A Biliary Tract-Specific Fluorescence Image-guided Surgery

摘要 包括肝内胆管癌在内的原发性肝癌构成了重大的全球疾病负担 在美国和全世界的发病率和死亡率都在增加。手术仍然是最有效的 治疗的形式。然而，中高度复杂性肝切除术的手术并发症发生率 即使在高技能人员和高容量中心，也能保持30-40%的范围。的重大挑战 似乎可归因于导航肝实质剥离，其中切除表面的大小， 与失血和肝实质漏胆有关，手术时间延长 解剖过程中的时间造成了重大障碍。 在这项研究中，我们建议开发一种升级的腹腔镜成像仪，用于更深层次的胆道特异性 使用短波红外（SWIR）传感器和高清RGB彩色视觉的荧光成像， 并测试我们的多模式腹腔镜成像技术在整个肝脏手术中的实用性。 临床前猪研究。肝内重要结构和功能的清晰解剖显示 生理学将使肝解剖对于任何肝切除术更安全和更有效。的目标 这项为期1年的研究是开发和评估新的胆汁特异性荧光和腹腔镜 视觉/显示通过以下具体目标;目标1：开发一种形状因子SWIR相机 荧光图像引导腹腔镜系统;目的2：验证 在临床前动物研究中开发了新的视觉平台。

Abstract The primary liver cancer including intrahepatic bile duct cancer pose significant global burden of illness with increasing incidence and mortality in US and around the world. Surgery remains the most effective form of treatment. However, surgical complication rates for medium to high complexity hepatectomies persist in 30-40% range even in highly skilled hands and at high volume centers. The critical challenges appear to be attributable to navigating liver parenchymal dissection, where size of resection surface, associated with blood loss and missed bile leaks from the liver parenchyma, and prolonged operative time during dissection pose significant obstacle. In this research, we propose to develop an upgraded laparoscopic imager for deeper biliary-specific fluorescent imaging using a short-wave infrared (SWIR) sensor and high-definition RGB color vision, and to test the utility of our multimodal laparoscopic imaging technique in liver surgery throughout preclinical swine studies. The clear anatomic display of intrahepatic critical structures and functional physiology will make the hepatic dissection safer and more efficient for any liver resection. The goal of this 1-year research is to develop and evaluate the novel biliary-specific fluorescence and laparoscopic vision/display through the following specific aims; Aim1: To develop a formfactor SWIR camera system for fluorescence image-guided laparoscopy; Aim 2: To validate the usefulness of the developed new vision platform in preclinical animal studies.