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CN117562584A - Phased array ultrasonic guided flexible surgical robot and control method - Google Patents

Phased array ultrasonic guided flexible surgical robot and control method Download PDF

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Publication number
CN117562584A
CN117562584A CN202210944998.5A CN202210944998A CN117562584A CN 117562584 A CN117562584 A CN 117562584A CN 202210944998 A CN202210944998 A CN 202210944998A CN 117562584 A CN117562584 A CN 117562584A
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China
Prior art keywords
biopsy
phased array
ablation
imaging
surgical robot
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Pending
Application number
CN202210944998.5A
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Chinese (zh)
Inventor
周欣欢
马俊
刘宇钦
赵佳慧
王伟
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Shenzhen Xinhuan Technology Co ltd
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Shenzhen Xinhuan Technology Co ltd
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Priority to CN202210944998.5A priority Critical patent/CN117562584A/en
Publication of CN117562584A publication Critical patent/CN117562584A/en
Pending legal-status Critical Current

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    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/12—Diagnosis using ultrasonic, sonic or infrasonic waves in body cavities or body tracts, e.g. by using catheters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/005—Flexible endoscopes
    • A61B1/0051—Flexible endoscopes with controlled bending of insertion part
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
    • A61B1/015—Control of fluid supply or evacuation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/04—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/267—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the respiratory tract, e.g. laryngoscopes, bronchoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00—Instruments for taking body samples for diagnostic purposes; Other methods or instruments for diagnosis, e.g. for vaccination diagnosis, sex determination or ovulation-period determination; Throat striking implements
    • A61B10/02—Instruments for taking cell samples or for biopsy
    • A61B10/04—Endoscopic instruments, e.g. catheter-type instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/02—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/1815—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using microwaves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
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    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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    • A61B8/44—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61B8/44—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device
    • A61B8/4444—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device related to the probe
    • A61B8/445—Details of catheter construction
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
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    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
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    • A—HUMAN NECESSITIES
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    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/361—Image-producing devices, e.g. surgical cameras
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37—Surgical systems with images on a monitor during operation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/02—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
    • A61B2018/0212—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques using an instrument inserted into a body lumen, e.g. catheter
    • A—HUMAN NECESSITIES
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    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/1815—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using microwaves
    • A61B2018/1861—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using microwaves with an instrument inserted into a body lumen or cavity, e.g. a catheter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
    • A61B2034/301—Surgical robots for introducing or steering flexible instruments inserted into the body, e.g. catheters or endoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37—Surgical systems with images on a monitor during operation
    • A61B2090/378—Surgical systems with images on a monitor during operation using ultrasound
    • A61B2090/3782—Surgical systems with images on a monitor during operation using ultrasound transmitter or receiver in catheter or minimal invasive instrument

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • General Health & Medical Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Physics & Mathematics (AREA)
  • Pathology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Biophysics (AREA)
  • Otolaryngology (AREA)
  • Optics & Photonics (AREA)
  • Electromagnetism (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Pulmonology (AREA)
  • Plasma & Fusion (AREA)
  • Cardiology (AREA)
  • Robotics (AREA)
  • Physiology (AREA)
  • Gynecology & Obstetrics (AREA)
  • Ultra Sonic Daignosis Equipment (AREA)

Abstract

The embodiment of the invention discloses a flexible surgical robot guided by phased array ultrasound, a control method thereof and a storage medium, wherein the flexible surgical robot guided by phased array ultrasound comprises an optical probe, a phased array ultrasound probe, a flexible mechanical arm, a biopsy piece and an ablation piece; the optical probe is used for optical imaging guidance; the flexible mechanical arm is used for performing intrabronchial movement and reaching the suspected disease position; the phased array ultrasonic probe is used for performing lateral field imaging and real-time puncture guiding; the biopsy piece is used for taking biopsy operation of suspected lesions to be treated; the ablation part is used for performing ablation operation on a focus area, can utilize the phased array ultrasonic probe to perform real-time imaging guidance on suspected diseases outside the bronchus wall on the basis of optical imaging, monitor the relative positions of the biopsy part and the focus in real time, realize integration of biopsy taking and ablation operation, and improve the safety, precision and operation usability of operation.

Description

Phased array ultrasonic guided flexible surgical robot and control method
Technical Field
The invention relates to the technical field of acoustics, in particular to a phased array ultrasonic guided flexible surgical robot and a control method.
Background
Lung cancer is the first major cancer in humans, a malignancy originating from the bronchus mucosa or glands of the lung. The incidence and mortality of lung cancer are the leading major cancers, corresponding to the sum of prostate, breast and rectal cancers.
Compared with other cancers, the five-year survival rate of lung cancer is only 18%, and early diagnosis can improve the five-year survival rate to 55%, so that the lung cancer is the key point for preventing and treating lung cancer. CT imaging is often used clinically for lung nodule screening, however, the false positive rate of CT imaging is usually more than 96%, and lung nodule biopsy is a gold standard for lung cancer diagnosis and classification and is also a major problem in current clinic.
Traditional lung nodule biopsies are bronchoendoscopes using optical imaging, which are often inflexible, with accurate insertion sites during biopsy, affecting the accuracy and safety of the examination and procedure.
Disclosure of Invention
The application provides a phased array ultrasound guided flexible assisted surgery system and method.
In a first aspect, a phased array ultrasound guided flexible surgical robot is provided, comprising an optical probe and a phased array ultrasound probe, a flexible mechanical arm, a biopsy piece and an ablation piece;
the optical probe is used for optical imaging guidance;
the phased array ultrasonic probe is used for performing lateral field imaging and real-time imaging guidance;
the flexible mechanical arm is used for realizing bending adjustment in multiple directions so as to enable the flexible mechanical arm to advance in a snake shape to enter the appointed position of the bronchial tree under the control of a doctor;
the biopsy piece is used for taking biopsy operation of suspected lesions to be treated;
the flexible ablation member is used for performing ablation operation on a focus area.
Optionally, the flexible mechanical arm of the system comprises a lateral working channel and a forward working channel;
the lateral working channel is an instrument working channel which is guided by the phased array ultrasonic probe and used for taking biopsy operation and ablation operation;
the forward working channel is an instrument working channel based on biopsy taking and ablation operations guided by the optical probe.
Optionally, the system further comprises a torque transmission coil for controlling rotation of the phased array ultrasound probe and the lateral working channel.
In a second aspect, a phased array ultrasound guided flexible surgical robot control method is provided, and is applied to the phased array ultrasound guided flexible surgical robot in the first aspect, and the method includes:
controlling the robot to enter a target trachea according to a preset three-dimensional virtual bronchus image and marking information of a focus area, and controlling the robot to reach the focus area of the target trachea under the guidance of the optical imaging guidance and positioning system;
and under the condition that the suspected focus to be treated is positioned outside the target trachea, controlling the robot to carry out biopsy operation on the suspected focus to be treated by using a biopsy piece to pass through the target trachea under the real-time imaging guidance of the phased ultrasonic probe.
Optionally, the method further comprises:
and controlling and adjusting the angles of the phased array ultrasonic probe and the lateral working channel according to the angle to be operated so as to realize biopsy taking operation or ablation operation at the position corresponding to the angle to be operated.
Optionally, the method further comprises:
and under the condition that the suspected focus to be treated is positioned in the target device trachea, controlling the flexible surgical robot to carry out biopsy operation on the suspected focus to be treated by using the biopsy piece under the guidance of the optical imaging of the optical probe.
Optionally, the method further comprises:
and controlling the flexible surgical robot to perform B-mode or Doppler imaging by using the phased ultrasonic probe to obtain an imaging result, and displaying the imaging result on an ultrasonic host, wherein the imaging result is used for monitoring the process of the biopsy operation.
Optionally, the method further comprises:
taking out the biopsy piece, and performing pathological screening on the biopsy tissue collected by the biopsy piece;
and under the condition that the biopsy tissue is determined to be positive, controlling the robot to use the flexible ablation member to pass through a working channel of the biopsy member to reach the focus area for performing ablation operation.
Optionally, the manner of ablation operation includes, but is not limited to, any of the following:
radiofrequency ablation, cryoablation, focused ultrasound ablation, pulsed electric field ablation, and microwave ablation.
In a third aspect, there is provided a computer storage medium storing one or more instructions adapted to be loaded by a processor and to perform the steps of the second aspect and any one of its possible implementations.
The embodiment of the application provides a phased array ultrasonic guided flexible surgical robot, which comprises an optical probe, a phased array ultrasonic probe, a flexible mechanical arm, a biopsy piece and a flexible ablation piece; the optical probe is used for optical imaging guidance; the phased array ultrasonic probe is used for lateral field imaging, real-time imaging and surgical puncture guiding; the flexible mechanical arm is used for realizing bending adjustment in multiple directions so as to enable the flexible mechanical arm to advance in a snake shape to enter the appointed position of the bronchial tree under the control of a doctor; the biopsy piece is used for taking biopsy operation of suspected lesions to be treated; the ablation part is used for performing ablation operation on a focus area, can utilize the phased array ultrasonic probe to perform real-time imaging guidance on the basis of optical imaging, monitor the relative positions of the biopsy part and suspected focuses in real time, monitor surgical complications such as bleeding and the like in real time, realize the integration of biopsy taking and ablation operation, and improve the safety, precision and operation usability of the operation.
Drawings
In order to more clearly describe the technical solutions in the embodiments or the background of the present application, the following description will describe the drawings that are required to be used in the embodiments or the background of the present application.
Fig. 1 is a schematic structural diagram of a phased array ultrasound guided flexible surgical robot according to an embodiment of the present application;
FIG. 2 is a schematic diagram of a phased array ultrasound guided flexible surgical assistance system provided in an embodiment of the present application;
fig. 3 is a schematic flow chart of a phased array ultrasound guided flexible surgical robot control method according to an embodiment of the present application.
Detailed Description
In order to make the present application solution better understood by those skilled in the art, the following description will clearly and completely describe the technical solution in the embodiments of the present application with reference to the accompanying drawings in the embodiments of the present application, and it is apparent that the described embodiments are only some embodiments of the present application, not all embodiments. All other embodiments, which can be made by one of ordinary skill in the art based on the embodiments herein without making any inventive effort, are intended to be within the scope of the present application.
The terms first, second and the like in the description and in the claims of the present application and in the above-described figures, are used for distinguishing between different objects and not for describing a particular sequential order. Furthermore, the terms "comprise" and "have," as well as any variations thereof, are intended to cover a non-exclusive inclusion. For example, a process, method, system, article, or apparatus that comprises a list of steps or elements is not limited to only those listed steps or elements but may include other steps or elements not listed or inherent to such process, method, article, or apparatus.
Reference herein to "an embodiment" means that a particular feature, structure, or characteristic described in connection with the embodiment may be included in at least one embodiment of the present application. The appearances of such phrases in various places in the specification are not necessarily all referring to the same embodiment, nor are separate or alternative embodiments mutually exclusive of other embodiments. Those of skill in the art will explicitly and implicitly appreciate that the embodiments described herein may be combined with other embodiments.
The ultrasonic wave related in the embodiment of the application is a mechanical wave propagating in an elastic medium (biological tissue), has complex acoustic effects such as a fluctuation effect, a thermal effect, a mechanical effect and the like, has the advantages of deep penetrating force, good space directivity, dynamic focusing scanning and the like, and is widely applied in the medical field. In traditional biomedical ultrasound, ultrasonic diagnostic imaging techniques mainly exploit its wave effect.
The embodiment of the application provides a phased array ultrasonic guided flexible surgical robot, which comprises an optical probe and a phased array ultrasonic probe;
the optical probe is used for optical imaging guidance, and is used for guiding operation of suspected diseases in bronchus;
the phased array ultrasonic probe is used for lateral field imaging, real-time imaging and surgical puncture guidance, and is generally used for surgical operation guidance of suspected diseases located outside bronchi.
In an alternative embodiment, the flexible mechanical arm of the system comprises a lateral working channel and a forward working channel;
the lateral working channel is an instrument working channel which is guided by the phased array ultrasonic probe and used for taking biopsy operation and ablation operation, and is used for generally operating suspected symptom tissues outside the bronchial wall;
the forward working channel is an instrument working channel based on the biopsy taking operation and the ablation operation guided by the optical probe, and is used for generally operating on suspected pathological tissues inside the bronchus wall.
In an alternative embodiment, the system further comprises a torque transmission coil for controlling rotation of the phased array ultrasound probe and the lateral working channel.
Embodiments of the present application are described below with reference to the accompanying drawings in the embodiments of the present application.
Referring to fig. 1, fig. 1 is a schematic structural diagram of a phased array ultrasound guided flexible surgical robot according to an embodiment of the present application. As shown in fig. 1, the robot includes: a forward-looking optical probe, a forward working channel, a side ultrasonic probe, a side working channel, a three-dimensional positioning sensor, a torque transmission coil, a transducer, an optical probe lead wire harness, a four-way bending adjusting catheter and the like. Wherein, the three-dimensional positioning sensor is close to the ultrasonic probe, and can measure the spatial position of the ultrasonic probe. The forward optical probe can realize forward optical imaging, can be used for direct navigation and imaging, and the side ultrasonic probe (such as a phased array ultrasonic probe) can realize side ultrasonic imaging, so that real-time and large-depth imaging can be performed; the flexible mechanical arm is used for realizing bending adjustment in multiple directions so as to enable the flexible mechanical arm to advance into a designated position of a bronchial tree in a snake shape under the control of a doctor, the flexible mechanical arm comprises the lateral working channel and the forward working channel, the forward working channel is an instrument working channel for taking biopsy operation and ablation operation based on the guidance of a forward-looking optical probe, and the lateral working channel is an instrument working channel for taking biopsy operation and ablation operation based on the guidance of a lateral ultrasonic probe; in addition, the ultrasonic probe and the lateral working channel can be rotated through the torque transmission coil, so that full-circle 360-degree puncture is realized.
In one embodiment, the phased array ultrasound probe has a diameter of about 2mm, an imaging field of view of no less than 90 degrees, and can perform real-time large-depth imaging (e.g., a maximum depth of 10 cm) suitable for lateral biopsy of a suspected lesion to be treated located outside the bronchus. The optical probe can perform forward imaging and is suitable for taking biopsy of suspected lesions to be treated, which are positioned in bronchi. The suspected lesion to be treated can be a nodule, and whether the suspected lesion to be treated is a lesion or not can be determined by biopsy, so that the lesion can be ablated.
The phased array ultrasonic guided flexible surgical robot comprises an optical probe, a phased array ultrasonic probe, a flexible mechanical arm, a biopsy piece and a flexible ablation piece; the optical probe is used for optical imaging guidance; the phased array ultrasonic probe is used for lateral field imaging, real-time imaging and surgical puncture guiding; the biopsy piece is used for taking biopsy operation of suspected lesions to be treated; the ablation part is used for performing ablation operation on a focus area, and can be guided by utilizing the phased array ultrasonic probe to perform real-time imaging on the basis of optical imaging through the flexible surgical robot, so that the relative positions of the biopsy part and suspected focuses can be monitored in real time, surgical complications such as bleeding and the like can be monitored in real time, the integration of biopsy taking and ablation operation is realized, and the safety, precision and operation usability of the operation are improved.
Referring to fig. 2, fig. 2 is a schematic diagram of a phased array ultrasound guided flexible surgical assistance system according to an embodiment of the present application. As shown in fig. 2, the system includes an ultrasound mainframe, an optical mainframe, a server, and a phased array ultrasound-guided flexible surgical robot as in the embodiment shown in fig. 1, which are not described in detail herein. The ultrasonic host is used for controlling and realizing ultrasonic functions in the robot, the optical host is used for controlling and realizing optical functions in the robot, and the control and data transmission of the ultrasonic host can be processed based on the server.
Optionally, the phased array ultrasound guided flexible surgery assistance system may adjust various devices or subsystems therein as needed, for example, may further include a three-dimensional space positioning system, or add other functional or interactive devices, which is not limited in this embodiment of the present application.
The phased array ultrasound guided flexible surgical robot control method provided by the embodiment of the application can be executed based on the phased array ultrasound guided flexible surgical auxiliary system shown in fig. 2.
Referring to fig. 3, fig. 3 is a schematic flow chart of a phased array ultrasound guided flexible surgical robot control method according to an embodiment of the present application, where the method may be applied to the phased array ultrasound guided flexible surgical assistance system shown in fig. 2, or may be used to control (the control system of) a phased array ultrasound guided flexible surgical robot as shown in fig. 1. As shown in fig. 3, the method includes:
301. and controlling the robot to enter a target trachea according to a preset three-dimensional virtual bronchus image and marking information of a focus area, and controlling the robot to reach the focus area of the target trachea under the guidance of the optical imaging guiding and positioning system.
The procedure of the embodiment shown in fig. 3 will be described using the example of taking a center and outer Zhou Jiejie biopsy of the lung.
Specifically, the lung can be three-dimensionally scanned by using a CT or a C-arm, the suspicious focus is marked, and a three-dimensional virtual bronchus map is established at the same time, that is, the preset three-dimensional virtual bronchus image and the marking information of the focus area are obtained, wherein the focus area refers to the area where the suspicious focus to be treated is located.
In practice, the outer sheath may be inserted into the patient's mouth or nose to create a passageway for accessing the patient's pulmonary airways using a robot.
The robot in the embodiment of the application may be a flexible robot. The robot may navigate according to the optical mirrors of the front end or directly guide with optical imaging and reach the vicinity of the lesion area under the guidance of the electromagnetic positioning system. Step 302 may then be performed.
302. And under the condition that the suspected focus to be treated is positioned outside the target trachea, controlling the robot to carry out biopsy operation on the suspected focus to be treated by using a biopsy piece to pass through the target trachea under the real-time imaging guidance of the phased ultrasonic probe.
According to different conditions of the junction to be processed, the processing can be classified. Specifically, when the suspected lesion to be treated is located outside the target trachea, the robot can use a phased ultrasonic probe to pass through the target trachea by using a biopsy piece under the guidance of real-time imaging, and perform biopsy operation on the suspected lesion to be treated. Wherein, above-mentioned biopsy piece can be biopsy forceps or biopsy needle, this embodiment of this application does not limit.
In an alternative embodiment, the method further comprises:
and under the condition that the suspected focus to be treated is positioned in the target device trachea, controlling the robot to take the biopsy from the suspected focus to be treated by using a biopsy piece under the optical imaging guidance of the optical probe.
If the suspected focus to be treated is positioned in the lung and the trachea, the robot can use the optical probe to directly use the biopsy piece to take the biopsy operation on the suspected focus to be treated under the optical guidance.
In an alternative embodiment, the method further comprises:
and controlling and adjusting the angles of the phased array ultrasonic probe and the lateral working channel according to the angle to be operated so as to realize biopsy or ablation operation at the position corresponding to the angle to be operated.
The angle to be operated can be preset or manually set and adjusted by a person. The angle of the phased array ultrasonic probe and the lateral working channel of the phased array ultrasonic probe can be adjusted by the robot in the embodiment of the application to perform biopsy taking operation or ablation operation of 360 degrees in the whole circumference, and the operation angle is flexible.
Further optionally, the method further comprises:
and controlling the robot to perform Doppler imaging by using the phased ultrasonic probe to obtain an imaging result, displaying the imaging result on an ultrasonic host, wherein the imaging result is used for monitoring the process of the biopsy taking operation.
If the puncture focus biopsy in the bronchus is performed, the robot can also use ultrasonic Doppler imaging to display imaging results, thereby being convenient for monitoring complications such as bleeding in the operation and improving the safety of the operation.
The phased array ultrasonic probe can perform tissue Doppler blood flow imaging, and the robot in the embodiment of the application can perform endoscopic tissue or blood flow motion imaging by using the miniature phased array ultrasonic probe, so that the robot is more sensitive to complications such as bleeding in the puncturing process.
In an alternative embodiment, the method further comprises:
taking out the biopsy piece, and performing pathological screening on the biopsy tissue collected by the biopsy piece;
and under the condition that the biopsy tissue is positive, controlling the robot to use the flexible ablation member to pass through a working channel of the biopsy member to reach the focus area for performing ablation operation.
Specifically, after the biopsy piece is successfully sampled, the biopsy piece can be taken out, and pathology screening is carried out on the biopsy tissue collected by the biopsy piece. Optionally, a rapid pathology screening method can be adopted to obtain a screening result in time, and further, if the screening result of the biopsy tissue is positive, when ablation treatment is needed, the robot can be controlled to use a flexible ablation part such as an ablation needle to reach a focus area through a biopsy working channel, and ablation operation is directly carried out. Therefore, the robot provided by the embodiment of the application can be a diagnosis and treatment integrated operation robot for realizing the integration of the puncture biopsy and the ablation operation.
Optionally, the manner of the above-described ablation operation includes, but is not limited to, any of the following:
radiofrequency ablation, cryoablation, focused ultrasound ablation, pulsed electric field ablation (PFA), microwave ablation.
Optionally, the ultrasound in the embodiments of the present application may also use an ultrasound plaque tracking method to track myocardial and blood flow motion, and use parallel computing to accelerate post-computation processing.
Alternatively, post-processing algorithms may be used in embodiments of the present application, including but not limited to artificial intelligence methods, for image enhancement of lesions and biopsy needles.
Alternatively, in the embodiment of the present application, a phased array ultrasonic probe that is linearly arranged may be used, and a linear array probe, a convex array probe, or an area array probe may be used, where the material may be PZT ceramic, a composite material, a CMUT or a PMUT probe.
Alternatively, the optical probe in the examples of the present application may be a CCD or CMOS sensor.
In an alternative embodiment, the plaque tracking method may be performed based on an ultrasound B-mode image, and in practical application, the plaque tracking method may also be performed directly based on an ultrasound radio frequency digital (RF) signal, so as to further improve the accuracy and speed of post-processing.
To improve imaging accuracy, ultrasound contrast agents may also be used in embodiments of the present application to improve imaging contrast, such as microbubbles or droplets.
To improve the contrast of blood, the ultrasound transmission scheme in the embodiment of the application may be a harmonic imaging mode, so as to reduce the signal of myocardial tissue.
Ultrasound doppler methods are currently a common method of cardiac tissue and blood flow tracking. Since blood flow and myocardial motion are vectors, and contain three velocity components, it is generally necessary to rapidly transmit at least three beams in different directions according to the doppler principle, and scan the same pixel point alternately from different transmission positions and directions. For different beam directions, velocity components in the beam directions are obtained by the following doppler formulas:
wherein f d For Doppler frequency, which is proportional to tissue or blood flow velocity, θ is the angle of the ultrasonic beam to tissue or blood flow velocity, c is the ultrasonic sound velocity, which is typically 1540m/s, f 0 Is the center frequency of the ultrasound. Repeating the above scanning process for at least three times to obtain heartThree velocity components of muscle and blood flow.
Compared with the Doppler method, the ultrasonic plaque tracking method has the advantages of quick imaging (real-time imaging), large imaging field of view and high resolution. Meanwhile, the measurement accuracy of the ultrasonic plaque tracking method is irrelevant to the imaging angle, so that the accuracy is higher than that of a Doppler method when complex myocardial motion and heart blood flow are measured.
According to the phased array ultrasonic guided flexible surgical robot control method, the robot is controlled to enter a target trachea according to a preset three-dimensional virtual bronchus image and marking information of a focus area, and the robot is controlled to reach the focus area of the target trachea under the guidance of the optical imaging guiding and positioning system; under the condition that the suspected focus to be treated is located outside the target trachea, the robot is controlled to carry out biopsy operation on the suspected focus to be treated through the target trachea under the real-time imaging guidance of the phased ultrasonic probe, the phased array ultrasonic probe can be used for carrying out real-time imaging guidance on the basis of optical imaging, the relative positions of the biopsy piece and the suspected focus are monitored in real time, and surgical complications such as bleeding and the like are monitored in real time, so that the safety, precision and operational usability of the operation are improved.
Existing lung biopsy protocols often include: 1. percutaneous aspiration biopsy, 2, bronchoscopic needle aspiration biopsy (Transbronchial Needle Aspiration, TBNA) and 3, bronchoscopic robots.
According to the phased array ultrasonic guided flexible surgical robot, the phased array ultrasonic probe can be used for guiding real-time imaging on the basis of optical imaging, the relative positions of a biopsy piece and a focus are monitored in real time, the safety and the precision of surgery are improved, and diagnosis and treatment integration can be achieved.
While percutaneous biopsy is usually performed under the guidance of CT, the patient always performs respiratory motion to cause the movement of lung focus, so focus movement errors caused by respiratory motion often exist in the puncturing process, puncturing efficiency is usually low, and certain complications such as pneumothorax (the probability of occurrence of the percutaneous puncture is 42 percent); compared to regimen 1, the present application can significantly reduce the risk of pneumothorax or bleeding. The catheter in this application has greater flexibility and access to the periphery Zhi Qiguan than in case 2 because most bronchoscopes are thicker, and the transbronchial biopsy needle can only reach the central lesion. Compared with the scheme 3, the single-array element ultrasonic probe is used, the scheme in the application can realize real-time puncture guiding by real-time imaging, monitor the relative positions of the biopsy piece and the focus, and improve the safety and the precision of detection or operation.
Therefore, the scheme in this application embodiment provides a new improvement, namely carries out the puncture guide of flexible surgical robot through miniature phased array supersound, wherein, this phased array ultrasonic probe diameter can select about 2mm, does not additionally increase flexible robot's diameter, can carry out 90 visual field imaging of side direction, possesses the function of real-time imaging guide, consequently can real-time supervision biopsy piece and focus's relative position, has improved the security and the precision of operation to risk such as can effectively reduce bleeding.
The embodiment of the application also provides a computer storage medium (Memory), which is a Memory device in the electronic device and is used for storing programs and data. It is understood that the computer storage media herein may include both built-in storage media in the electronic device and extended storage media supported by the electronic device. The computer storage medium provides a storage space that stores an operating system of the electronic device. Also stored in the memory space are one or more instructions, which may be one or more computer programs (including program code), adapted to be loaded and executed by the processor. The computer storage medium herein may be a high-speed RAM memory or a non-volatile memory (non-volatile memory), such as at least one magnetic disk memory; optionally, at least one computer storage medium remote from the processor may be present.
In one embodiment, one or more instructions stored in a computer storage medium may be loaded and executed by a processor to implement the corresponding steps in the above embodiments; in particular, one or more instructions in the computer storage medium may be loaded by the processor and perform any steps of the method of fig. 3, which are not described herein.
It will be clearly understood by those skilled in the art that, for convenience and brevity of description, the specific working process of the apparatus and modules described above may refer to the corresponding process in the foregoing method embodiment, which is not repeated herein.
In the several embodiments provided in this application, it should be understood that the disclosed systems, devices, and methods may be implemented in other manners. For example, the division of the module is merely a logical function division, and there may be another division manner when actually implemented, for example, a plurality of modules or components may be combined or may be integrated into another system, or some features may be omitted or not performed. The coupling or direct coupling or communication connection shown or discussed with each other may be through some interface, device or module indirect coupling or communication connection, which may be in electrical, mechanical, or other form.
The modules illustrated as separate components may or may not be physically separate, and components shown as modules may or may not be physical modules, i.e., may be located in one place, or may be distributed over a plurality of network modules. Some or all of the modules may be selected according to actual needs to achieve the purpose of the solution of this embodiment.
In the above embodiments, it may be implemented in whole or in part by software, hardware, firmware, or any combination thereof. When implemented in software, may be implemented in whole or in part in the form of a computer program product. The computer program product includes one or more computer instructions. When loaded and executed on a computer, produces a flow or function in accordance with embodiments of the present application, in whole or in part. The computer may be a general purpose computer, a special purpose computer, a computer network, or other programmable apparatus. The computer instructions may be stored in or transmitted across a computer-readable storage medium. The computer instructions may be transmitted from one website, computer, server, or data center to another website, computer, server, or data center by a wired (e.g., coaxial cable, fiber optic, digital subscriber line (digital subscriber line, DSL)) or wireless (e.g., infrared, wireless, microwave, etc.). The computer readable storage medium may be any available medium that can be accessed by a computer or a data storage device such as a server, data center, etc. that contains an integration of one or more available media. The usable medium may be a read-only memory (ROM), or a random-access memory (random access memory, RAM), or a magnetic medium, such as a floppy disk, a hard disk, a magnetic tape, a magnetic disk, or an optical medium, such as a digital versatile disk (digital versatile disc, DVD), or a semiconductor medium, such as a Solid State Disk (SSD), or the like.

Claims (10)

1. The phased array ultrasonic guided flexible surgical robot is characterized by comprising an optical probe, a phased array ultrasonic probe, a flexible mechanical arm, a biopsy piece and an ablation piece;
the optical probe is used for optical imaging guidance;
the phased array ultrasonic probe is used for lateral field imaging, real-time imaging and surgical puncture guiding;
the flexible mechanical arm is used for realizing bending adjustment in multiple directions so as to enable the flexible mechanical arm to advance in a snake shape to enter the appointed position of the bronchial tree under the control of a doctor;
the biopsy piece is used for taking biopsy operation of suspected lesions to be treated;
the ablating member is used for performing an ablation operation on the focal region.
2. A phased array ultrasound guided flexible surgical robot according to claim 1, wherein the flexible robotic arm of the system comprises a lateral working channel and a forward working channel;
the lateral working channel is an instrument working channel which is guided by the phased array ultrasonic probe and used for taking biopsy operation and ablation operation;
the forward working channel is an instrument working channel based on biopsy taking and ablation operations guided by the optical probe.
3. The phased array ultrasound guided flexible surgical robot of claim 1, wherein the system further comprises a torque transmission coil for controlling rotation of the phased array ultrasound probe and the lateral working channel.
4. A method of controlling a phased array ultrasound guided flexible surgical robot, characterized by being applied to the phased array ultrasound guided flexible surgical robot of any one of claims 1 to 3; the method comprises the following steps:
controlling the robot to enter a target trachea according to a preset three-dimensional virtual bronchus image and marking information of a focus area, and controlling the robot to reach the focus area of the target trachea under the guidance of the optical imaging guidance and positioning system;
and under the condition that the suspected focus to be treated is positioned outside the target trachea, controlling the robot to carry out biopsy operation on the suspected focus to be treated by using a biopsy piece to pass through the target trachea under the real-time imaging guidance of the phased ultrasonic probe.
5. The phased array ultrasound guided flexible surgical robot control method of claim 4, further comprising:
and controlling and adjusting the angles of the phased array ultrasonic probe and the lateral working channel according to the angle to be operated so as to realize biopsy taking operation or ablation operation at the position corresponding to the angle to be operated.
6. The phased array ultrasound guided flexible surgical robot control method of claim 4, further comprising:
and under the condition that the suspected focus to be treated is positioned in the target device trachea, controlling the robot to carry out biopsy operation on the suspected focus to be treated by using the biopsy piece under the guidance of optical imaging of the optical probe.
7. The phased array ultrasound guided flexible surgical robot control method of claim 6, further comprising:
and controlling the robot to perform Doppler imaging by using the phased ultrasonic probe to obtain an imaging result, and displaying the imaging result on an ultrasonic host, wherein the imaging result is used for monitoring the process of the biopsy operation.
8. The phased array ultrasound guided flexible surgical robot control method of any of claims 4-7, further comprising:
taking out the biopsy piece, and performing pathological screening on the biopsy tissue collected by the biopsy piece;
and under the condition that the biopsy tissue is determined to be positive, controlling the robot to use the flexible ablation member to pass through a working channel of the biopsy member to reach the focus area for performing ablation operation.
9. The phased array ultrasound guided flexible surgical robot control method of claim 7, wherein the manner of ablation operation includes, but is not limited to, any of the following:
radiofrequency ablation, cryoablation, focused ultrasound ablation, pulsed electric field ablation, and microwave ablation.
10. A computer readable storage medium storing a computer program, which when executed by a processor causes the processor to perform the steps of the method according to any one of claims 4-9.
CN202210944998.5A 2022-08-08 2022-08-08 Phased array ultrasonic guided flexible surgical robot and control method Pending CN117562584A (en)

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