Photoacoustic-Guided Laparoscopic and Open Hysterectomy Procedures Demonstrated With Human Cadavers
Photoacoustic-Guided Laparoscopic and Open Hysterectomy Procedures Demonstrated With Human Cadavers
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DOI：
10.1109/tmi.2021.3082555
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发表时间：
2021-12-01
影响因子：
10.6
通讯作者：
Bell, Muyinatu A. Lediju
中科院分区：
文献类型：
--
作者：
Wiacek, Alycen;Wang, Karen C.;Bell, Muyinatu A. Lediju
子宫切除术（即，手术切除子宫）需要切断子宫的主要血液供应（即，子宫动脉），同时保留附近的、通常重叠的输尿管。在本文中，我们研究了基于双波长和视听光声成像的方法，以可视化和区分输尿管和子宫动脉，并提供所需的实时信息，以避免输尿管切除术中输尿管意外损伤。双波长690/750 nm光声成像在对人类尸体进行腹腔镜和开放性子宫切除术期间实施，具有设计用于可视化输尿管和子宫动脉的定制显示方法。通过在光声图像中跟踪手术工具并将距离映射到听觉信号来计算和传达手术工具到输尿管的接近度。双波长显示器显示了输尿管和子宫动脉在三个分离距离（即，4 mm、5 mm和6 mm）。在腹腔镜子宫切除术中，输尿管和子宫动脉在双波长图像中可视化，对比度差异高达24 dB。输尿管和手术工具之间的距离范围为2.47至7.31 mm。这些结果对于引入双波长光声成像以区分输尿管和子宫动脉，估计输尿管相对于手术工具尖端的位置，将基于光声的距离测量映射到听觉信号，并最终指导子宫切除术以降低意外输尿管损伤的风险。
Hysterectomy (i.e., surgical removal of the uterus) requires severing the main blood supply to the uterus (i.e., the uterine arteries) while preserving the nearby, often overlapping, ureters. In this paper, we investigate dual-wavelength and audiovisual photoacoustic imaging-based approaches to visualize and differentiate the ureter from the uterine artery and to provide the real-time information needed to avoid accidental ureteral injuries during hysterectomies. Dual-wavelength 690/750 nm photoacoustic imaging was implemented during laparoscopic and open hysterectomies performed on human cadavers, with a custom display approach designed to visualize the ureter and uterine artery. The proximity of the surgical tool to the ureter was calculated and conveyed by tracking the surgical tool in photoacoustic images and mapping distance to auditory signals. The dual-wavelength display showed up to 10 dB contrast differences between the ureter and uterine artery at three separation distances (i.e., 4 mm, 5 mm, and 6 mm) during the open hysterectomy. During the laparoscopic hysterectomy, the ureter and uterine artery were visualized in the dual-wavelength image with up to 24 dB contrast differences. Distances between the ureter and the surgical tool ranged from 2.47 to 7.31 mm. These results are promising for the introduction of dual-wavelength photoacoustic imaging to differentiate the ureter from the uterine artery, estimate the position of the ureter relative to a surgical tool tip, map photoacoustic-based distance measurements to auditory signals, and ultimately guide hysterectomy procedures to reduce the risk of accidental ureteral injuries.