue.
但是，用于规划的医学图像通常是组织切除前的图像，即使是基于实时超声图像进行规划，也仅反映组织被切除前的状态，在手术过程中，伴随切除动作的进行，待切除组织及其周围组织的状态可能已经发生改变，这种改变导致实际的手术执行轨迹可能与预先规划的手术执行轨迹不同，导致出现偏差。偏差有时因为设备故障造成，例如在水刀出现松动但驱动部件不能知晓这一情况仍然进行水刀的运动驱动时，可能产生偏差。更多的可能与设备故障或轨迹规划无关，而是由于例如手术环境或患者的特殊体质相关。无论何种原因，偏差都是不希望发生的，因为一方面偏差产生就意味着执行轨迹与规划的目标轨迹相比发生偏离，使得原本应按照规划轨迹执行的手术失去精准可控性，另一方面，偏差可能会导致对患者的不必要的损伤。因此，有必要对实际的手术执行轨迹进行实时监测，一方面可以基于闭环反馈机制确保手术按照规划的目标轨迹进行，在监测到偏差发生时及时调整，更重要的，对实际的手术执行轨迹进行实时监测还可以进一步确保手术安全性，尤其是在进行前列腺增生切除手术时对精阜等敏感位置的额外保护尤其重要，即使按照规划轨迹执行手术也可能导致损伤；而实现准确实时的手术执行轨迹监测则可以最大程度确保基于规划进行的手术过程的精准控制、并最大程度的避免手术损伤。However, the medical images used for planning are usually images before tissue resection. Even if planning is based on real-time ultrasound images, it only reflects the state of the tissue before resection. During the operation, as the resection proceeds, the state of the tissue to be resected and its surrounding tissues may have changed. This change may cause the actual surgical execution trajectory to be different from the pre-planned surgical execution trajectory, resulting in deviations. Deviations are sometimes caused by equipment failures. For example, when the water jet is loose but the driving component cannot know this and still drives the water jet, deviations may occur. More likely, it has nothing to do with equipment failure or trajectory planning, but is related to, for example, the surgical environment or the patient's special physique. Regardless of the reason, deviations are undesirable because, on the one hand, the occurrence of deviations means that the execution trajectory deviates from the planned target trajectory, making the surgery that should have been performed according to the planned trajectory lose its precision and controllability. On the other hand, deviations may cause unnecessary damage to the patient. Therefore, it is necessary to monitor the actual surgical execution trajectory in real time. On the one hand, based on the closed-loop feedback mechanism, it can ensure that the operation is performed according to the planned target trajectory, and timely adjustments can be made when deviations are detected. More importantly, real-time monitoring of the actual surgical execution trajectory can further ensure the safety of the operation, especially during prostate hyperplasia resection surgery. Additional protection of sensitive positions such as the verumontanum is particularly important, which may cause damage even if the operation is performed according to the planned trajectory. Accurate and real-time monitoring of the surgical execution trajectory can ensure the precise control of the planned surgical process to the greatest extent and avoid surgical injuries to the greatest extent.
但是，对水刀的实际的手术执行轨迹进行实时监测存在诸多困难，主要原因在于：由于水刀在手术过程中需要喷射高压水射流，形成水柱区域，在超声图像中存在大量伪影、噪声，导致通过实时超声图像仅可用于粗略的观察，无法用于对水刀的实际的手术执行轨迹相关的具体参数进行准确计算，因而无法实现对水刀的实际手术执行轨迹的实时监测。However, there are many difficulties in real-time monitoring of the actual surgical execution trajectory of the water knife. The main reason is that since the water knife needs to spray high-pressure water jets during the operation to form a water column area, there are a lot of artifacts and noise in the ultrasound image, resulting in real-time ultrasound images that can only be used for rough observation. It cannot be used to accurately calculate the specific parameters related to the actual surgical execution trajectory of the water knife, and therefore it is impossible to achieve real-time monitoring of the actual surgical execution trajectory of the water knife.
也有部分研究者提出基于内窥镜的监测方法，但是由于手术过程中水刀是运动状态，通常采取手动操控或图像跟踪控制方式使内窥镜能观测到水刀，但是手动操控内窥镜费时费力；而图像跟踪算法的程序实现则通常较为复杂，难以实现对手术区域的实时有效追踪，再结合轨迹参数的监测计算，整体运算量大、计算速度慢，更难以实现对水刀的实际的手术执行轨迹相关的具体参数的实时计算。此外，水刀手术过程中喷射的水射流会使得通过内窥镜观测图像非常容易发生模糊现象，导致通过内窥镜观测水刀的清晰度降低。并且，在将水刀用于前列腺增生切除的手术场景时，由于内窥镜插入过程中会遇到周围组织被挤压形成塌陷进而遮挡内窥镜视野的情形，也会导致通过内窥镜观测视野不全的问题。Some researchers have also proposed endoscope-based monitoring methods. However, since the water jet is in motion during surgery, manual control or image tracking control is usually used to enable the endoscope to observe the water jet. However, manual control of the endoscope is time-consuming and laborious. The program implementation of the image tracking algorithm is usually more complicated, and it is difficult to achieve real-time and effective tracking of the surgical area. Combined with the monitoring and calculation of trajectory parameters, the overall amount of calculation is large and the calculation speed is slow, making it even more difficult to achieve real-time calculation of specific parameters related to the actual surgical execution trajectory of the water jet. In addition, the water jet sprayed during the water jet surgery will make the image observed through the endoscope very easy to blur, resulting in reduced clarity of the water jet observed through the endoscope. Moreover, when the water jet is used in the surgical scene of prostate hyperplasia resection, the surrounding tissue will be squeezed and collapsed during the insertion of the endoscope, thereby blocking the endoscope's field of view, which will also lead to the problem of incomplete field of view observed through the endoscope.
发明内容Summary of the invention
为了解决以上技术问题，本申请提供一种基于内窥镜的水刀运动位置轨迹参数的监测装置，包括水刀、内窥镜、水刀驱动部、内窥镜驱动部、控制部，其特征在于：In order to solve the above technical problems, the present application provides a monitoring device for the motion position trajectory parameters of a water jet based on an endoscope, comprising a water jet, an endoscope, a water jet driving unit, an endoscope driving unit, and a control unit, characterized in that:
所述水刀驱动部和所述内窥镜驱动部均与所述控制部电连接；The water jet driving unit and the endoscope driving unit are both electrically connected to the control unit;
所述水刀能够按照规划运动轨迹进行运动并喷射水射流进行组织切除或消融；所述水刀的运动轨迹由水刀运动位置轨迹参数限定；The water jet can move according to the planned motion trajectory and spray a water jet to perform tissue resection or ablation; the motion trajectory of the water jet is defined by the water jet motion position trajectory parameters;
所述控制部基于所述水刀的规划运动轨迹确定所述内窥镜的跟随运动轨迹；The control unit determines the following motion trajectory of the endoscope based on the planned motion trajectory of the water jet;
所述内窥镜与所述水刀的直线运动方向相互平行，所述内窥镜位于所述水刀的后方，且内窥镜的观测镜头与水射流喷射部之间具有预定距离S；The linear motion directions of the endoscope and the water jet are parallel to each other, the endoscope is located behind the water jet, and there is a predetermined distance S between the observation lens of the endoscope and the water jet injection portion;
所述内窥镜在跟随运动模式下按照跟随运动轨迹跟随所述水刀进行至少直线运动，并对所述水刀的实际运动位置轨迹参数进行监测；其中，所述跟随运动轨迹由跟随运动位置轨迹参数限定，所述控制部基于所述水刀的规划运动位置轨迹参数确定所述内窥镜的跟随运动位置轨迹参数。In the following motion mode, the endoscope follows the water jet for at least linear motion according to the following motion trajectory, and monitors the actual motion position trajectory parameters of the water jet; wherein the following motion trajectory is defined by the following motion position trajectory parameters, and the control unit determines the following motion position trajectory parameters of the endoscope based on the planned motion position trajectory parameters of the water jet.
进一步地，所述控制部还基于内窥镜最佳工作距离L确定所述内窥镜的跟随运动位置轨迹参数，所述内窥镜最佳工作距离L表示内窥镜镜头与水刀刀头之间的最佳工作距离，在该距离范围内，通过所述内窥镜可对视野范围内的水刀刀头及水射流清晰成像；Furthermore, the control unit further determines the tracking motion position trajectory parameters of the endoscope based on the optimal working distance L of the endoscope, wherein the optimal working distance L of the endoscope represents the optimal working distance between the endoscope lens and the water jet cutter head, within which the water jet cutter head and the water jet within the field of view can be clearly imaged through the endoscope;
和/或，and / or,
所述控制部还基于组织塌缩可视距离T确定所述内窥镜的跟随运动位置轨迹参数，所述组织塌缩可视距离T为用于表征组织塌缩效应对内窥镜视野影响的内窥镜与水刀刀头之间的距离值，在组织塌缩可视距离T内可以在内窥镜视野中观察到水射流，超出该距离后因组织收缩挤压包裹的影响，阻挡内窥镜的视野。The control unit also determines the follow-up motion position trajectory parameters of the endoscope based on the tissue collapse visible distance T. The tissue collapse visible distance T is the distance value between the endoscope and the water jet head, which is used to characterize the influence of the tissue collapse effect on the endoscope field of view. Within the tissue collapse visible distance T, the water jet can be observed in the endoscope field of view. When the distance is exceeded, the field of view of the endoscope is blocked due to the influence of tissue contraction, squeezing and wrapping.
进一步地，所述内窥镜还具有自主运动模式，在所述自主运动模式下，所述内窥镜的运动与所述水刀的运动相互独立；在所述自主运动模式下驱动内窥镜运动并采集参数，所述控制部基于所采集的参数设置或更新跟随运动位置轨迹参数。Furthermore, the endoscope also has an autonomous motion mode, in which the movement of the endoscope and the movement of the water jet are independent of each other; in the autonomous motion mode, the endoscope is driven to move and parameters are collected, and the control unit sets or updates the follow-up motion position trajectory parameters based on the collected parameters.
进一步地，所述内窥镜还包括图像采集单元，所述图像采集单元采集图像并传送至所述控制部，所述控制部对所采集的图像数据进行分析，并基于分析结果对所述水刀的规划运动轨迹和所述内窥镜的跟随运动轨迹进行调整。Furthermore, the endoscope also includes an image acquisition unit, which acquires images and transmits them to the control unit. The control unit analyzes the acquired image data and adjusts the planned motion trajectory of the water jet and the follow-up motion trajectory of the endoscope based on the analysis results.
进一步地，所述水刀的运动轨迹为多个步长的水刀运动位置轨迹参数的数组组合，所述内窥镜的跟随运动位置轨迹为同样多个步长的跟随运动位置轨迹参数的数组组合，所述控制部根据每个步长的数组所包含的水刀运动位置轨迹参数确定该步长对应的内窥镜的跟随运动位置轨迹参数。Furthermore, the motion trajectory of the water jet is an array combination of water jet motion position trajectory parameters of multiple steps, and the following motion position trajectory of the endoscope is an array combination of following motion position trajectory parameters of the same multiple steps. The control unit determines the following motion position trajectory parameters of the endoscope corresponding to each step based on the water jet motion position trajectory parameters contained in the array of each step.
进一步地，所述内窥镜在跟随运动模式下实时获取所述水刀刀头及水射流的内窥镜图像，所述控制部基于所获取的内窥镜图像进行分析并确定所述水刀的实际运动位置轨迹参数中的射流长度轨迹参数和/或旋转运动位置轨迹参数。Furthermore, the endoscope acquires endoscopic images of the water jet cutter head and the water jet in real time in a following motion mode, and the control unit analyzes and determines the jet length trajectory parameters and/or the rotational motion position trajectory parameters in the actual motion position trajectory parameters of the water jet based on the acquired endoscopic images.
进一步地，所述控制部基于水刀的预设轨迹中旋转角度范围与所述组织塌缩可视角度范围的比较结果，采用不同的水刀旋转运动位置轨迹参数监测方法。Furthermore, the control unit adopts different water jet rotation motion position trajectory parameter monitoring methods based on the comparison result of the rotation angle range in the preset trajectory of the water jet and the visible angle range of tissue collapse.
进一步地，当通过内窥镜能够观察到全部水柱时，所述控制部通过测算内窥镜图像中水柱摆动角度范围的方式监测评估水刀的实际旋转运动位置轨迹参数与规划的旋转运动位置轨迹参数是否一致。Furthermore, when the entire water column can be observed through the endoscope, the control unit monitors and evaluates whether the actual rotational motion position trajectory parameters of the water jet are consistent with the planned rotational motion position trajectory parameters by measuring the water column swing angle range in the endoscopic image.
进一步地，当水射流处于所述内窥镜的视野范围的情况下，所述控制部基于内窥镜的监测图像中的隔着偶数个步长的同一个内窥镜观测角度的水射流图像，计算所述水刀的摆动频率；当水射流未处于所述内窥镜的视野范围的情况下，所述控制部基于内窥镜的观测图像中的隔着偶数个步长的同一内窥镜观测角度的水刀特征点图像，计算所述水刀的摆动频率。Furthermore, when the water jet is within the field of view of the endoscope, the control unit calculates the oscillation frequency of the water jet based on the water jet image at the same endoscopic observation angle separated by an even number of steps in the monitoring image of the endoscope; when the water jet is not within the field of view of the endoscope, the control unit calculates the oscillation frequency of the water jet based on the water jet feature point image at the same endoscopic observation angle separated by an even number of steps in the observation image of the endoscope.
进一步地，所述控制部通过比较步长内水柱运动的实际摆动频率与该步长的旋转运动轨迹参数确定的摆动频率，进而评估该步长内水刀的实际旋转运动位置轨迹参数与规划的旋转运动位置轨迹参数是否一致。Furthermore, the control unit compares the actual swing frequency of the water column movement within the step length with the swing frequency determined by the rotational motion trajectory parameters of the step length, and then evaluates whether the actual rotational motion position trajectory parameters of the water knife within the step length are consistent with the planned rotational motion position trajectory parameters.
进一步地，所述控制部基于所述内窥镜在跟随运动模式下获取的图像确定敏感部位，并基于敏感部位的轮廓边界与水刀刀头之间的最短距离确定针对该敏感部位的安全切除深度。Furthermore, the control unit determines the sensitive part based on the image acquired by the endoscope in the follow-up motion mode, and determines the safe resection depth for the sensitive part based on the shortest distance between the contour boundary of the sensitive part and the water jet cutter head.
进一步地，所述控制部还基于预先设置的去除安全距离确定安全切除深度。Furthermore, the control unit also determines a safe removal depth based on a preset removal safety distance.
根据本申请所提出的上述方案，能够有效地解决背景技术中的技术问题，针对水刀在实际手术过程中的实际的手术执行轨迹相关的具体参数进行有效、准确、且实时的监测与计算，本申请尤其适用于自动水刀系统中，在水刀按照规划的手术执行轨迹运动执行组织消融或切除操作时，本申请的方案可以对水刀的实际的运动位置轨迹参数进行实时监测，有利于实现基于实时监测结果对规划的运动位置轨迹参数进行调整；并且本申请还可以在实际手术过程中对水刀工作区域，尤其是涉及敏感部位的区域进行监测，并基于实时监测结果评估确定预先规划的运动轨迹的安全风险，根据安全风险评估结果在水刀执行消融或切除之前预先触动报警机制或修改规划方案以减少损伤，还可根据实时监测结果修正预先规划的运动位置轨迹参数，充分确保实际手术过程的安全性。According to the above-mentioned scheme proposed in the present application, it is possible to effectively solve the technical problems in the background technology, and to effectively, accurately and in real time monitor and calculate the specific parameters related to the actual surgical execution trajectory of the water knife during the actual operation. The present application is particularly suitable for an automatic water knife system. When the water knife moves according to the planned surgical execution trajectory to perform tissue ablation or resection operations, the scheme of the present application can monitor the actual motion position trajectory parameters of the water knife in real time, which is conducive to adjusting the planned motion position trajectory parameters based on the real-time monitoring results; and the present application can also monitor the working area of the water knife during the actual operation, especially the area involving sensitive parts, and determine the safety risks of the pre-planned motion trajectory based on the real-time monitoring results. According to the safety risk assessment results, the alarm mechanism can be triggered in advance or the planning scheme can be modified before the water knife performs ablation or resection to reduce damage. The pre-planned motion position trajectory parameters can also be corrected according to the real-time monitoring results to fully ensure the safety of the actual surgical process.
附图说明BRIEF DESCRIPTION OF THE DRAWINGS
图1是根据本申请一实施例的手术执行设备的结构示意图。FIG1 is a schematic structural diagram of a surgical execution device according to an embodiment of the present application.
图2是根据本申请一实施例的手术执行设备的截面示意图。FIG. 2 is a cross-sectional schematic diagram of a surgical execution device according to an embodiment of the present application.
图3是示意性地示出内窥镜的视野范围的图。FIG. 3 is a diagram schematically showing the field of view of an endoscope.
图4是示意性地表示病患管腔内的敏感部位的图。FIG. 4 is a diagram schematically showing sensitive areas within a patient's lumen.
图5是示意性地表示水射流的切除深度的测定方法的图。FIG. 5 is a diagram schematically showing a method for measuring the cutting depth of a water jet.
图6是表示可倾斜的内窥镜的图。FIG. 6 is a diagram showing a tiltable endoscope.
图7是根据本申请一实施例的组织切除工具的手术流程的图。FIG. 7 is a diagram of a surgical procedure of a tissue removal tool according to an embodiment of the present application.
具体实施方式Detailed ways
以下参照附图详细描述本申请的各种示例性实施例。对示例性实施例的描述仅仅是说明性的，决不作为对本申请及其应用或使用的任何限制。本申请可以以许多不同的形式实现，不限于这里所述的实施例。提供这些实施例是为了使本申请透彻且完整，并且向本领域技术人员充分表达本申请的范围。应注意到：除非另有说明，否则在这些实施例中阐述的部件和步骤的相对布置、数字表达式和数值等应被解释为仅仅是示例性的，而不是作为限制。本申请使用的所有术语（包括技术术语或者科学术语）与本申请所属领域的普通技术人员理解的含义相同，除非另外特别定义。还应当理解，在诸如通用词典中定义的术语应当被理解为具有与它们在相关技术的上下文中的含义相一致的含义，而不应用理想化或极度形式化的意义来解释，除非本文有明确地这样定义。对于本部分中未详细描述的部件、部件的具体型号等参数、部件之间的相互关系以及控制电路，可被认为是相关领域普通技术人员已知的技术、方法和设备，但在适当情况下，所述技术、方法和设备应当被视为说明书的一部分。Various exemplary embodiments of the present application are described in detail below with reference to the accompanying drawings. The description of the exemplary embodiments is merely illustrative and is in no way intended to limit the present application and its application or use. The present application can be implemented in many different forms and is not limited to the embodiments described herein. These embodiments are provided to make the present application thorough and complete and to fully express the scope of the present application to those skilled in the art. It should be noted that unless otherwise specified, the relative arrangement of the components and steps, numerical expressions, and numerical values described in these embodiments should be interpreted as being merely exemplary and not as a limitation. All terms (including technical terms or scientific terms) used in this application have the same meaning as those understood by ordinary technicians in the field to which this application belongs, unless otherwise specifically defined. It should also be understood that terms defined in general dictionaries, such as general dictionaries, should be understood to have meanings consistent with their meanings in the context of the relevant technology, and should not be interpreted in an idealized or extremely formalized sense, unless explicitly defined herein. For components, parameters such as specific models of components, interrelationships between components, and control circuits not described in detail in this section, they can be considered as technologies, methods, and devices known to ordinary technicians in the relevant field, but where appropriate, the technologies, methods, and devices should be considered as part of the specification.
本申请中使用的“包括”或者“包含”等类似的词语意指在该词前的要素涵盖在该词后列举的要素，并不排除也涵盖其它要素的可能。The words “include” or “comprising” and the like used in this application mean that the elements preceding the words include the elements listed after the words, and do not exclude the possibility of also including other elements.
以及，本申请中“前”或“远端”或“末端”表示手术器械（水刀或内窥镜）更靠近组织或手术区域的方位，“后”或“近端”表示手术器械（水刀或内窥镜）更靠近操作者的方位。Also, in this application, "front" or "distal" or "end" means that the surgical instrument (water jet or endoscope) is closer to the tissue or surgical area, and "rear" or "proximal" means that the surgical instrument (water jet or endoscope) is closer to the operator.
图1是根据本申请一实施例的手术执行设备的结构示意图。典型地，该手术执行设备包含水刀及其运动轨迹的监测装置。如图1所示，在手术执行设备的前端包括水刀和内窥镜，在手术执行设备的末端包括水刀驱动部、内窥镜驱动4以及控制部。控制部与水刀驱动部电连接，水刀驱动部与水刀驱动连接，控制部还与内窥镜驱动部电连接，内窥镜驱动部与内窥镜驱动连接。FIG1 is a schematic diagram of the structure of a surgical execution device according to an embodiment of the present application. Typically, the surgical execution device includes a water jet and a monitoring device for its motion trajectory. As shown in FIG1 , the front end of the surgical execution device includes a water jet and an endoscope, and the end of the surgical execution device includes a water jet drive unit, an endoscope drive 4, and a control unit. The control unit is electrically connected to the water jet drive unit, and the water jet drive unit is connected to the water jet drive. The control unit is also electrically connected to the endoscope drive unit, and the endoscope drive unit is connected to the endoscope drive.
水刀包括鞘套和设置于鞘套内的可移动的耐高压管路，耐高压管路的前端能够喷射高压水射流以消融或切除组织。在本申请中，水刀刀头指的是耐高压管路的射出水射流的前端部（也称为水射流喷射部或喷嘴），耐高压管路的除刀头以外的部分也被称为刀身，在有的语境下，水刀和水刀刀头不做严格意义的区分。另外，本申请中，对“消融”或“切除”不做严格意义的区分，二者含义近似，某些语境下也称为“去除”；对“水射流”或“水柱”不做严格意义的区分，均指从水刀刀头喷射的高压水射流。The water jet includes a sheath and a movable high-pressure resistant pipeline arranged in the sheath. The front end of the high-pressure resistant pipeline can spray a high-pressure water jet to ablate or remove tissue. In the present application, the water jet head refers to the front end of the high-pressure resistant pipeline that emits a water jet (also called a water jet injection portion or nozzle). The part of the high-pressure resistant pipeline other than the blade head is also called a blade body. In some contexts, the water jet and the water jet head are not strictly distinguished. In addition, in the present application, "ablation" or "resection" is not strictly distinguished. The two have similar meanings and are also called "removal" in some contexts; "water jet" or "water column" is not strictly distinguished, and both refer to the high-pressure water jet ejected from the water jet head.
控制部与水刀驱动部电连接，水刀在水刀驱动部的驱动下，进入目标组织区域（在前列腺增生切除手术环境下，可以是经尿道进入，或者经会阴进入），并通过喷射高压水射流执行消融或切除。The control unit is electrically connected to the water jet drive unit. Driven by the water jet drive unit, the water jet enters the target tissue area (in the case of prostate hyperplasia resection surgery, it can be through the urethra or through the perineum) and performs ablation or resection by spraying high-pressure water jets.
水刀按照规划路径进行运动，规划的路径可以是医生或处理器基于图像信息预先设计的路径。按照规划路径运动形成的轨迹为规划运动轨迹，规划运动轨迹可以是影像规划模块根据在所述导航图像上预先规划的连续边界位置轨迹拟合生成的运动控制位置轨迹。The water jet moves along the planned path, which may be a path pre-designed by a doctor or processor based on image information. The trajectory formed by the movement along the planned path is the planned motion trajectory, which may be a motion control position trajectory generated by the image planning module according to the pre-planned continuous boundary position trajectory on the navigation image.
水刀在水刀驱动部的驱动下，能够进行直线运动和/或旋转运动，水刀的直线运动是指水刀沿水刀鞘套通道所限定的直线方向前进或后退的运动过程，水刀的旋转运动为水刀相对于水刀刀身的轴线方向旋转，在旋转的同时刀头喷射水射流，从而以扫描的方式对目标组织执行消融或去除。Driven by the water jet drive unit, the water jet can perform linear motion and/or rotational motion. The linear motion of the water jet refers to the movement of the water jet forward or backward along the straight line direction defined by the water jet sheath channel. The rotational motion of the water jet refers to the rotation of the water jet relative to the axial direction of the water jet blade. While rotating, the blade head sprays a water jet, thereby performing ablation or removal of the target tissue in a scanning manner.
水刀在进行直线运动和/或旋转运动之外，从水刀刀头还喷射高压水射流，水射流的长短表示水射流作用点的远近，由于水射流的长短系通过管路及液压动力模块可控的，水射流长度也是用于描述水刀运动轨迹的重要参数。In addition to linear motion and/or rotational motion, the water jet also ejects a high-pressure water jet from the water jet head. The length of the water jet indicates the distance of the water jet's point of action. Since the length of the water jet is controllable through pipelines and hydraulic power modules, the water jet length is also an important parameter used to describe the water jet's motion trajectory.
为了表征水刀的上述运动过程，本申请中，以水刀的运动位置轨迹参数限定水刀的运动轨迹，水刀的运动位置轨迹参数表示水刀坐标系下水刀的水射流作用点的位置，运动控制模块可通过水刀运动控制电机、管路及液压动力模块的液压泵使水刀按照预设的运动位置轨迹参数进行运动，所述预设的运动位置轨迹参数可以是基于规划运动轨迹确定的。In order to characterize the above-mentioned movement process of the water jet, in the present application, the movement trajectory of the water jet is defined by the movement position trajectory parameters of the water jet, which represent the position of the water jet action point of the water jet in the water jet coordinate system. The motion control module can control the water jet motion according to the preset movement position trajectory parameters through the water jet motion control motor, pipeline and hydraulic pump of the hydraulic power module. The preset movement position trajectory parameters can be determined based on the planned movement trajectory.
优选地，表征水刀的直线运动的直线运动位置轨迹参数可以是水刀坐标系下作用点射流长轴位置和/或作用点射流长轴速度；表征水刀的旋转运动的旋转运动位置轨迹参数可以是作用点横断面夹角和/或横断面旋转速度；表征水刀刀头喷射水射流的长短（即水射流喷射部与作用点之间距离）的射流长度轨迹参数可以是作用点射流长度。Preferably, the linear motion position trajectory parameter characterizing the linear motion of the water jet may be the long axis position of the jet at the action point and/or the long axis velocity of the jet at the action point in the water jet coordinate system; the rotational motion position trajectory parameter characterizing the rotational motion of the water jet may be the cross-sectional angle at the action point and/or the cross-sectional rotation velocity; the jet length trajectory parameter characterizing the length of the water jet ejected by the water jet head (i.e., the distance between the water jet ejection portion and the action point) may be the jet length at the action point.
本申请中，内窥镜设有跟随运动模式，为此，将内窥镜设置于水刀的附近，内窥镜的轴线和水刀的轴线相互平行，内窥镜和水刀的直线运动方向也相互平行。In the present application, the endoscope is provided with a following motion mode, for which the endoscope is arranged near the water jet, the axis of the endoscope and the axis of the water jet are parallel to each other, and the linear motion directions of the endoscope and the water jet are also parallel to each other.
可以采取多种固定安装方式将内窥镜设置于水刀附近，例如，设置内窥镜与水刀共用一个鞘套，内窥镜和水刀分别在鞘套所限定的两个平行通道内，或者内窥镜与水刀各自有独立的鞘套，但设置内窥镜的鞘套和水刀的鞘套一体地构成、或者二者相对于同一基体固定安装。设置内窥镜和水刀共用鞘套或二者的鞘套一体构成，更利于实现内窥镜与水刀的相对运动路径固定，确保内窥镜的跟随运动轨迹与水刀的运动轨迹二者关系对应的一致性，有利于实现内窥镜跟随运动的稳定性。The endoscope can be arranged near the water jet in a variety of fixed installation methods, for example, the endoscope and the water jet share a sheath, the endoscope and the water jet are respectively in two parallel channels defined by the sheath, or the endoscope and the water jet each have an independent sheath, but the sheath of the endoscope and the sheath of the water jet are integrally formed, or the two are fixedly installed relative to the same substrate. The endoscope and the water jet share a sheath or the sheaths of the two are integrally formed, which is more conducive to achieving the fixed relative motion path of the endoscope and the water jet, ensuring the consistency of the corresponding relationship between the following motion trajectory of the endoscope and the motion trajectory of the water jet, and is conducive to achieving the stability of the following motion of the endoscope.
控制部还与内窥镜驱动部电连接，内窥镜在内窥镜驱动部的驱动下，也进入目标组织区域。内窥镜对水刀及其附近的组织环境进行拍摄，实时地获取内窥镜视野内的图像，并将所获取的内窥镜图像数据传送至控制部。The control unit is also electrically connected to the endoscope drive unit, and the endoscope is driven by the endoscope drive unit to enter the target tissue area. The endoscope takes pictures of the water jet and the tissue environment near it, obtains images in the endoscope field of view in real time, and transmits the obtained endoscope image data to the control unit.
内窥镜在内窥镜驱动部的驱动下，能够进行直线运动和/或旋转运动，其直线运动系内窥镜沿内窥镜鞘套通道所限定的直线方向进行前进或后退的运动过程，其旋转运动为可选择的，例如为了调整内窥镜视野使内窥镜相对于其轴向旋转。Driven by the endoscope driving unit, the endoscope can perform linear motion and/or rotational motion. The linear motion refers to the movement process of the endoscope moving forward or backward along the straight line direction defined by the endoscope sheath channel. The rotational motion is optional, for example, in order to adjust the endoscope field of view, the endoscope is rotated relative to its axis.
本申请中，内窥镜具有跟随运动模式，在跟随运动模式下，内窥镜能够按照跟随运动轨迹跟随水刀进行至少直线运动，内窥镜的直线运动与水刀的直线运动同步。In the present application, the endoscope has a following motion mode. In the following motion mode, the endoscope can follow the water jet to perform at least linear motion according to the following motion trajectory, and the linear motion of the endoscope is synchronized with the linear motion of the water jet.
在一些实施例中的跟随运动模式下，设置内窥镜仅跟随水刀进行直线运动，但不跟随水刀进行旋转运动，以利于内窥镜以固定视角观测水刀的直线和旋转运动。In the following motion mode in some embodiments, the endoscope is set to only follow the water jet for linear motion but not for rotational motion, so as to facilitate the endoscope to observe the linear and rotational motion of the water jet at a fixed viewing angle.
在另一些实施例中的跟随运动模式下，设置内窥镜不仅跟随水刀进行直线运动，还跟随水刀进行旋转运动，以确保旋转运动的水刀及水柱均在内窥镜的观察视野中。In the following motion mode in other embodiments, the endoscope is configured to follow the water jet not only in linear motion but also in rotational motion, to ensure that the rotating water jet and the water column are within the observation field of the endoscope.
为实现内窥镜的跟随运动模式，控制部基于水刀的规划运动轨迹，生成内窥镜的跟随运动轨迹，并将所生成的内窥镜的跟随运动轨迹发送至内窥镜驱动部，用于控制内窥镜按照跟随运动轨迹运动。To realize the following motion mode of the endoscope, the control unit generates a following motion trajectory of the endoscope based on the planned motion trajectory of the water jet, and sends the generated following motion trajectory of the endoscope to the endoscope driving unit for controlling the endoscope to move according to the following motion trajectory.
内窥镜的跟随运动轨迹由跟随运动位置轨迹参数限定，跟随运动位置轨迹参数至少包含直线跟随运动位置轨迹参数。所述直线跟随运动位置轨迹参数系基于水刀的直线运动位置轨迹参数确定。The following motion trajectory of the endoscope is defined by the following motion position trajectory parameters, which at least include linear following motion position trajectory parameters. The linear following motion position trajectory parameters are determined based on the linear motion position trajectory parameters of the water jet.
内窥镜还可具有自主运动模式，在自主运动模式下，内窥镜在内窥镜鞘套通道内独立地进行直线运动和/或旋转运动，与水刀的直线运动和/或旋转运动相互独立。The endoscope may also have an autonomous motion mode, in which the endoscope independently performs linear motion and/or rotational motion within the endoscope sheath channel, which is independent of the linear motion and/or rotational motion of the water jet.
用户可通过控制部或类似机构选择内窥镜的运动模式，以满足不同场景的需求，例如，在术前设备调试阶段，可选择内窥镜进入自主运动模式，手动操控或电机驱动内窥镜在其鞘套通道内运动，采集相关参数，并基于所采集的参数设置或更新跟随运动位置轨迹参数。在水刀到位准备启动对组织的消除或消融操作时，选择内窥镜进入跟随运动模式，以电机驱动内窥镜运动，可以实现对水刀工作过程中实际的运动位置轨迹参数的实时监测。The user can select the motion mode of the endoscope through the control unit or similar mechanism to meet the needs of different scenarios. For example, in the preoperative equipment debugging stage, the endoscope can be selected to enter the autonomous motion mode, manually control or drive the endoscope to move in its sheath channel, collect relevant parameters, and set or update the follow-up motion position trajectory parameters based on the collected parameters. When the water jet is in place and ready to start the elimination or ablation operation of the tissue, the endoscope is selected to enter the follow-up motion mode and the motor drives the endoscope to move, which can realize the real-time monitoring of the actual motion position trajectory parameters during the water jet operation.
优选地，内窥镜的图像采集单元采集图像并传送至控制部，控制部获取到图像数据后对图像数据进行分析，并基于图像数据的分析结果对水刀的规划运动轨迹以及内窥镜的跟随运动轨迹进行调整。Preferably, the image acquisition unit of the endoscope acquires images and transmits them to the control unit. After acquiring the image data, the control unit analyzes the image data and adjusts the planned motion trajectory of the water jet and the follow-up motion trajectory of the endoscope based on the analysis results of the image data.
控制部可以将规划运动轨迹或参数转化为运动位置轨迹参数，例如，将医生在图像坐标系中规划设置的运动轨迹或参数，转换为运动控制位置轨迹或参数，并进一步转换为水刀坐标系下的运动位置轨迹参数；或者直接将收到的规划的运动轨迹或参数、或者运动控制位置轨迹或参数转化为水刀坐标系下的运动位置轨迹参数。The control unit can convert the planned motion trajectory or parameters into motion position trajectory parameters. For example, the motion trajectory or parameters planned and set by the doctor in the image coordinate system can be converted into motion control position trajectory or parameters, and further converted into motion position trajectory parameters in the water jet coordinate system; or the received planned motion trajectory or parameters, or motion control position trajectory or parameters can be directly converted into motion position trajectory parameters in the water jet coordinate system.
控制部可以直接获取水刀运动位置轨迹参数，所述水刀运动位置轨迹参数系基于预先规划的运动轨迹确定，控制部将基于预先规划的运动轨迹所确定的水刀运动位置轨迹参数发送至水刀驱动部，以驱动水刀按照所述水刀运动位置轨迹参数运动。The control unit can directly obtain the water jet motion position trajectory parameters, which are determined based on a pre-planned motion trajectory. The control unit sends the water jet motion position trajectory parameters determined based on the pre-planned motion trajectory to the water jet driving unit to drive the water jet to move according to the water jet motion position trajectory parameters.
所述运动位置轨迹参数包含：直线运动位置轨迹参数、旋转运动位置轨迹参数、以及射流长度轨迹参数。The motion position trajectory parameters include: linear motion position trajectory parameters, rotational motion position trajectory parameters, and jet length trajectory parameters.
直线运动位置轨迹参数可以是水刀坐标系下的作用点射流长轴位置z和/或作用点射流长轴速度Vz，旋转运动位置轨迹参数可以是水刀坐标系下的作用点横断面夹角θ和/或横断面旋转速度Vθ，射流长度位置轨迹参数可以是水刀坐标系下的作用点射流长度R。The linear motion position trajectory parameter can be the long axis position z of the action point jet and/or the long axis velocity Vz of the action point jet in the water jet coordinate system, the rotational motion position trajectory parameter can be the cross-sectional angle θ of the action point and/or the cross-sectional rotation velocity Vθ in the water jet coordinate system, and the jet length position trajectory parameter can be the jet length R of the action point in the water jet coordinate system.
进一步地，直线运动位置轨迹参数可以包括直线速度Vz、直线起始位置z_start、直线结束位置z_stop等；旋转运动位置轨迹参数可以包括旋转速度Vθ、旋转起始角度θ_start、旋转结束角度θ_stop等；射流长度轨迹参数可以包括射流长度R、切除深度D等。Furthermore, the linear motion position trajectory parameters may include linear speed Vz, linear starting position z_start, linear ending position z_stop, etc.; the rotational motion position trajectory parameters may include rotational speed Vθ , rotation starting angle θ_start, rotation ending angle θ_stop, etc.; the jet length trajectory parameters may include jet length R, resection depth D, etc.
可以将水刀的整体运动轨迹分为多个步长，并基于每个步长赋予该步长内的运动位置轨迹参数。每个步长的运动位置轨迹参数可以用数组表示，例如：[{stepNO, z_start,z_stop, Vz, θ_start, θ_stop, Vθ, R}]，其中，stepNO为水刀运动的步长编号，z_start为水刀在该步长内的直线起始位置，z_stop为水刀在该步长内的直线结束位置，Vz为水刀在该步长内运动的直线速度，θ_start为水刀在该步长内的旋转起始角度，θ_stop为水刀在该步长内的旋转结束角度，Vθ为水刀在该步长内的旋转速度，R为水刀在该步长内的射流长度，可替换的，也可用水刀在该步长内的切除深度D来表示该步长内的射流长度轨迹参数，本申请中，切除深度D与射流长度R视为近似相等的参数。The overall motion trajectory of the water jet can be divided into multiple steps, and the motion position trajectory parameters within the step length are assigned based on each step length. The motion position trajectory parameters of each step length can be represented by an array, for example: [{stepNO, z_start, z_stop, Vz, θ_start, θ_stop, Vθ , R}], where stepNO is the step number of the water jet motion, z_start is the linear starting position of the water jet within the step length, z_stop is the linear ending position of the water jet within the step length, Vz is the linear speed of the water jet within the step length, θ_start is the rotation starting angle of the water jet within the step length, θ_stop is the rotation ending angle of the water jet within the step length, Vθ is the rotation speed of the water jet within the step length, R is the jet length of the water jet within the step length, alternatively, the jet length trajectory parameters within the step length can also be represented by the resection depth D of the water jet within the step length, and in this application, the resection depth D and the jet length R are regarded as approximately equal parameters.
通过将水刀的运动位置轨迹参数用每个步长的数组表示，可以以各个步长的运动位置轨迹参数数组的组合来表述水刀的部分或整体的运动轨迹。By representing the motion position trajectory parameters of the water jet with an array of each step length, the partial or entire motion trajectory of the water jet can be described by a combination of the motion position trajectory parameter arrays of each step length.
每个步长的长度可以根据手术场景及手术目标适当地设定。例如前列腺增生切除或消融手术的情况下，设置水刀运动轨迹的每个步长长度数量级为mm，可以基本满足手术过程控制精度需求，实现精准可控的切除控制。对于手术精度要求不高的场景，每个步长的长度可以设置为较大数值。The length of each step can be appropriately set according to the surgical scenario and surgical objectives. For example, in the case of prostate hyperplasia resection or ablation surgery, setting the length of each step of the water jet motion trajectory to mm can basically meet the control accuracy requirements of the surgical process and achieve precise and controllable resection control. For scenarios where surgical accuracy requirements are not high, the length of each step can be set to a larger value.
为了利用内窥镜监测水刀工作过程中实际的运动位置轨迹参数，本申请设置内窥镜具有跟随运动模式，在跟随运动模式下，内窥镜按照跟随运动轨迹跟随水刀进行运动。因此控制部需要预先基于水刀的规划运动轨迹，确定内窥镜的跟随运动轨迹。具体地，基于所述水刀的规划运动位置轨迹参数确定所述内窥镜的跟随运动位置轨迹参数。In order to use the endoscope to monitor the actual motion position trajectory parameters during the operation of the water jet, the present application sets the endoscope to have a follow motion mode. In the follow motion mode, the endoscope moves along the water jet according to the follow motion trajectory. Therefore, the control unit needs to determine the follow motion trajectory of the endoscope based on the planned motion trajectory of the water jet in advance. Specifically, the follow motion position trajectory parameters of the endoscope are determined based on the planned motion position trajectory parameters of the water jet.
对于将水刀的整体运动轨迹分为多个步长、并基于每个步长赋予该步长内的运动位置轨迹参数的情形，也将内窥镜的跟随运动轨迹分为同样多个步长，并基于水刀的每个步长内的运动位置轨迹参数生成内窥镜的每个步长内的跟随运动位置轨迹参数，以内窥镜的各个步长的跟随运动位置轨迹参数数组的组合来表述内窥镜的跟随运动轨迹。In the case where the overall motion trajectory of the water jet is divided into multiple steps and the motion position trajectory parameters within each step are assigned, the following motion trajectory of the endoscope is also divided into the same multiple steps, and the following motion position trajectory parameters within each step of the endoscope are generated based on the motion position trajectory parameters within each step of the water jet. The following motion trajectory of the endoscope is expressed by a combination of the following motion position trajectory parameter arrays of each step of the endoscope.
具体地，水刀的每个步长的运动位置轨迹参数例如表示为[{stepNO, z_start,z_stop, Vz, θ_start, θ_stop, Vθ, R}]，内窥镜的每个步长的跟随运动位置轨迹参数表示为[{CstepNO,Cz_start, Cz_stop, CVz}] ，其中，基于水刀的规划运动位置轨迹参数中的步长编号stepNO，确定内窥镜的与之对应的跟随运动的步长编号CstepNO；基于水刀在该步长内的直线起始位置z_start，确定内窥镜在该步长内的直线起始位置Cz_start；基于水刀在该步长内的直线结束位置z_stop，确定内窥镜在该步长内的直线结束位置Cz_stop；基于水刀的直线运动速度 Vz确定内窥镜的直线运动速度CVz。Specifically, the motion position trajectory parameters of each step of the water knife are expressed as [{stepNO, z_start, z_stop, Vz, θ_start, θ_stop, Vθ , R}], and the following motion position trajectory parameters of each step of the endoscope are expressed as [{CstepNO, Cz_start, Cz_stop, CVz}], wherein, based on the step number stepNO in the planned motion position trajectory parameters of the water knife, the step number CstepNO of the corresponding following motion of the endoscope is determined; based on the straight line starting position z_start of the water knife within the step, the straight line starting position Cz_start of the endoscope within the step is determined; based on the straight line ending position z_stop of the water knife within the step, the straight line ending position Cz_stop of the endoscope within the step is determined; and based on the straight line motion speed Vz of the water knife, the straight line motion speed CVz of the endoscope is determined.
优选的，内窥镜的步长与水刀的步长一致、直线运动速度一致，可设置CstepNO=stepNO，CVz=Vz。进一步地，优选设置内窥镜的每个步长内的直线运动时间和水刀的每个步长内的直线运动时间一致，因此通过CVz＝Vz×（Cz_stop－Cz_start）/（z_stop－z_start）计算出内窥镜的直线移动速度CVz。Preferably, the step length of the endoscope is consistent with the step length of the water jet, and the linear motion speed is consistent, and CstepNO=stepNO, CVz=Vz can be set. Furthermore, it is preferred to set the linear motion time within each step length of the endoscope to be consistent with the linear motion time within each step length of the water jet, so the linear motion speed CVz of the endoscope is calculated by CVz=Vz×(Cz_stop-Cz_start)/(z_stop-z_start).
由于水刀的水射流喷射部在工作状态持续喷射水射流形成放射状态水柱（通常含有空化气团的气液混合体），内窥镜的观测镜头如果在水射流喷射部下方则不可避免地受到水柱辐射的视觉干扰，无法实现清晰观测，而如果内窥镜的观测镜头设置在水射流喷射部的前端，则意味着内窥镜的运动区域超出水刀运动区域，使得在同样的插入深度下水刀运动区域限缩。为实现内窥镜对水刀的清晰观测，本申请将内窥镜设置于水刀的后方，并设置内窥镜的观测镜头与水射流喷射部之间具有预定距离S。以此方式，可以使得内窥镜观测既避开了喷射的水射流造成的干扰，且有助于提供手术区域不受限的改善的观测视野和观测效果。进一步地，在确定了S后，即可根据水刀的规划运动位置轨迹参数中每个步长的直线起始位置 z_start确定内窥镜的跟随运动位置轨迹参数中每个步长的直线起始位置Cz_start，并根据水刀的规划运动位置轨迹参数中每个步长的直线结束位置 z_stop确定内窥镜的跟随运动位置轨迹参数中每个步长的直线结束位置Cz_stop。具体地，在进行前列腺增生切除手术时，水刀和内窥镜先同步运动至最远端位置后（以该位置为起点），然后驱动内窥镜后退至水射流喷射部后方，将内窥镜设在水刀后方距离S的位置处，相应地，设置内窥镜的跟随运动轨迹参数中的内窥镜的直线起始位置Cz_start=z_start+S，直线结束位置Cz_stop ＝ z_stop+S。Since the water jet injection part of the water knife continuously sprays water jets to form a radial water column (usually containing a gas-liquid mixture of cavitation gas masses) in the working state, if the observation lens of the endoscope is below the water jet injection part, it will inevitably be visually disturbed by the radiation of the water column and cannot achieve clear observation. If the observation lens of the endoscope is set at the front end of the water jet injection part, it means that the movement area of the endoscope exceeds the movement area of the water knife, so that the movement area of the water knife is limited at the same insertion depth. In order to achieve clear observation of the water knife by the endoscope, the present application sets the endoscope behind the water knife and sets a predetermined distance S between the observation lens of the endoscope and the water jet injection part. In this way, the endoscopic observation can avoid the interference caused by the sprayed water jet and help provide an improved observation field and observation effect without restriction of the surgical area. Further, after S is determined, the straight line starting position Cz_start of each step in the follow-up motion position trajectory parameters of the endoscope can be determined according to the straight line starting position z_start of each step in the planned motion position trajectory parameters of the water knife, and the straight line ending position Cz_stop of each step in the follow-up motion position trajectory parameters of the endoscope can be determined according to the straight line ending position z_stop of each step in the planned motion position trajectory parameters of the water knife. Specifically, when performing a prostate hyperplasia resection operation, the water knife and the endoscope first move synchronously to the farthest position (with this position as the starting point), and then the endoscope is driven to retreat to the rear of the water jet injection part, and the endoscope is set at a distance S behind the water knife. Accordingly, the straight line starting position Cz_start of the endoscope in the follow-up motion trajectory parameters of the endoscope is set to be z_start=z_start+S, and the straight line ending position Cz_stop ＝z_stop+S.
通过在内窥镜与水刀在轴向位置向后错开一定距离后，水刀可实现无遮挡地喷射水射流，内窥镜不会对水刀喷射的水射流形成遮挡，且使得内窥镜对水刀的水射流进行有效拍摄成为可能。然而仅设置内窥镜在水刀后方预定距离是不够的，S的确定方式是实现清晰观测的重要因素，By staggering the endoscope and the water jet axially backward by a certain distance, the water jet can spray water without obstruction, the endoscope will not block the water jet sprayed by the water jet, and it is possible for the endoscope to effectively shoot the water jet of the water jet. However, it is not enough to simply set the endoscope at a predetermined distance behind the water jet. The determination of S is an important factor in achieving clear observation.
图3为在内窥镜的视野范围可见区域示意图，如图所示，C表示内窥镜的大致圆心，A表示水刀在内窥镜的视野中的成像，E表示从水射流喷射部喷射出的水射流即水柱。在确定内窥镜的跟随运动位置轨迹参数时，需确保内窥镜视野能够清楚观测到水刀A和水射流E，以利用水刀A和水射流E的图像信息进行计算处理。FIG3 is a schematic diagram of the visible area within the field of view of the endoscope. As shown in the figure, C represents the approximate center of the endoscope, A represents the image of the water jet in the field of view of the endoscope, and E represents the water jet, i.e., the water column, ejected from the water jet ejection portion. When determining the tracking motion position trajectory parameters of the endoscope, it is necessary to ensure that the water jet A and the water jet E can be clearly observed in the field of view of the endoscope so as to use the image information of the water jet A and the water jet E for calculation and processing.
由于不同的内窥镜的拍摄能力存在差别，为了确保清晰成像，在确定内窥镜镜头与水刀刀头之间的距离时，本申请引入参数内窥镜最佳工作距离L。内窥镜最佳工作距离L表示物体距内窥镜镜头能清晰成像的距离，该距离通常与内窥镜焦距相关，在本申请中，内窥镜最佳工作距离L表示内窥镜镜头与水刀刀头之间的最佳工作距离，在该距离范围内，通过内窥镜可对视野范围内的水刀刀头A及水柱E清晰成像。L可以通过实验预先测定。例如在自主运动模式下，驱动水刀进入目标组织区域后停止运动，再驱动内窥镜在内窥镜鞘套通道内前进至水刀刀头附近并往复运动直至通过内窥镜可清晰观测到水刀刀头A及水柱E图像的区域，并对能清晰观测到水刀刀头A及水柱E图像的区域的位置进行记录，根据所记录的位置确定内窥镜最佳工作距离L。Since different endoscopes have different shooting capabilities, in order to ensure clear imaging, this application introduces the parameter endoscope optimal working distance L when determining the distance between the endoscope lens and the water jet cutter head. The endoscope optimal working distance L indicates the distance at which an object can be clearly imaged from the endoscope lens. This distance is usually related to the focal length of the endoscope. In this application, the endoscope optimal working distance L indicates the optimal working distance between the endoscope lens and the water jet cutter head. Within this distance range, the water jet cutter head A and the water column E within the field of view can be clearly imaged through the endoscope. L can be determined in advance through experiments. For example, in the autonomous motion mode, the water jet is driven to enter the target tissue area and then stop moving, and then the endoscope is driven to move forward in the endoscope sheath channel to the vicinity of the water jet cutter head and reciprocate until the area where the water jet cutter head A and the water column E image can be clearly observed through the endoscope, and the position of the area where the water jet cutter head A and the water column E image can be clearly observed is recorded, and the endoscope optimal working distance L is determined according to the recorded position.
内窥镜最佳工作距离L可以是一个数值范围，也可以是与水刀位置相关的动态变化的一组数值，即可针对不同的水刀固定位置P，确定不同的内窥镜最佳工作距离L，并将内窥镜最佳工作距离L与水刀位置P对应的数组存储。The optimal working distance L of the endoscope can be a numerical range or a set of dynamically changing numerical values related to the water jet position. That is, different optimal working distances L of the endoscope can be determined for different fixed positions P of the water jet, and the array corresponding to the optimal working distance L of the endoscope and the water jet position P can be stored.
可以基于内窥镜最佳工作距离L确定内窥镜的跟随运动位置轨迹参数，例如设置内窥镜的直线跟随运动位置轨迹参数中的内窥镜的直线起始位置Cz_start= z_start+L,直线结束位置Cz_stop ＝z_stop+L。The tracking motion position trajectory parameters of the endoscope can be determined based on the optimal working distance L of the endoscope, for example, the linear starting position Cz_start of the endoscope is set to z_start+L, and the linear ending position Cz_stop is set to z_stop+L.
在水刀插入人体组织时，伴随水刀的插入，水刀周围会形成组织塌陷，尤其是前列腺增生切除手术中水刀经由尿道插入，周围的前列腺增生组织被挤压产生收缩塌陷，围拢在水刀周围，如图3中所示，B、D、F表示由于水刀插入对周围组织造成挤压变形、出现在内窥镜视野内的组织。When the water jet is inserted into human tissue, tissue collapse will occur around the water jet, especially in prostate hyperplasia resection surgery where the water jet is inserted through the urethra. The surrounding prostate hyperplasia tissue is squeezed and collapsed, surrounding the water jet, as shown in Figure 3. B, D, and F represent tissues that appear in the endoscope field of view due to squeezing and deformation of the surrounding tissues caused by the insertion of the water jet.
发明人经反复实验发现，由于被挤压的组织是柔软可变形的，所形成的对内窥镜的镜头视野的遮挡发生在手术器械运动过程中，遮挡程度与组织的体积和质地有关，也与内窥镜与水刀刀头之间的距离有关。例如，当内窥镜紧挨水刀刀头时，由于在前插入的水刀刀头对周围组织提供一定的撑起扩张作用，内窥镜视野几乎不会发生组织塌缩效应或组织塌缩效应较小不影响观测；当内窥镜与水刀刀头之间距离较远时，由于在前插入的水刀刀头对周围组织提供的撑起扩张作用已消失，刀身周围组织塌缩效应较为明显，严重的情况几乎造成对内窥镜的全部视野的遮挡。The inventor has found through repeated experiments that, because the squeezed tissue is soft and deformable, the obstruction of the endoscope's lens field of view occurs during the movement of the surgical instrument, and the degree of obstruction is related to the volume and texture of the tissue, as well as the distance between the endoscope and the water jet cutter head. For example, when the endoscope is close to the water jet cutter head, the water jet cutter head inserted in front provides a certain support and expansion effect on the surrounding tissue, and the endoscope's field of view will hardly experience a tissue collapse effect, or the tissue collapse effect is small and does not affect observation; when the distance between the endoscope and the water jet cutter head is far, the support and expansion effect provided by the water jet cutter head inserted in front on the surrounding tissue has disappeared, and the collapse effect of the tissue around the blade is more obvious. In severe cases, the entire field of view of the endoscope is almost blocked.
为解决该问题，本申请引入参数组织塌缩可视距离T，参数组织塌缩可视距离T为内窥镜与水刀刀头之间的距离值，用于表征组织塌缩效应对内窥镜视野的影响。预先由实验获得超声图像中不同组织部位在水刀插入时的组织塌缩可视距离T。例如在自主运动模式下，驱动水刀进入目标组织区域后停止运动，再驱动内窥镜在内窥镜鞘套通道内前进至水刀刀头正下方后逐步远离水刀刀头，在组织塌缩可视距离T内可以在内窥镜视野中观察到水柱E，超出该距离后因组织收缩挤压包裹的影响，阻挡内窥镜视野。以内窥镜视野不被阻挡到开始被阻挡或被阻挡小部分区域的位置为限，记录该位置对应的内窥镜与水刀刀头之间的距离作为组织塌缩可视距离T。换句话说，组织塌缩可视距离T指的是水刀刀头附近的、尚未或较小受到组织挤压变形的遮挡影响的距离。To solve this problem, the present application introduces a parameter tissue collapse visible distance T, which is the distance between the endoscope and the water jet cutter head, and is used to characterize the effect of tissue collapse effect on the endoscope field of view. The tissue collapse visible distance T of different tissue parts in the ultrasound image when the water jet is inserted is obtained in advance by experiments. For example, in the autonomous motion mode, the water jet is driven to enter the target tissue area and then stops moving, and then the endoscope is driven to move forward in the endoscope sheath channel to the bottom of the water jet cutter head and then gradually moves away from the water jet cutter head. Within the tissue collapse visible distance T, the water column E can be observed in the endoscope field of view. Beyond this distance, the endoscope field of view is blocked due to the influence of tissue contraction, squeezing and wrapping. The endoscope field of view is limited to the position where the endoscope field of view is not blocked to the position where it begins to be blocked or a small part of the area is blocked, and the distance between the endoscope and the water jet cutter head corresponding to this position is recorded as the tissue collapse visible distance T. In other words, the tissue collapse visible distance T refers to the distance near the water jet cutter head that has not been or is less affected by the occlusion of tissue squeezing and deformation.
组织塌缩可视距离T可以是一个数值范围，也可以是与水刀位置相关的动态变化的一组数值，即可针对不同的水刀固定位置P，确定不同的组织塌缩可视距离T，并将组织塌缩可视距离T与水刀位置P对应的数组存储。The tissue collapse visible distance T can be a numerical range or a set of dynamically changing numerical values related to the water jet position. That is, different tissue collapse visible distances T can be determined for different water jet fixed positions P, and the array corresponding to the tissue collapse visible distance T and the water jet position P can be stored.
进一步地，可以基于组织塌缩可视距离T确定内窥镜的跟随运动位置轨迹参数，设置内窥镜的直线跟随运动位置轨迹参数中的内窥镜的直线起始位置Cz_start= z_start+T,直线结束位置Cz_stop ＝z_stop+T。以此方式，可以确保跟随运动模式下内窥镜的观察视野不受到组织塌缩效应的影响。Furthermore, the tracking motion position trajectory parameters of the endoscope can be determined based on the tissue collapse visible distance T, and the linear starting position Cz_start of the endoscope in the linear tracking motion position trajectory parameters of the endoscope is set to be z_start=z_start+T, and the linear ending position Cz_stop=z_stop+T. In this way, it can be ensured that the observation field of the endoscope in the tracking motion mode is not affected by the tissue collapse effect.
更优地，本申请可同时基于组织塌缩可视距离T、和内窥镜最佳工作距离L确定内窥镜的跟随运动轨迹参数。例如，设置Cz_start ＝ z_start+min(L, T)；以及设置Cz_stop＝ z_stop+min(L, T)。以此方式，可以确保跟随运动模式下内窥镜的观察视野既不受组织塌缩效应的影响，且可获得较佳的成像效果。Preferably, the present application can determine the tracking motion trajectory parameters of the endoscope based on the tissue collapse visible distance T and the endoscope optimal working distance L. For example, Cz_start is set to z_start+min(L, T); and Cz_stop is set to z_stop+min(L, T). In this way, it can be ensured that the observation field of the endoscope in the following motion mode is not affected by the tissue collapse effect, and a better imaging effect can be obtained.
进一步的，本申请还可设置调整内窥镜景深delta，在内窥镜景深delta的允许范围内适当调整内窥镜镜头与水刀刀头的间距，以尽可能地确保水刀及其喷射的水射流落入内窥镜的视野范围。内窥镜景深delta是内窥镜在前述的内窥镜最佳工作距离L的前后的可工作范围，即内窥镜在焦距最清晰时的景深。Furthermore, the present application may also be configured to adjust the endoscope depth of field delta, and appropriately adjust the distance between the endoscope lens and the water jet head within the allowable range of the endoscope depth of field delta to ensure that the water jet and its ejected water jet fall into the field of view of the endoscope as much as possible. The endoscope depth of field delta is the working range of the endoscope before and after the aforementioned optimal working distance L of the endoscope, that is, the depth of field of the endoscope when the focus is clearest.
通过以上设置，使得在水刀实际工作时，内窥镜能够启动跟随运动模式，驱使内窥镜按照跟随运动位置轨迹运动，由于内窥镜的跟随运动位置轨迹参数系基于水刀的规划运动位置轨迹参数确定的，因此按照跟随运动位置轨迹参数运动的内窥镜的直线运动与按照规划运动位置轨迹参数运动的水刀的直线运动可以始终保持同步，确保内窥镜在考虑了水柱喷射以及周围组织塌缩的影响的情况下，仍能对水刀的刀头及其所喷射的水柱以及周围组织区域进行清晰观测。并且，由于内窥镜的跟随运动模式是预先设置的，内窥镜的跟随运动位置轨迹参数也是预先基于水刀的规划运动位置轨迹参数确定，使得内窥镜执行跟随运动时无需进行追踪等大量的图像数据计算，大幅度减少了内窥镜的运动过程中控制部或处理器的计算量，使得控制部或处理器能够有充足计算余力基于内窥镜图像对水刀工作过程中实际的运动位置轨迹参数进行计算分析，实现几乎实时监测的技术效果。具体的监测方式如下详述。Through the above settings, when the water jet is actually working, the endoscope can start the follow-up motion mode and drive the endoscope to move according to the follow-up motion position trajectory. Since the follow-up motion position trajectory parameters of the endoscope are determined based on the planned motion position trajectory parameters of the water jet, the linear motion of the endoscope moving according to the follow-up motion position trajectory parameters and the linear motion of the water jet moving according to the planned motion position trajectory parameters can always be synchronized, ensuring that the endoscope can still clearly observe the water jet head, the water jet it sprays, and the surrounding tissue area while considering the effects of the water jet and the collapse of the surrounding tissue. In addition, since the follow-up motion mode of the endoscope is pre-set, the follow-up motion position trajectory parameters of the endoscope are also pre-determined based on the planned motion position trajectory parameters of the water jet, so that the endoscope does not need to perform tracking and other large amounts of image data calculations when performing the follow-up motion, which greatly reduces the amount of calculation of the control unit or processor during the movement of the endoscope, so that the control unit or processor can have sufficient computing power to calculate and analyze the actual motion position trajectory parameters during the operation of the water jet based on the endoscopic image, and achieve the technical effect of almost real-time monitoring. The specific monitoring method is described in detail as follows.
跟随运动模式下的内窥镜可实时获取水刀刀头以及所喷射水柱的内窥镜图像，如前所述，基于本申请的跟随运动轨迹确定方式，基于所获取的内窥镜图像能清晰识别水刀刀头和水柱的图像。如图5所示，控制部或处理器针对所获取的内窥镜图像利用图像分割算法确定每幅图像中的水柱区域，计算水柱长度，所得的水柱长度即为水刀实际运动位置轨迹参数中的射流长度轨迹参数R。由于图像是清晰的且图像分割算法已经非常成熟，射流长度轨迹参数R的计算结果的获得几乎是实时的。The endoscope in the following motion mode can obtain the endoscopic images of the water jet cutter head and the sprayed water column in real time. As mentioned above, based on the following motion trajectory determination method of the present application, the images of the water jet cutter head and the water column can be clearly identified based on the acquired endoscopic images. As shown in FIG5 , the control unit or processor uses the image segmentation algorithm to determine the water column area in each image for the acquired endoscopic images, calculates the length of the water column, and the obtained water column length is the jet length trajectory parameter R in the actual motion position trajectory parameter of the water jet. Since the image is clear and the image segmentation algorithm is very mature, the calculation result of the jet length trajectory parameter R is obtained almost in real time.
例如，可以通过对内窥镜图像中水柱区域E进行分割，获取其水柱区域E及其外包围多边形区域。通过对外包围多边形区域的测量，如通过最小外包矩形的高度h和宽度w的图像检测，即可确定实际的水射流的作用范围w及长度h进行监测，长度h为实测的射流长度轨迹参数，通过将测算的长度h与规划的射流长度轨迹参数R进行比较，即可评估该步长内水刀的实测射流长度轨迹参数与规划的射流长度轨迹参数是否一致。For example, the water column area E in the endoscope image can be segmented to obtain the water column area E and its outer enclosing polygonal area. By measuring the outer enclosing polygonal area, such as by image detection of the height h and width w of the minimum outer rectangle, the actual water jet range w and length h can be determined for monitoring. The length h is the measured jet length trajectory parameter. By comparing the measured length h with the planned jet length trajectory parameter R, it can be evaluated whether the measured jet length trajectory parameter of the water jet within the step length is consistent with the planned jet length trajectory parameter.
进一步地，控制部或处理器可对跟随运动模式下所获取的内窥镜图像进行分析，计算得出水刀实际运动位置轨迹参数中的旋转运动位置轨迹参数。本申请通过测算水柱的摆动角度和/或水柱的摆动频率，监测所述水刀的旋转运动位置轨迹参数，并且进一步的还可基于水刀的预设轨迹中旋转角度范围与组织塌陷可视角度范围的比较结果，采用不同的水刀旋转运动位置轨迹参数监测方法。Furthermore, the control unit or processor can analyze the endoscopic image acquired in the follow-up motion mode to calculate the rotational motion position trajectory parameters in the actual motion position trajectory parameters of the water jet. The present application monitors the rotational motion position trajectory parameters of the water jet by measuring the swing angle and/or the swing frequency of the water jet, and further, different water jet rotational motion position trajectory parameter monitoring methods can be used based on the comparison results of the rotation angle range in the preset trajectory of the water jet and the visible angle range of tissue collapse.
测算摆动角度用于评估水刀的实际旋转运动位置轨迹参数The swing angle is measured to evaluate the actual rotational motion position trajectory parameters of the water jet
当通过内窥镜能够观察到全部水柱时，可以通过测算水柱摆动角度范围的方式直接获得水刀的旋转角度轨迹参数，例如，可以获取系列内窥镜图像帧，通过分割每帧的水柱图像，计算水柱的摆动角度。When the entire water column can be observed through an endoscope, the rotation angle trajectory parameters of the water jet can be directly obtained by measuring the water column swing angle range. For example, a series of endoscopic image frames can be obtained, and the water column swing angle can be calculated by segmenting the water column image of each frame.
具体地，可以在一个步长的运动过程中，记录从该步长运动的开始到结束过程中所有帧的分割出的水柱图像，计算所有水柱图像中水柱的长轴轴线与竖直方向的角度，以从水刀刀头出发竖直向下的角度为0度，得到该步长的运动过程中所有水柱图像中水柱长轴轴线的最小摆动角度RotateStartReal和最大摆动角度RotatestopReal，（RotateStartReal，RotatestopReal）作为摆动角度范围，即为该步长内水柱运动的实测旋转角度范围。通过比较该步长内水柱运动的实测旋转角度范围（RotateStartReal，RotatestopReal）与该步长的旋转运动轨迹参数确定的规划角度范围（θ_start，θ_stop），即可评估该步长内水刀的实测旋转运动位置轨迹参数与规划的旋转运动位置轨迹参数是否一致。Specifically, during the movement of a step length, the segmented water column images of all frames from the beginning to the end of the step length movement can be recorded, and the angle between the long axis of the water column in all water column images and the vertical direction can be calculated. The angle vertically downward from the water jet cutter head is 0 degrees, and the minimum swing angle RotateStartReal and the maximum swing angle RotatestopReal of the long axis of the water column in all water column images during the movement of the step length are obtained. (RotateStartReal, RotatestopReal) is used as the swing angle range, which is the measured rotation angle range of the water column movement in the step length. By comparing the measured rotation angle range (RotateStartReal, RotatestopReal) of the water column movement in the step length with the planned angle range (θ_start, θ_stop) determined by the rotational motion trajectory parameters of the step length, it can be evaluated whether the measured rotational motion position trajectory parameters of the water jet in the step length are consistent with the planned rotational motion position trajectory parameters.
然而前述仅为理想情况，实际观测过程中发现，尽管在跟随运动位置轨迹参数确定时考虑了组织塌缩可视距离，但是实际观察时仍会存在或多或少的组织挤压遮挡，在此情形下，水刀摆动的角度可能会超出内窥镜的视野范围，即仅从内窥镜的视野无法观测水刀摆动的全角度范围。如图2所示，是本申请的水刀的截面示意图，W表示水刀的圆心，C表示内窥镜的圆心，实线的圆表示水射流的辐射范围，虚线的圆表示内窥镜的视野范围。由于水刀和内窥镜的结构限制，通常水射流的辐射范围和内窥镜的视野范围并不是360度，而是小于360度的扇形区域。如图2所示，水射流的辐射范围是扇形区域PWQ，而内窥镜的视野范围是扇形区域PCQ；以及参照图3，由于水刀自身结构（例如上方鞘套）的遮挡，以及周围组织塌陷的影响，使得水射流的辐射范围的一部分存在未落入内窥镜的视野范围的可能，这导致基于内窥镜观察水刀及其喷射的水射流的情况存在被遮挡而导致的拍摄不全问题。However, the above is only an ideal situation. It is found in the actual observation process that although the visible distance of tissue collapse is taken into account when determining the parameters of the follow-up motion position trajectory, there will still be more or less tissue extrusion and obstruction during actual observation. In this case, the angle of the water jet swing may exceed the field of view of the endoscope, that is, the full angle range of the water jet swing cannot be observed only from the field of view of the endoscope. As shown in Figure 2, it is a cross-sectional schematic diagram of the water jet of the present application, W represents the center of the water jet, C represents the center of the endoscope, the solid circle represents the radiation range of the water jet, and the dotted circle represents the field of view of the endoscope. Due to the structural limitations of the water jet and the endoscope, the radiation range of the water jet and the field of view of the endoscope are usually not 360 degrees, but a fan-shaped area less than 360 degrees. As shown in FIG2 , the radiation range of the water jet is the fan-shaped area PWQ, and the field of view of the endoscope is the fan-shaped area PCQ; and referring to FIG3 , due to the obstruction of the water jet's own structure (such as the upper sheath) and the influence of the collapse of the surrounding tissue, a part of the radiation range of the water jet may not fall into the field of view of the endoscope, which leads to the problem of incomplete shooting due to obstruction when observing the water jet and its ejected water jet based on the endoscope.
此种情况下，如果仍然采用前述计算水刀的摆动角度的方式，必然会存在数据丢失导致监测结果不准确的问题。In this case, if the aforementioned method of calculating the swing angle of the water jet is still used, there will inevitably be a problem of data loss leading to inaccurate monitoring results.
为解决上述问题，本申请首先定义了组织塌缩可视角度，根据不同的组织塌缩可视角度范围，选择不同的旋转运动位置轨迹参数监测方法。In order to solve the above problems, the present application first defines the visible angle of tissue collapse, and selects different rotational motion position trajectory parameter monitoring methods according to different visible angle ranges of tissue collapse.
具体地，组织塌缩可视角度由Tθ_start 与Tθ_stop限定。Tθ_start 与Tθ_stop的确定方式如下：在组织塌缩可视距离T下，以水刀刀头为圆心、以规划射流长度R为半径的水柱E与周围塌缩组织边界相切的切线的起始角度和终止角度。可以对内窥镜的实时图像利用图像分割算法求出图3中的A、B、C、D、E、F等区域，确定组织塌缩可视距离T的组织塌缩可视角度（Tθ_start，Tθ_stop）。Specifically, the tissue collapse visual angle is defined by Tθ_start and Tθ_stop. Tθ_start and Tθ_stop are determined as follows: at the tissue collapse visual distance T, the starting angle and the ending angle of the tangent line of the water column E with the water jet tip as the center and the planned jet length R as the radius and the surrounding collapsed tissue boundary. The image segmentation algorithm can be used to obtain the A, B, C, D, E, F and other areas in Figure 3 for the real-time image of the endoscope to determine the tissue collapse visual angle (Tθ_start, Tθ_stop) at the tissue collapse visual distance T.
本申请还定义了waterjet_visible参数，该参数用于表示是否能够由内窥镜拍摄到水射流。将水刀的规划角度范围（θ_start , θ_stop）与基于内窥镜图像分割确定的组织塌陷可视角度（Tθ_start，Tθ_stop）进行比较，根据比较结果确定waterjet_visible参数的赋值。例如，以从水刀刀头出发竖直向下的角度为0度，当Tθ_start≤θ_start，且同时Tθ_stop≥θ_stop，意味着通过内窥镜能观察到该步长的旋转运动范围内的水柱时，设置waterjet_visible = 2；当Tθ_stop≤θ_start，或者Tθ_start≥θ_stop时，意味着通过内窥镜无法观察到该步长的旋转运动范围内的任何水柱，设置waterjet_visible= 0；当θ_start＜Tθ_stop＜θ_stop，或者θ_start＜Tθ_start＜θ_stop时，意味着通过内窥镜能观察到该步长的旋转运动范围内的部分水柱，设置waterjet_visible = 1。This application also defines a waterjet_visible parameter, which is used to indicate whether the water jet can be photographed by the endoscope. The planned angle range of the water jet (θ_start, θ_stop) is compared with the visible angle of tissue collapse (Tθ_start, Tθ_stop) determined based on the endoscopic image segmentation, and the value of the waterjet_visible parameter is determined based on the comparison result. For example, taking the vertical downward angle from the water jet head as 0 degrees, when Tθ_start≤θ_start and Tθ_stop≥θ_stop, it means that the water column within the rotational motion range of the step length can be observed through the endoscope, and waterjet_visible = 2 is set; when Tθ_stop≤θ_start, or Tθ_start≥θ_stop, it means that any water column within the rotational motion range of the step length cannot be observed through the endoscope, and waterjet_visible = 0 is set; when θ_start＜Tθ_stop＜θ_stop, or θ_start＜Tθ_start＜θ_stop, it means that part of the water column within the rotational motion range of the step length can be observed through the endoscope, and waterjet_visible = 1 is set.
测算水柱摆动频率用于评估水刀的实际旋转运动位置轨迹参数The water column oscillation frequency is measured to evaluate the actual rotational motion position trajectory parameters of the water jet.
当waterjet_visible = 1时，可以测算水柱的摆动频率用于评估水刀的实际旋转运动位置轨迹参数，即用于评估水刀是否按照规划运动轨迹执行作业。When waterjet_visible = 1, the oscillation frequency of the water column can be measured to evaluate the actual rotational motion position trajectory parameters of the water jet, that is, to evaluate whether the water jet performs operations according to the planned motion trajectory.
定义观测角度位置CameraObserve_degree，CameraObserve_degree为选定的内窥镜图像中观测的水柱的摆动位置的角度位置，该角度位置用来观测并计算水柱的实际摆动频率，CameraObserve_degree是带有方向的矢量，既包含水柱摆动到该位置的角度值，又包含水柱摆动到该位置的角度值变化的方向或趋势。Define the observation angle position CameraObserve_degree. CameraObserve_degree is the angle position of the swing position of the water column observed in the selected endoscopic image. This angle position is used to observe and calculate the actual swing frequency of the water column. CameraObserve_degree is a vector with direction, which includes both the angle value of the water column swinging to this position and the direction or trend of the change of the angle value of the water column swinging to this position.
水刀在每个步长以扫过一个扇形的方式进行切除，进入下一步长后，再次反向以扫过一个扇形的方式进行切除。因此，连续多个步长进行切除时，水柱表现为类似于螺旋状的运动方式，并且每个步长内的旋转（摆动）具有与前述的Vθ，θ_start, θ_stop相关的周期（频率）。这里所称的水柱的摆动频率计算为其中两个步长运动时间和的倒数。当相邻步长之间的运动连续变化不发生突变时，则水刀摆动通过观测角度位置的频率可近似为其中一个步长的运动时间（从θ_start运动到θ_stop所需时间）的倒数的1/2。由于内窥镜的图像采集频率远大于水柱的摆动频率。因此通过观测角度位置采集及计算其摆动频率，能够判定水刀是否按照规划的旋转运动轨迹执行作业。The water jet cuts by sweeping a sector in each step, and after entering the next step, it cuts by sweeping a sector in the opposite direction again. Therefore, when cutting is performed in multiple consecutive steps, the water column exhibits a spiral-like motion, and the rotation (swing) in each step has a period (frequency) related to the aforementioned Vθ , θ_start, θ_stop. The swing frequency of the water column referred to here is calculated as the reciprocal of the movement time of two steps. When the movement between adjacent steps changes continuously without sudden changes, the frequency of the water jet swinging through the observed angle position can be approximated to 1/2 of the reciprocal of the movement time of one of the steps (the time required to move from θ_start to θ_stop). Since the image acquisition frequency of the endoscope is much greater than the swing frequency of the water column. Therefore, by observing the angle position acquisition and calculating its swing frequency, it is possible to determine whether the water jet performs operations according to the planned rotational motion trajectory.
首先，获取当前步长的水刀的规划运动轨迹中的旋转运动轨迹参数，包括水刀在该步长内的旋转起始角度θ_start、水刀在该步长内的旋转结束角度θ_stop、水刀在该步长内的旋转速度Vθ；基于规划的旋转运动轨迹参数计算该步长内水柱的规划摆动频率θ_f：θ_f=0.5*Vθ/(θ_stop-θ_start)。First, obtain the rotational motion trajectory parameters in the planned motion trajectory of the water jet of the current step length, including the starting rotation angle θ_start of the water jet in the step length, the ending rotation angle θ_stop of the water jet in the step length, and the rotation speed Vθ of the water jet in the step length; calculate the planned swing frequency θ_f of the water column in the step length based on the planned rotational motion trajectory parameters: θ_f=0.5*Vθ /(θ_stop-θ_start).
记录从该步长运动开始到结束过程中所有帧的分割出的水柱图像，通过分割每帧的水柱图像，获得水柱到达相邻观测角度位置（CameraObserve_degree）的时间间隔，即确定水柱角度值和水柱角度值变化方向均相同的两个相邻CameraObserve_degree位置的时间间隔，该时间间隔的倒数即为水刀的实际摆动频率θ_fReal。The segmented water column images of all frames from the beginning to the end of the step movement are recorded. By segmenting the water column image of each frame, the time interval for the water column to reach the adjacent observation angle position (CameraObserve_degree) is obtained, that is, the time interval between two adjacent CameraObserve_degree positions with the same water column angle value and the same direction of change of the water column angle value is determined. The reciprocal of this time interval is the actual swing frequency θ_fReal of the water knife.
由于水刀的周期性运动，水柱角度值和角度值变化方向均相同的两个观测角度位置（CameraObserve_degree）通常是隔着奇数个步长而出现的。理论上只要是隔着奇数个步长的角度值和角度值变化方向均相同的两个CameraObserve_degree，均可以用于计算摆动频率。但是考虑到切除通道的连续性，优选为通过间隔隔一个步长的角度值和角度值的变化方向均相同的两个观测角度位置（CameraObserve_degree）来计算摆动频率。在此，将间隔一个步长出现的角度值和角度值变化方向均相同的两个观测角度位置（CameraObserve_degree）称为相邻的观测角度位置，计算相邻观测角度位置的时间间隔，该时间间隔的倒数即为水刀在该步长内的实际摆动频率θ_fReal。Due to the periodic motion of the water jet, two observation angle positions (CameraObserve_degree) with the same angle value of the water column and the same direction of change of the angle value usually appear at intervals of an odd number of steps. Theoretically, as long as there are two CameraObserve_degrees with the same angle value and the same direction of change of the angle value separated by an odd number of steps, they can be used to calculate the swing frequency. However, considering the continuity of the resection channel, it is preferred to calculate the swing frequency by using two observation angle positions (CameraObserve_degree) with the same angle value and the same direction of change of the angle value separated by one step. Here, two observation angle positions (CameraObserve_degree) with the same angle value and the same direction of change of the angle value that appear at an interval of one step are called adjacent observation angle positions, and the time interval between adjacent observation angle positions is calculated. The reciprocal of the time interval is the actual swing frequency θ_fReal of the water jet within the step.
通过比较该步长内水柱运动的实际摆动频率θ_fReal与该步长的旋转运动轨迹参数确定的规划摆动频率θ_f，即可判断二者的偏差，进而评估该步长内水刀的实测旋转运动位置轨迹参数与规划的旋转运动位置轨迹参数是否一致。By comparing the actual swing frequency θ_fReal of the water column movement within the step length with the planned swing frequency θ_f determined by the rotational motion trajectory parameters of the step length, the deviation between the two can be determined, and then it can be evaluated whether the measured rotational motion position trajectory parameters of the water jet within the step length are consistent with the planned rotational motion position trajectory parameters.
测算刀身关键点摆动频率用于评估水刀的实际旋转运动位置轨迹参数Calculate the swing frequency of the key points of the blade to evaluate the actual rotational motion position trajectory parameters of the water jet
对于极端的情况，当waterjet_visible = 0时，即通过内窥镜无法观察到该步长的旋转运动范围内的任何水柱时，可采用监测刀身关键点的摆动频率测算方法确定的数值作为水柱摆动频率，用于评估水刀的实际旋转运动位置轨迹参数。For extreme cases, when waterjet_visible = 0, that is, any water column within the rotational motion range of the step length cannot be observed through the endoscope, the value determined by the swing frequency measurement method of monitoring the key points of the blade can be used as the water column swing frequency, which is used to evaluate the actual rotational motion position trajectory parameters of the water jet.
具体地，如图3所示，A区为水刀区域，对分割出的A区域图像，使用关键点检测算法如SIFT关键点等识别并标记出关键点，通过对内窥镜图像的采样，确定所识别的关键点角度到达观察角度值和角度值变化方向均相同的相邻观测角度位置（CameraObserve_degree）的时间间隔，将该时间间隔的倒数作为水柱的实际摆动频率θ_fReal。进一步地，通过比较该步长内水柱运动的实测摆动频率θ_fReal与该步长的旋转运动轨迹参数确定的规划摆动频率θ_f，即可判断水柱的实际摆动频率与规划摆动频率的偏差，进而评估该步长内水刀的实测旋转运动位置轨迹参数与规划的旋转运动位置轨迹参数是否一致。Specifically, as shown in FIG3 , area A is the water jet area. For the segmented image of area A, a key point detection algorithm such as SIFT key points is used to identify and mark key points. By sampling the endoscopic image, the time interval for the identified key point angle to reach the adjacent observation angle position (CameraObserve_degree) with the same observation angle value and angle value change direction is determined, and the reciprocal of the time interval is taken as the actual swing frequency θ_fReal of the water column. Furthermore, by comparing the measured swing frequency θ_fReal of the water column movement within the step length with the planned swing frequency θ_f determined by the rotational motion trajectory parameters of the step length, the deviation between the actual swing frequency of the water column and the planned swing frequency can be determined, and then whether the measured rotational motion position trajectory parameters of the water jet within the step length are consistent with the planned rotational motion position trajectory parameters can be evaluated.
以上测算评估水刀实际的旋转运动轨迹参数的方法中，基于刀身关键点摆动频率的测算方法也可以用于waterjet_visible = 1或2的情形，基于水柱摆动频率的测算方法也可用于waterjet_visible= 2的情形，但是为了实现更优的计算速度和准确度，基于水刀的预设轨迹中旋转角度范围与组织塌陷可视角度范围的比较结果，即针对不同的waterjet_visible赋值，选择不同的水刀旋转运动位置轨迹参数监测方法，当waterjet_visible = 2时，选择基于摆动角度的测算方法，当waterjet_visible = 1时，选择基于水柱摆动频率的测算方法，当waterjet_visible = 0时，选择基于刀身关键点摆动频率的测算方法。Among the above methods for measuring and evaluating the actual rotational motion trajectory parameters of the water jet, the calculation method based on the swing frequency of the key points of the blade can also be used in the case of waterjet_visible = 1 or 2, and the calculation method based on the swing frequency of the water column can also be used in the case of waterjet_visible = 2. However, in order to achieve better calculation speed and accuracy, based on the comparison results of the rotation angle range and the visible angle range of tissue collapse in the preset trajectory of the water jet, that is, for different waterjet_visible assignments, different water jet rotational motion position trajectory parameter monitoring methods are selected. When waterjet_visible = 2, the calculation method based on the swing angle is selected. When waterjet_visible = 1, the calculation method based on the water column swing frequency is selected. When waterjet_visible = 0, the calculation method based on the swing frequency of the key points of the blade is selected.
内窥镜的旋转运动Rotational movement of the endoscope
大多数情况下，内窥镜的镜头与水刀的轴向平行（即朝向正前方），然而，在确定内窥镜的最佳工作距离L时，用于测试的水柱E通常为直接向下或仅在一定角度范围内进行测试，实际工作时水柱的旋转范围却可能超出内窥镜的视野。In most cases, the endoscope lens is parallel to the axis of the water jet (i.e., facing straight ahead). However, when determining the optimal working distance L of the endoscope, the water column E used for testing is usually directed directly downward or only tested within a certain angle range. In actual operation, the rotation range of the water column may exceed the field of view of the endoscope.
例如，图6中的左图所示意的，当内窥镜的镜头与水刀的轴向平行（即朝向正前方）时，内窥镜的可视角度为∠S2-C-S1，当实际工作时水柱的旋转范围超出内窥镜的视野，使得通过内窥镜镜头无法观测到水柱时，即waterjet_visible = 0。当内窥镜镜头无法观测到水柱时，尽管可以采用前述替代的测算方式，但是其精确度可能存在缺陷，为此可采用替换的方案，即增加内窥镜的旋转运动，采用能够旋转的内窥镜镜头，如图6中的右图所示，使用具有一定倾角的内窥镜镜头，通过随着内窥镜的旋转调整内窥镜镜头的倾角，以使得旋转后的内窥镜能够在前述基于min（L,T）确定的有限距离内满足内窥镜的可视角度要求。For example, as shown in the left figure of FIG6 , when the endoscope lens is parallel to the axis of the water jet (i.e., facing straight ahead), the viewing angle of the endoscope is ∠S2-C-S1. When the rotation range of the water column exceeds the field of view of the endoscope during actual operation, the water column cannot be observed through the endoscope lens, i.e., waterjet_visible = 0. When the endoscope lens cannot observe the water column, although the aforementioned alternative measurement method can be used, its accuracy may be defective. For this reason, an alternative solution can be adopted, i.e., increasing the rotational movement of the endoscope and using a rotatable endoscope lens, as shown in the right figure of FIG6 , using an endoscope lens with a certain inclination angle, by adjusting the inclination angle of the endoscope lens as the endoscope rotates, so that the rotated endoscope can meet the viewing angle requirement of the endoscope within the limited distance determined based on min (L, T) as mentioned above.
对于内窥镜镜头倾角可调的情形，可设置内窥镜的跟随运动包含旋转运动，即将内窥镜的跟随运动模式设置为不仅跟随水刀的直线运动、还跟随水刀进行旋转运动，相应地，跟随运动位置轨迹参数还包含表示内窥镜在该步长内的旋转起始角度的Cθ_start，在该步长内的旋转结束角度Cθ_stop，在该步长内的旋转速度CVθ。内窥镜的跟随运动的目的在于调整内窥镜视野区域，确保其尽可能地观测到水刀及喷射水柱的全貌。此时，同样需要基于水刀的θ_start,θ_stop, Vθ确定内窥镜的Cθ_start, Cθ_stop, CVθ。For situations where the inclination angle of the endoscope lens is adjustable, the following motion of the endoscope can be set to include rotational motion, that is, the following motion mode of the endoscope is set to not only follow the linear motion of the water jet, but also follow the rotational motion of the water jet. Accordingly, the following motion position trajectory parameters also include Cθ_start, which represents the starting angle of rotation of the endoscope within the step length, Cθ_stop, which represents the ending angle of rotation within the step length, and CVθ , which represents the rotation speed within the step length. The purpose of the following motion of the endoscope is to adjust the field of view of the endoscope to ensure that it can observe the full view of the water jet and the jet of water as much as possible. At this time, it is also necessary to determine Cθ_start, Cθ_stop, and CVθ of the endoscope based on θ_start, θ_stop, and Vθ of the water jet.
通过上述步骤，可以基于内窥镜图像测算水刀工作过程中实际的旋转运动位置轨迹参数及射流长度轨迹参数，并判断是否与规划的旋转运动位置轨迹参数及射流长度轨迹参数存在偏差，当存在偏差时，可启动报警机制或将偏差反馈至控制部，根据反馈结果对水刀的规划轨迹进行补偿和调整。Through the above steps, the actual rotational motion position trajectory parameters and jet length trajectory parameters during the water jet operation process can be calculated based on the endoscopic image, and it can be determined whether there is a deviation from the planned rotational motion position trajectory parameters and jet length trajectory parameters. When there is a deviation, the alarm mechanism can be activated or the deviation can be fed back to the control unit, and the planned trajectory of the water jet can be compensated and adjusted according to the feedback result.
针对敏感部位的安全监测Safety monitoring for sensitive areas
参见图4，图4示意性地示出病患管腔内的敏感部位。图中C表示内窥镜的大致圆心，A表示水刀在内窥镜的视野中的成像，B、D、F表示被水刀挤压变形的组织或管腔内的其他组织，E表示水射流。前列腺手术场景下，F是管腔内的敏感部位组织，例如输尿管口或精阜，该敏感部位的组织在术中是应当避免切除的，以免对病患造成伤害。See Figure 4, which schematically shows the sensitive parts in the patient's lumen. In the figure, C represents the approximate center of the endoscope, A represents the image of the water jet in the field of view of the endoscope, B, D, and F represent the tissues squeezed and deformed by the water jet or other tissues in the lumen, and E represents the water jet. In the prostate surgery scenario, F is the sensitive part of the tissue in the lumen, such as the ureteral orifice or the seminal fossa, and the tissue in this sensitive part should be avoided from being removed during the operation to avoid causing harm to the patient.
通常而言，基于术前图像或基于超声图像确定水刀的规划运动轨迹时，已经考虑了对敏感部位的切除规避。但是，因超声图像的精度或生物体的移动等，在手术实际执行过程中，生物体的敏感部位的实际位置相较于术前图像或超声图像的识别结果可能存在偏差，导致基于规划方案仍然有被伤害的风险。Generally speaking, when the planned motion trajectory of the water jet is determined based on preoperative images or ultrasound images, the avoidance of resection of sensitive parts has been considered. However, due to the accuracy of ultrasound images or the movement of the organism, during the actual execution of the operation, the actual position of the sensitive parts of the organism may deviate from the recognition results of the preoperative images or ultrasound images, resulting in the risk of injury based on the planning scheme.
在本申请中，跟随运动模式的内窥镜可以获取水刀及水柱的清晰的实时图像，基于所获取的实时图像，增加敏感部位安全保护功能，其实现思路包括基于射流长度轨迹参数的敏感部位安全监测，或者基于旋转运动位置轨迹参数的敏感部位安全监测。In the present application, the endoscope following the motion mode can obtain clear real-time images of the water jet and the water column, and based on the real-time images obtained, increase the safety protection function of sensitive parts. The implementation ideas include safety monitoring of sensitive parts based on the jet length trajectory parameters, or safety monitoring of sensitive parts based on the rotational motion position trajectory parameters.
基于射流长度轨迹参数的敏感部位安全监测Safety monitoring of sensitive parts based on jet length trajectory parameters
首先，通过跟随运动模式的内窥镜获取实时清晰图像，利用图像分割算法识别出内窥镜图像中的敏感部位F，并测算出所识别的敏感部位F的轮廓边界与水刀刀头的最短距离S1。First, a real-time clear image is obtained by following the motion mode of the endoscope, and the sensitive part F in the endoscope image is identified using the image segmentation algorithm, and the shortest distance S1 between the contour boundary of the identified sensitive part F and the water jet cutter head is calculated.
接着，基于敏感部位F的轮廓边界与水刀刀头之间的最短距离确定针对该敏感部位F的安全切除深度。优选的，还基于预先设置的去除安全距离确定安全切除深度。预先通过实验确定或基于经验或手术需求等因素预先设置得出去除安全距离。设置去除安全距离有助于在水射流不触及该敏感部位F的前提下，还赋予更大的余量以确保安全。例如，去除安全距离设为S2的情况下，水刀的切除深度应当在距离敏感部位F的轮廓S2处停止。进一步地，在敏感部位F的轮廓边界与水刀刀头之间的最短距离为S1、以及去除安全距离设为S2的情况下，确定该敏感部位F的安全切除深度为S1-S2。Next, the safe resection depth for the sensitive part F is determined based on the shortest distance between the contour boundary of the sensitive part F and the water jet cutter head. Preferably, the safe resection depth is also determined based on a preset removal safety distance. The removal safety distance is determined in advance through experiments or is pre-set based on factors such as experience or surgical requirements. Setting the removal safety distance helps to provide a larger margin to ensure safety without the water jet touching the sensitive part F. For example, when the removal safety distance is set to S2, the resection depth of the water jet should stop at a distance S2 from the contour of the sensitive part F. Further, when the shortest distance between the contour boundary of the sensitive part F and the water jet cutter head is S1, and the removal safety distance is set to S2, the safe resection depth of the sensitive part F is determined to be S1-S2.
进一步地，遍历水刀的规划运动轨迹，如计算出有某一步长的规划的射流长度轨迹参数大于前述的水刀的安全切除深度，说明水刀后续有切到敏感部位F的风险。这种情况下，手术执行设备100发出警报，暂停切除。这时，可以重新调整水刀规划，避开敏感部位或调整敏感部位的去除安全距离S2，避免切割到敏感部位而造成安全问题及手术失败等问题。例如根据监测结果得出该内窥镜步长对应到该位置水刀规划步长中射流长度需要减少的距离，进而通过调整水刀规划步长中实际运动位置轨迹参数中的射流长度轨迹参数R来实现对水刀规划轨迹的动态调整。Furthermore, by traversing the planned motion trajectory of the water jet, if it is calculated that the planned jet length trajectory parameter of a certain step length is greater than the aforementioned safe resection depth of the water jet, it means that the water jet is at risk of cutting the sensitive part F in the future. In this case, the surgical execution device 100 issues an alarm and suspends the resection. At this time, the water jet planning can be readjusted to avoid sensitive parts or adjust the safe removal distance S2 of sensitive parts to avoid cutting sensitive parts and causing safety problems and surgical failure. For example, based on the monitoring results, it is determined that the endoscope step length corresponds to the distance that the jet length needs to be reduced in the planned step length of the water jet at that position, and then the dynamic adjustment of the planned trajectory of the water jet is achieved by adjusting the jet length trajectory parameter R in the actual motion position trajectory parameter in the planned step length of the water jet.
基于旋转运动位置轨迹参数的敏感部位安全监测Safety monitoring of sensitive parts based on rotational motion position trajectory parameters
根据另一实施例，可针对敏感部位设置非去除区域。以图4所示为例，F是敏感部位，E至E’为规划去除区域，D为目标去除物。定义非去除区域C为以水刀A为圆心的辐射并包含敏感部位F的扇形区域，非去除区域C可以用（Sθ_start，Sθ_stop）表达，Sθ_start表示以水刀A为圆心的敏感部位轮廓切线的起始角度，Sθ_stop表示以水刀A为圆心的敏感部位轮廓切线的结束角度。此种情况下，当水刀朝向敏感部位F时不喷射水射流，即对于非去除区域C即（Sθ_start，Sθ_stop）内的组织完全不进行消融或切除。对于此种方案，可基于旋转运动位置轨迹参数实现对敏感部位的安全监测，具体实现步骤如下：According to another embodiment, a non-removal area can be set for sensitive parts. Taking Figure 4 as an example, F is the sensitive part, E to E' are the planned removal areas, and D is the target removal object. The non-removal area C is defined as a fan-shaped area radiating from the water jet A as the center and including the sensitive part F. The non-removal area C can be expressed by (Sθ_start, Sθ_stop), where Sθ_start represents the starting angle of the tangent line of the sensitive part contour with the water jet A as the center, and Sθ_stop represents the ending angle of the tangent line of the sensitive part contour with the water jet A as the center. In this case, when the water jet is directed toward the sensitive part F, no water jet is sprayed, that is, no ablation or resection is performed on the tissue within the non-removal area C, i.e., (Sθ_start, Sθ_stop). For this solution, safe monitoring of sensitive parts can be achieved based on the rotational motion position trajectory parameters, and the specific implementation steps are as follows:
首先，通过跟随运动模式的内窥镜获取实时清晰图像，利用图像分割算法识别出内窥镜图像中的敏感部位F，并测算出实际的非去除区域（Sθ_start，Sθ_stop）。First, a real-time clear image is obtained by following the motion pattern of the endoscope, and the sensitive part F in the endoscope image is identified using the image segmentation algorithm, and the actual non-removal area (Sθ_start, Sθ_stop) is calculated.
接着，比较非去除区域C与规划去除区域EE’是否重叠，即比较（Sθ_start，Sθ_stop）与（θ_start，θ_stop）是否有重叠，根据是否有重叠或重叠程度执行安全策略，报警、暂停切除或调整规划。Next, compare whether the non-removal area C overlaps with the planned removal area EE’, that is, compare whether (Sθ_start, Sθ_stop) overlaps with (θ_start, θ_stop). According to whether there is overlap or the degree of overlap, execute the safety strategy, alarm, suspend removal or adjust the plan.
优选的，也可设置安全重叠范围U，安全重叠范围U可以是面积大小，即非去除区域C和规划去除区域EE’的重叠面积大于某一个阈值时，认为存在风险。此外，安全重叠范围U也可以是重叠比例的大小，例如非去除区域C和规划去除区域EE’的重叠面积与非去除区域C的比值大于某一阈值时，认为存在风险。Preferably, a safe overlap range U can also be set. The safe overlap range U can be an area size, that is, when the overlapping area of the non-removal area C and the planned removal area EE' is greater than a certain threshold, it is considered that there is a risk. In addition, the safe overlap range U can also be the size of the overlap ratio, for example, when the ratio of the overlapping area of the non-removal area C and the planned removal area EE' to the non-removal area C is greater than a certain threshold, it is considered that there is a risk.
当判定为存在风险时，可再调整水刀规划，避开敏感部位F或调整敏感部位F的安全重叠范围U，避免切割到敏感部位F的造成安全问题及手术失败等问题。同时也可根据在内窥镜图像中实时获取的非去除区域C区域，提前计算后续每步水刀规划中C∩EE’的关系，作为水刀规划运动轨迹的切割范围的实时反馈，自动调整后续步长中的水刀的规划运动轨迹的切割范围，实现水刀切割规划轨迹的动态调整。When it is determined that there is a risk, the water jet planning can be adjusted to avoid the sensitive part F or adjust the safe overlapping range U of the sensitive part F to avoid safety problems and surgical failure caused by cutting the sensitive part F. At the same time, the relationship C∩EE’ in each subsequent water jet planning step can be calculated in advance based on the non-removable area C area obtained in real time in the endoscopic image, which serves as real-time feedback on the cutting range of the water jet planning motion trajectory, and automatically adjusts the cutting range of the planned motion trajectory of the water jet in the subsequent step length, realizing dynamic adjustment of the water jet cutting planning trajectory.
在前述的方案中，可以基于对水刀的实际运动位置轨迹参数监测情况，和/或基于对实际敏感部位的监测情况触发报警机制。尤其是，本申请中报警机制是基于内窥镜在跟随运动模式下进行的实时监测情形设置，在实际手术场景中，水刀刀头的直线运动轨迹为从前向后的运动方向，位于水刀刀头后方的内窥镜所观测的组织区域（包含切除范围、敏感部位等）包含水刀刀头即将执行切割的区域，因此能够预判偏差及风险，实现预警功能，有助于提供更好的规划方案及安全保障。In the aforementioned scheme, the alarm mechanism can be triggered based on the monitoring of the actual motion position trajectory parameters of the water jet, and/or based on the monitoring of the actual sensitive parts. In particular, the alarm mechanism in the present application is set based on the real-time monitoring situation of the endoscope in the follow-up motion mode. In the actual surgical scene, the linear motion trajectory of the water jet head is the motion direction from front to back, and the tissue area (including the resection range, sensitive parts, etc.) observed by the endoscope behind the water jet head includes the area where the water jet head is about to perform cutting. Therefore, it is possible to predict deviations and risks, realize the early warning function, and help provide better planning solutions and safety guarantees.
接下来，参照图7说明本申请的手术执行设备进行切除手术的流程之一。本领域技术人员能够理解的是，以下说明的流程只是本申请的一个应用，各步骤的顺序及具体内容可以根据实际场景来适当地设定。Next, one of the processes of performing a resection operation by the surgical execution device of the present application is described with reference to Figure 7. Those skilled in the art can understand that the process described below is only an application of the present application, and the order and specific content of each step can be appropriately set according to the actual scenario.
步骤S1，获取水刀的规划运动轨迹，计算内窥镜的跟随运动轨迹。Step S1, obtaining the planned motion trajectory of the water jet and calculating the follow-up motion trajectory of the endoscope.
步骤S2，计算内窥镜的初始监控位置，并使内窥镜移动到初始监控位置。Step S2, calculating the initial monitoring position of the endoscope and moving the endoscope to the initial monitoring position.
步骤S3，在术中，基于内窥镜的监测图像，检测生物体组织的敏感部位，并基于该敏感部位调整后续切除规划。Step S3, during the operation, based on the monitoring image of the endoscope, the sensitive parts of the biological tissue are detected, and the subsequent resection plan is adjusted based on the sensitive parts.
步骤S4，在术中，基于内窥镜的监测图像，监测水刀的实际运动位置轨迹参数，并基于实际运动位置轨迹参数与规划运动位置轨迹参数的偏差调整后续切除规划。Step S4, during the operation, based on the monitoring image of the endoscope, the actual motion position trajectory parameters of the water knife are monitored, and the subsequent resection plan is adjusted based on the deviation between the actual motion position trajectory parameters and the planned motion position trajectory parameters.
步骤S5，在术中，监测危险场景并警报。在此，危险场景指的是，例如，在内窥镜的视野范围内同时丢失水刀和水柱的时间超过规定的阈值，水刀的摆动频率或切除深度相对于规划频率或切除深度超出了安全阈值等。Step S5, during the operation, monitor dangerous scenarios and issue an alarm. Here, dangerous scenarios refer to, for example, the time when the water jet and water column are lost simultaneously within the field of view of the endoscope exceeds a specified threshold, the swing frequency or resection depth of the water jet exceeds a safety threshold relative to the planned frequency or resection depth, etc.
通过本申请的以上实施例，能够有效地解决背景技术中的技术问题，针对水刀手术过程中的执行情况进行有效、准确、且实时的监测，本申请尤其适用于自动水刀系统中，在水刀按照规划的运动位置轨迹参数运动并工作时，本申请的方案可以对水刀的实际运动位置轨迹参数进行实时监测，有利于实现对运动位置轨迹参数的实时调整；并且本申请还可以对水刀实际工作场景，尤其是涉及敏感部位的区域进行实时监测，并基于实时监测结果确定规划运动轨迹的安全风险，并可及时触动报警机制以采取应急措施。Through the above embodiments of the present application, the technical problems in the background technology can be effectively solved, and the execution status of the water jet surgery process can be effectively, accurately and in real time monitored. The present application is particularly suitable for an automatic water jet system. When the water jet moves and works according to the planned motion position trajectory parameters, the solution of the present application can monitor the actual motion position trajectory parameters of the water jet in real time, which is conducive to the real-time adjustment of the motion position trajectory parameters; and the present application can also monitor the actual working scene of the water jet, especially the areas involving sensitive parts in real time, and determine the safety risks of the planned motion trajectory based on the real-time monitoring results, and can promptly trigger the alarm mechanism to take emergency measures.
| Application Number | Priority Date | Filing Date | Title |
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| CN202410588561.1ACN118319430A (en) | 2023-12-29 | 2023-12-29 | Monitoring device of water sword motion trail based on endoscope |
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| CN202410588561.1ACN118319430A (en) | 2023-12-29 | 2023-12-29 | Monitoring device of water sword motion trail based on endoscope |
| CN202311841041.9ACN117481753B (en) | 2023-12-29 | 2023-12-29 | A method and device for monitoring the motion trajectory of a water jet based on an endoscope |
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| CN202311841041.9ADivisionCN117481753B (en) | 2023-12-29 | 2023-12-29 | A method and device for monitoring the motion trajectory of a water jet based on an endoscope |
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| CN202410588561.1APendingCN118319430A (en) | 2023-12-29 | 2023-12-29 | Monitoring device of water sword motion trail based on endoscope |
| CN202311841041.9AActiveCN117481753B (en) | 2023-12-29 | 2023-12-29 | A method and device for monitoring the motion trajectory of a water jet based on an endoscope |
| Application Number | Title | Priority Date | Filing Date |
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| CN202311841041.9AActiveCN117481753B (en) | 2023-12-29 | 2023-12-29 | A method and device for monitoring the motion trajectory of a water jet based on an endoscope |
| Country | Link |
|---|---|
| CN (2) | CN118319430A (en) |
| WO (1) | WO2025140258A1 (en) |
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN119229150A (en)* | 2024-12-02 | 2024-12-31 | 北京智愈医疗科技有限公司 | A method and system for identifying the deflection degree of a water jet |
| WO2025140258A1 (en)* | 2023-12-29 | 2025-07-03 | 北京智愈医疗科技有限公司 | Endoscope-based monitoring apparatus for water jet movement trajectory |
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN118948385A (en)* | 2024-04-01 | 2024-11-15 | 北京智愈医疗科技有限公司 | A method and device for quickly eliminating water jet force |
| CN117958912B (en)* | 2024-04-01 | 2024-06-25 | 北京智愈医疗科技有限公司 | Automatic water jet optimization control method and device |
| CN119548257B (en)* | 2025-01-24 | 2025-04-22 | 成都美创医疗科技股份有限公司 | Visual angle adjustable operation camera device and visual operation system |
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US6572578B1 (en)* | 2000-08-25 | 2003-06-03 | Patrick A. Blanchard | Fluid-jet catheter and its application to flexible endoscopy |
| DE102004057366B4 (en)* | 2004-11-27 | 2009-04-09 | Erbe Elektromedizin Gmbh | Device for a water jet surgical device |
| CN102755184B (en)* | 2012-07-26 | 2014-05-21 | 中国人民解放军军事医学科学院卫生装备研究所 | Water cutter head merged with wireless endoscope |
| WO2014157477A1 (en)* | 2013-03-29 | 2014-10-02 | 富士フイルム株式会社 | Endoscopic surgery device |
| JP6294255B2 (en)* | 2015-03-25 | 2018-03-14 | 富士フイルム株式会社 | Endoscope diagnosis apparatus, image processing method, program, and recording medium |
| KR101812793B1 (en)* | 2016-07-25 | 2017-12-27 | 서울대학교병원 | Medical Device for Conjunctival Bleb Reconstruction |
| CN107689045B (en)* | 2017-09-06 | 2021-06-29 | 艾瑞迈迪医疗科技（北京）有限公司 | Image display method, device and system for endoscope minimally invasive surgery navigation |
| CN107928760B (en)* | 2017-11-29 | 2025-02-18 | 域鑫科技（惠州）有限公司 | Tissue crusher water jet |
| CN107928759A (en)* | 2017-11-29 | 2018-04-20 | 域鑫科技（惠州）有限公司 | Possesses the medical water jet of visual function |
| US11229492B2 (en)* | 2018-10-04 | 2022-01-25 | Biosense Webster (Israel) Ltd. | Automatic probe reinsertion |
| US20210386491A1 (en)* | 2020-06-10 | 2021-12-16 | Mazor Robotics Ltd. | Multi-arm robotic system enabling multiportal endoscopic surgery |
| WO2022054428A1 (en)* | 2020-09-10 | 2022-03-17 | オリンパス株式会社 | Medical system and control method |
| US12290319B2 (en)* | 2021-09-29 | 2025-05-06 | Cilag Gmbh International | Methods for controlling cooperative surgical instruments |
| WO2023052936A1 (en)* | 2021-09-29 | 2023-04-06 | Cilag Gmbh International | Systems for controlling cooperative surgical instruments with variable surgical site access trajectories |
| CN113940753B (en)* | 2021-11-12 | 2023-12-19 | 北京智愈医疗科技有限公司 | A multi-image information fusion method and system for automatic tissue cutting path planning |
| CN114533253A (en)* | 2022-03-22 | 2022-05-27 | 上海交通大学医学院附属仁济医院 | Cystoscope electric cutting device capable of identifying tumors in real time |
| CN115737119A (en)* | 2022-09-08 | 2023-03-07 | 湖南医科医工科技有限公司 | Scalpel real-time monitoring system and method thereof |
| CN115607282B (en)* | 2022-12-02 | 2023-04-07 | 北京智愈医疗科技有限公司 | A water jet track preset method and device |
| CN118319430A (en)* | 2023-12-29 | 2024-07-12 | 北京智愈医疗科技有限公司 | Monitoring device of water sword motion trail based on endoscope |
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2025140258A1 (en)* | 2023-12-29 | 2025-07-03 | 北京智愈医疗科技有限公司 | Endoscope-based monitoring apparatus for water jet movement trajectory |
| CN119229150A (en)* | 2024-12-02 | 2024-12-31 | 北京智愈医疗科技有限公司 | A method and system for identifying the deflection degree of a water jet |
| Publication number | Publication date |
|---|---|
| CN117481753B (en) | 2024-04-05 |
| WO2025140258A1 (en) | 2025-07-03 |
| CN117481753A (en) | 2024-02-02 |
| Publication | Publication Date | Title |
|---|---|---|
| CN117481753B (en) | A method and device for monitoring the motion trajectory of a water jet based on an endoscope | |
| EP3142572B1 (en) | Computer aided image-based enhanced intracorporeal lithotripsy | |
| US20240350164A1 (en) | Automated image-guided tissue resection and treatment | |
| CN113796952B (en) | Tissue resection system and cutting parameter determination method thereof | |
| US20210282868A1 (en) | Elongate treatment probe with encoder for robotics surgery | |
| JP6403695B2 (en) | Aqua ablation aqua beam ophthalmic surgery method and apparatus | |
| EP2642913B1 (en) | Ablation and temperature measurement devices | |
| JP6461971B2 (en) | Tissue excision and treatment using scattered pulses | |
| US20200261170A1 (en) | Robotic system for minimally invasive surgery | |
| JPH10155805A (en) | Surgery method by fixed position laser | |
| WO2015047459A1 (en) | Electrosurgical fibroid ablation system and method | |
| CN115515470A (en) | Hemostatic methods and devices | |
| KR20170057838A (en) | Guidewire with ray tracing capability | |
| CN113907875A (en) | Autonomous ultrasound guided endoscope | |
| JPH11318810A (en) | Endoscope fog removing system | |
| JP7232755B2 (en) | laser sternotomy | |
| CN119214745B (en) | Endoscope displacement control system and method | |
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| CN118902595A (en) | Single-port laparoscope analysis system for hysteromyoma stripping | |
| Wahrburg et al. | A new system for minimal invasive ablation of deep seated brain tumours |
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