Multifunctional Image Guided Surgical Platform

描述（由申请人提供）：拟议项目的总体目标是开发一种新型多功能图像引导手术（MIGS）平台，用于执行精细和复杂的手术。MIGS平台将在单一平台上集成高分辨率深度分辨率光学成像系统、激光手术刀、微型多轴平移系统、图像处理器和控制系统。在外科手术过程中，能够以微米级的分辨率看到埋藏的组织平面和血管，这有可能彻底改变外科手术过程，包括去除不同组织之间的粘连。在很多情况下，组织都是相互附着的。这些患者包括以前做过手术，接受过放射治疗，有肿瘤或炎症过程的患者。当组织平面被这些过程破坏时，需要进行手术的外科医生就处于严重的劣势，因为他们缺乏正常的组织平面指导来识别和操作各种器官。当盲目地切开这些类型的手术野时，可能会造成严重的后果。在某些情况下，致密粘连和组织损伤的结合阻碍了外科医生实现他们的目标，使一些疾病过程得不到治疗。到目前为止，还没有技术可以指导外科医生进行这个过程。拟议的MIGS平台将使外科医生能够在没有某种形式的指导的情况下进行目前无法进行或非常危险的手术。MIGS平台的开发将通过实现以下具体目标来完成：1)开发一种紧凑且坚固的3D光学成像探针，该探针针对图像引导手术应用进行了优化；2)将光纤激光手术刀与成像探针集成在一起，以进行精确的组织切割；3)在体内大鼠腹部粘连模型中测试MIGS平台的性能。公共卫生相关性：拟议的研究工作解决了成像引导手术器械的重要医疗需求，该器械将使目前不可能或非常危险的手术成为可能。该仪器的发展将使外科医生能够以前所未有的精度和准确度可视化和精确地放置切口。如果所提出的工作的目标得到满足，多功能手术指导系统将可用于执行精细和复杂的手术。

DESCRIPTION (provided by applicant): The overall objective of the proposed project is the development of a novel Multifunctional Image Guided Surgical (MIGS) platform for performing delicate and intricate surgeries. The MIGS platform will integrate a high resolution depth- resolved optical imaging system, a laser scalpel, a miniature multi-axis translation system, an image processor, and a control system on a single platform. Being able to see buried tissue planes and blood vessels with micrometer resolution during surgical procedures has the potential to revolutionize surgical procedures that involve removal of adhesion between different tissues. There are many scenarios where tissues are adherent to one another. These include patients who have had prior surgeries, been radiated, have tumors or inflammatory processes. When tissue planes are obliterated by these processes, surgeons needing to conduct operations are at a serious disadvantage for lack of the normal tissue plane guidance they rely on to identify and operate upon various organs. When blindly cutting into these types of operative fields injuries can occur that can have devastating consequences. In some circumstances, the combination of dense adhesions and tissue injury preclude surgeons from accomplishing their objectives, leaving some disease processes untreated. To date, no technology exists to guide surgeons during this process. The proposed MIGS platform will enable surgeons to perform surgeries that cannot be currently performed or are very risky without some form of guidance. The development of the MIGS platform will be done by accomplishing the following specific aims, 1) Develop a compact and robust 3D optical imaging probe that is optimized for image guided surgical applications, 2) Integrate a fiber laser scalpel with the imaging probe for precision tissue cutting, and 3) Test the performance of the MIGS platform in an in vivo rat model of abdominal adhesions. PUBLIC HEALTH RELEVANCE: The proposed research work addresses an important medical need of an imaged guided surgical instrument which will enable surgeries that are currently not possible or are very risky. The development of the proposed instrument will enable surgeons to visualize and precisely place incision with unprecedented precision and accuracy. If the objectives of the proposed work are met a multifunctional surgical guidance system will be available for performing delicate and intricate surgeries.