CN114533253A - Cystoscope electric cutting device capable of identifying tumors in real time - Google Patents
Cystoscope electric cutting device capable of identifying tumors in real time Download PDFInfo
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- 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
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- 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
- A61B1/04—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
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- A61B1/06—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 with illuminating arrangements
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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
- A61B1/307—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 urinary organs, e.g. urethroscopes, cystoscopes
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- 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
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- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00505—Urinary tract
- A61B2018/00517—Urinary bladder or urethra
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- 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
- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
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Abstract
The utility model provides a cystoscope electrotomy device of ability real-time identification tumour, includes the cystoscope sheath, is provided with a probe tissue groove along its axial in the left end face of probe sheath, and probe tissue inslot is provided with the raman detection probe, and raman detection probe's right-hand member downside fixedly connected with a control push rod, control push rod passes the lateral wall of cystoscope sheath downwards, and the right-hand member downside of cystoscope sheath is provided with the grab handle, the right-hand member of cutting electrode be connected with the electrotomy ring control lever, the electrotomy ring control lever passes the lateral wall of cystoscope sheath downwards. The operation flow of the invention is simple and coherent, and in order to realize accurate detection, the invention designs the push rod type Raman detection probe structure, and the push rod can be controlled to extend out by detection control, so that the tissue which can not be judged in general form can be judged. The probe sheath is made of black ceramic materials, so that the tissue is prevented from being damaged, and white light can be isolated. Therefore, the Raman detection is realized under the direct vision guide of the endoscope without turning off the white light source.
Description
Technical Field
The invention relates to human living goods, in particular to a medical instrument, and particularly relates to a cystoscope resectoscope device capable of identifying tumors in real time.
Background
Bladder cancer is the urinary system tumor with the highest incidence in China, and non-muscle invasive tumors account for about 75% of initial diagnosis patients, and the diagnosis of bladder cancer depends on white light cystoscopy and is treated by cystoscopy. However, the current white light cystoscope has a plurality of defects, such as missed diagnosis of tiny or flat lesions, difficult diagnosis of atypical lesions, insufficient range and depth of lesion excision and the like, which lead to missed diagnosis and postoperative recurrence and progression. In order to overcome the defects of the traditional white light cystoscope, new diagnostic technologies such as photodynamic diagnosis, narrow-spectrum optical imaging, confocal laser fiber endoscopic imaging and the like are developed in recent years, but the defects of low specificity, complex imaging operation, more imaging interference and the like still exist, so that a new cystoscope system is developed, and the white light cystoscope system has important clinical significance and market value.
During the occurrence and development of bladder tumor cells, the growth characteristics and molecular metabolism of the cells are remarkably different, so that the diagnosis of tumors by analyzing the tissue molecular difference is a reliable method. The Raman spectrum can reflect information such as molecular structure, group composition and the like through light scattering frequency change caused by substance molecule vibration, is called as a molecular fingerprint spectrum, has unique advantages of no damage, high sensitivity, high specificity and the like in tumor diagnosis, and a meta-analysis research shows that the sensitivity and the specificity of the Raman spectrum diagnosis bladder cancer tissue reach 91 percent and 93 percent, and has strong clinical transformation value.
The prior art has the following disadvantages:
1. the current white light cystoscope applied clinically has a plurality of defects, such as missed diagnosis of tiny or flat focus, difficult diagnosis of atypical lesion, insufficient range and depth of focus excision and the like, which cause missed diagnosis and postoperative recurrence and progression.
2. The new endoscopic diagnostic techniques such as photodynamic diagnosis, narrow spectrum optical imaging, confocal laser fiber endoscopic imaging and the like still have the defects of low specificity, complex imaging operation, more imaging interference and the like.
3. At present, in an endoscope system integrating a Raman spectrum technology, in order to avoid interference of white light on Raman signals, a white light source needs to be turned off for detection, and therefore, the detection position is easy to be inaccurate.
Disclosure of Invention
The invention aims to provide a cystoscope resectoscope device capable of identifying tumors in real time, which aims to solve the technical problems of low specificity, complex imaging operation and inaccurate detection of the cystoscope resectoscope device in the prior art.
The cystoscope resectoscope device capable of identifying tumors in real time comprises a cystoscope sheath and a computer, wherein an endoscope channel, a resectoscope channel and a detection channel are arranged in the cystoscope sheath along the axial direction of the cystoscope sheath, an endoscope is arranged in the endoscope channel, a cutting electrode is arranged in the resectoscope channel, a probe sheath is arranged in the detection channel, the probe sheath is arranged below the endoscope, and the cutting electrode surrounds the periphery of the probe sheath;
the probe sheath is made of light-blocking materials, an endoscope camera is arranged on the right side of the endoscope and is connected with a camera device through a signal line, a white light connector is arranged at the right end of the endoscope, and the white light connector is connected with a white light source;
a probe tissue groove is formed in the left end face of the probe sheath along the axial direction of the probe sheath, a Raman detection probe is arranged in the probe tissue groove, a control push rod is fixedly connected to the lower side of the right end of the Raman detection probe, the control push rod penetrates through the side wall of the cystoscope sheath downwards, and the Raman detection probe and the control push rod and the cystoscope sheath form a sliding pair parallel to the length direction of the cystoscope sheath; the right side of the Raman detection probe is connected with an optical fiber connector, the optical fiber connector is connected with a laser light source and a Raman spectrometer through a transmission optical fiber, the left end of the Raman detection probe is provided with a Raman detection probe, a collection optical fiber and a detection optical fiber are arranged in the Raman detection probe, and the collection optical fiber and the detection optical fiber are both parallel to the length direction of the Raman detection probe;
a grab handle is arranged on the lower side of the right end of the cystoscope sheath, the right end of the cutting electrode is connected with an electric cutting ring control rod, and the electric cutting ring control rod downwards penetrates through the side wall of the cystoscope sheath;
the camera device and the Raman spectrometer are connected with the input end and the output end of the computer, and the computer is connected with a display.
Furthermore, a water inlet and a water outlet are arranged on the cystoscope sheath, the water inlet is communicated with the endoscope channel, and the water outlet is communicated with the detection channel.
Further, the cystoscope sheath is made of metal.
Further, the probe sheath is made of black ceramic material.
Furthermore, the Raman detection probe is of a ball lens structure.
Furthermore, the number of the detection optical fibers is one, the number of the collection optical fibers is four, and the four collection optical fibers are respectively arranged above, below, on the left and on the right of the detection optical fibers in the cross section.
Furthermore, the section of the cutting electrode is in a semicircular arc shape.
Compared with the prior art, the invention has positive and obvious effect.
1. The invention realizes tissue type discrimination under the endoscope and synchronous endoscopic treatment.
2. The invention utilizes the principle of identifying the bladder cancer tissue biomolecules by Raman spectrum, integrates the white light imaging device, the Raman detection device and the electric excision device, realizes the integration of the functions of white light system observation and positioning, Raman system detection and diagnosis and electric excision loop treatment of the cystoscope, and has simple and coherent operation flow.
3. In order to realize accurate detection, the push rod type Raman detection probe structure is designed, the Raman detection probe can be controlled to extend out by detecting the control push rod, the laser source is started, the Raman detection mode is controlled to enter, and tissues with general shapes which cannot be judged can be judged. The probe sheath is made of black ceramic materials, so that the tissue is prevented from being damaged, and white light can be isolated. Therefore, the white light source does not need to be turned off, the Raman detection is realized under the direct vision guide of the endoscope, the suspicious tissue enters the probe tissue groove, the white light is isolated, the interference of the white light on the Raman spectrum is avoided, and the Raman spectrum is more efficiently and accurately focused and collected by the ball lens Raman detection probe.
Drawings
Fig. 1 is a schematic structural diagram of a cystoscope resectoscope device capable of identifying tumors in real time.
Fig. 2 is a schematic structural diagram of the left end of a cystoscope sheath in the cystoscope resecting device capable of identifying tumors in real time.
Fig. 3 is a schematic structural diagram of a cystoscope sheath, a grab handle and an electrotomy ring control rod in the cystoscope electrotomy device capable of identifying tumors in real time.
Fig. 4 is a schematic structural diagram of an endoscope in the cystoscope resecting device capable of identifying tumors in real time according to the present invention.
Fig. 5 is a schematic structural diagram of a cutting electrode in the cystoscope resecting device capable of identifying tumors in real time according to the present invention.
FIG. 6 is a schematic structural diagram of a Raman detection probe in a cystoscope resectoscope device capable of identifying tumors in real time according to the present invention.
Fig. 7 is a schematic structural diagram of a raman detection probe in a cystoscope resectoscope device capable of identifying tumors in real time according to the present invention.
Detailed Description
The present invention will be further described with reference to the drawings and examples, but the present invention is not limited to the examples, and all similar structures and similar variations using the present invention shall fall within the scope of the present invention. The use of the directions of up, down, front, rear, left, right, etc. in the present invention is only for convenience of description and does not limit the technical solution of the present invention.
Example 1
As shown in fig. 1-7, the cystoscope resectoscope device capable of identifying tumors in real time comprises a cystoscope sheath 21 and a computer 2, wherein an endoscope channel, a resectoscope channel and a detection channel are arranged in the cystoscope sheath 21 along the axial direction of the cystoscope sheath, an endoscope 18 is arranged in the endoscope channel, a cutting electrode 19 is arranged in the resectoscope channel, a probe sheath 22 is arranged in the detection channel, the probe sheath 22 is arranged below the endoscope 18, and the cutting electrode 19 is surrounded on the periphery of the probe sheath 22;
the probe sheath 22 is made of light-blocking materials, the right side of the endoscope 18 is provided with an endoscope camera 8, the endoscope camera 8 is connected with the camera device 4 through a signal line, the right end of the endoscope 18 is provided with a white light connector 11, and the white light connector 11 is connected with a white light source 9;
a probe tissue groove 222 is formed in the left end face of the probe sheath 22 along the axial direction of the probe tissue groove, a Raman detection probe 17 is arranged in the probe tissue groove 222, a control push rod 12 is fixedly connected to the lower side of the right end of the Raman detection probe 17, the control push rod 12 penetrates through the side wall of the cystoscope sheath 21 downwards, and the Raman detection probe 17 and the control push rod 12 and the cystoscope sheath 21 form a sliding pair parallel to the length direction of the cystoscope sheath 21; the right side of the Raman detection probe 17 is connected with an optical fiber connector 10, the optical fiber connector 10 is connected with a laser light source 6 and a Raman spectrometer 5 through a transmission optical fiber 7, the left end of the Raman detection probe 17 is provided with a Raman detection probe 20, a collection optical fiber 201 and a detection optical fiber 202 are arranged in the Raman detection probe 20, and the collection optical fiber 201 and the detection optical fiber 202 are both parallel to the length direction of the Raman detection probe 17;
a grab handle 14 is arranged on the lower side of the right end of the cystoscope sheath 21, the right end of the cutting electrode 19 is connected with an electric cutting ring control rod 13, and the electric cutting ring control rod 13 downwards penetrates through the side wall of the cystoscope sheath 21;
the camera 4 and the Raman spectrometer 5 are connected with the input and output end of the computer 2, and the computer 2 is connected with the display 1.
Further, a water inlet 16 and a water outlet 15 are arranged on the cystoscope sheath 21, the water inlet 16 is communicated with the endoscope channel, a flushing water source is connected with the water inlet 16, and water flow enters the bladder to be full and ensure a clear visual field; the water outlet 15 is communicated with the detection channel to adjust the filling degree in the bladder.
Further, the cystoscope sheath 21 is made of metal.
Further, the probe sheath 22 is made of a black ceramic material.
Further, the raman detection probe 20 has a ball lens structure, a lens diameter of 2mm, and a refractive index of 1.77.
Further, the number of the detection optical fibers 202 is one, the number of the collection optical fibers 201 is four, and the four collection optical fibers 201 are respectively arranged above, below, left and right of the detection optical fibers 202 in the cross section. The structure can focus the excited tissue Raman spectrum, so that the Raman analysis and detection are stable and accurate.
Further, the section of the cutting electrode 19 is in a semicircular arc shape.
Specifically, the computer 2, the cutting electrode 19, the endoscope 18, the endoscope camera 8, the camera 4, the white light joint 11, the white light source 9, the optical fiber connector 10, the transmission optical fiber 7, the laser light source 6, the raman spectrometer 5, the collection optical fiber 201, the detection optical fiber 202, the electrical cutting ring control rod 13, the ball lens structure, and the like in this embodiment all adopt known schemes in the prior art, and those skilled in the art know that details are not described herein.
The working principle of the embodiment is as follows:
in cystoscopy and electrocision treatment applications, a cystoscope is assembled. When the Raman detection probe is used, sterile paraffin oil is smeared outside the cystoscope sheath 21, the sterile paraffin oil enters the bladder through the urethra of a patient, the camera device 4 is used for observing whether suspicious tissues exist in mucous membranes in the bladder, and when tissues with the general shape which can not be judged are met, the Raman detection control rod 12 is pushed, so that the Raman detection probe 17 extends out of the cystoscope sheath 21. Because the probe sheath 22 is made of black ceramic material, not only can the tissue be prevented from being damaged, but also white light can be isolated, and the interference of the white light on the Raman spectrum can be avoided, so that the white light source does not need to be turned off, the left end 221 of the probe sheath 22 is contacted with the suspicious tissue under the direct view of the camera device 4, and the tissue enters the probe tissue groove 222; then, a laser light source 6 is started, the Raman spectrum of the tissue is excited by the detection optical fiber 202 and transmitted to the detection optical fiber 202 through the transmission optical fiber 7, the optical fiber connector 10 and the Raman detection probe 17, the Raman spectrum signal of the tissue is collected by the optical fiber 201 and transmitted to the Raman spectrometer 5 through the optical fiber connector 10 and the transmission optical fiber 7, the Raman spectrometer 5 carries out spectrum information filtering, denoising and digitization, the tissue is judged in real time through a bladder cancer tissue Raman diagnosis system 3 built in the computer 2, and the tissue form and the tissue type are displayed on the display 1 at the same time. After the bladder cancer is determined, the handle 14 can be held by hand to control the electric excision ring control rod 13 to perform the electric excision operation of the bladder tumor.
The endoscope channel, the resectoscope channel and the detection channel in the cystoscope sheath 21 can be assembled by placing the components of the endoscope 18, the cutting electrode 19 and the Raman detection probe 17 according to requirements and are connected with corresponding working systems.
The cystoscope sheath 21 is 26Fr standard and 8.28mm in diameter. Endoscope 18 is preferably 3mm in diameter. The cutting electrode 19 is a monopolar cutting electrode with a ring diameter of 0.33mm, and the cutting electrode 19 surrounds the probe sheath 22 to ensure that the cut tissue is the corresponding detection site.
The built-in Raman detection needle sheath is a steel needle body and is a movable unit, and the Raman detection control rod can control the Raman detection probe 17 to extend out of the cystoscope sheath 21 by about 1cm so as to carry out Raman spectrum detection on suspicious tumor tissues. The detection fiber 202 has a diameter of 200 μm and the collection fiber 201 has a diameter of 300 μm.
The Raman spectrometer can filter noise signals such as fluorescence, reflected laser and the like, enhance Raman signals, analyze the Raman signals and convert the Raman signals into digital signals.
The computer is provided with a built-in bladder cancer tissue diagnosis system. The invention trains the Raman spectrum data of the urinary bladder urothelial cancer tissue and the normal bladder mucosa tissue by constructing a deep learning convolution network (CNN), performs 2-class learning and modeling, forms a bladder cancer CNN diagnosis model which can automatically calculate, has high efficiency and high accuracy, and can automatically display the tissue type on a computer in real time and guide an operator to perform operations such as electrocision when performing Raman detection on suspicious tissues.
The invention has the following remarkable characteristics and advantages:
1. the invention realizes tissue type discrimination under the endoscope and synchronous endoscopic treatment.
2. The invention utilizes the principle of identifying the bladder cancer tissue biomolecules by Raman spectrum, integrates the white light imaging device, the Raman detection device and the electric excision device, realizes the integration of the functions of white light system observation and positioning, Raman system detection and diagnosis and electric excision loop treatment of the cystoscope, and has simple and coherent operation flow.
3. In order to realize accurate detection, the push rod type Raman detection probe structure is designed, the Raman detection probe 17 can be controlled to extend out by the detection control push rod 12, the laser light source 6 is started, the Raman detection mode is controlled to enter, and tissues which cannot be judged in general form can be judged. The probe sheath 22 is made of black ceramic material to avoid tissue damage and isolate white light. Therefore, the white light source does not need to be turned off, the Raman detection is realized under the direct vision guidance of the endoscope 18, the suspicious tissue enters the probe tissue groove 222, the white light is isolated, the interference of the white light on the Raman spectrum is avoided, and the Raman spectrum is more efficiently and accurately focused and collected by the ball lens Raman detection probe 20.
4. The white light camera device 4 finds suspicious tumor tissues in the bladder, guides the Raman detection probe 17 to perform in-situ real-time detection, and cuts the electrode 19 to perform tumor resection treatment, so that the cystoscope examination diagnosis and treatment are more accurate, and the white light camera device has definite clinical value and application prospect. The endoscope 18, the cutting electrode 19, the Raman detection probe 17 and other components can be disassembled, and cleaning, disinfection and replacement are convenient.
5. The Raman detection probe 20 is of a ball lens structure, the diameter of the lens is large, the excitation optical fiber 202 is arranged in the middle of the Raman detection probe 20, 4 collection optical fibers 201 are distributed around the Raman detection probe, and the structure can better focus and collect the excited tissue Raman spectrum, so that Raman analysis and detection are stable and accurate.
6. The bladder cancer tissue Raman diagnosis system built in the computer host is obtained by training the bladder cancer tissue Raman spectrum big data through a deep learning convolution network (CNN), has the characteristics of high accuracy, high reliability, high speed and the like, and realizes real-time diagnosis in the operation.
Claims (7)
1. A cystoscope resectoscope device capable of identifying tumors in real time is characterized in that: the endoscope sheath is internally provided with an endoscope channel, an resectoscope channel and a detection channel along the axial direction of the cystoscope sheath, an endoscope is arranged in the endoscope channel, a cutting electrode is arranged in the resectoscope channel, a probe sheath is arranged in the detection channel and is arranged below the endoscope, and the cutting electrode surrounds the periphery of the probe sheath;
the right side of the endoscope is provided with an endoscope camera which is connected with a camera device through a signal line, the right end of the endoscope is provided with a white light joint, and the white light joint is connected with a white light source;
the Raman detection probe and the control push rod form a sliding pair parallel to the length direction of the cystoscope sheath; the right side of the Raman detection probe is connected with an optical fiber connector, the optical fiber connector is connected with a laser light source and a Raman spectrometer through a transmission optical fiber, the left end of the Raman detection probe is provided with a Raman detection probe, a collection optical fiber and a detection optical fiber are arranged in the Raman detection probe, and the collection optical fiber and the detection optical fiber are both parallel to the length direction of the Raman detection probe;
a grab handle is arranged on the lower side of the right end of the cystoscope sheath, the right end of the cutting electrode is connected with an electric cutting ring control rod, and the electric cutting ring control rod downwards penetrates through the side wall of the cystoscope sheath;
the camera device and the Raman spectrometer are connected with the input end and the output end of the computer, and the computer is connected with a display.
2. The cystoscopic resecting device capable of real-time tumor identification according to claim 1, wherein: the cystoscope sheath is provided with a water inlet and a water outlet, the water inlet is communicated with the endoscope channel, and the water outlet is communicated with the detection channel.
3. The cystoscopic resecting device capable of real-time tumor identification according to claim 1, wherein: the cystoscope sheath is made of metal.
4. The cystoscopic resecting device capable of real-time tumor identification according to claim 1, wherein: the probe sheath is made of black ceramic material.
5. The cystoscopic resecting device capable of real-time tumor identification according to claim 1, wherein: the Raman detection probe is of a ball lens structure.
6. The cystoscopic resecting device capable of real-time tumor identification according to claim 1, wherein: the number of the detection optical fibers is one, the number of the collection optical fibers is four, and the four collection optical fibers are respectively arranged above, below, on the left and on the right of the detection optical fibers in the cross section.
7. The cystoscopic resecting device capable of real-time tumor identification according to claim 1, wherein: the section of the cutting electrode is in a semicircular arc shape.
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202210282607.8A CN114533253A (en) | 2022-03-22 | 2022-03-22 | Cystoscope electric cutting device capable of identifying tumors in real time |
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| CN202210282607.8A CN114533253A (en) | 2022-03-22 | 2022-03-22 | Cystoscope electric cutting device capable of identifying tumors in real time |
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN117481753A (en) * | 2023-12-29 | 2024-02-02 | 北京智愈医疗科技有限公司 | Method and device for monitoring movement track of water jet knife based on endoscope |
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2022
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Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN117481753A (en) * | 2023-12-29 | 2024-02-02 | 北京智愈医疗科技有限公司 | Method and device for monitoring movement track of water jet knife based on endoscope |
| CN117481753B (en) * | 2023-12-29 | 2024-04-05 | 北京智愈医疗科技有限公司 | Method and device for monitoring movement track of water jet knife based on endoscope |
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