Technology Development of Electromagnetically Tracked Flexible Endoscope

电磁跟踪软性内窥镜技术进展

• 批准号: 7938042
• 负责人: ROBERT L. GALLOWAY
• 金额: $ 25.59万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-24 至 2012-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7938042
• 关键词: Accounting; Address; Adverse effects; Anatomic Models; Anatomy; Animals; Area; Back; Biomedical Engineering; Body cavities; Cadaver; Carboplatin; Cicatrix; Clinical; Clinical Trials; Colorectal Surgery; Communicable Diseases; Data Set; Detection; Development; Devices; Diffuse; Discipline; Endoscopes; Endoscopic Surgical Procedures; Endoscopy; Engineering; Event; Eye; Eye Movements; Fatty acid glycerol esters; Future; Health; Image; Imaging technology; Injection of therapeutic agent; Intervention; Liver; Location; Magnetism; Malignant Childhood Neoplasm; Malignant Neoplasms; Maps; Measurement; Measures; Medical; Metric; Motion; Myopia; Neurosurgeon; Ocular orbit; Operative Surgical Procedures; Ophthalmologist; Ophthalmology; Optic Nerve; Optics; Orthopedic Procedures; Outcome; Outcome Measure; Patient Care; Performance; Pharmaceutical Preparations; Positioning Attribute; Procedures; Process; Relative (related person); Research; Retinoblastoma; Sinus; Solutions; Surgeon; Surgical Models; Surgical incisions; Surgical wound; System; Techniques; Technology; Testing; Time; Toxic effect; Translating; Urology; Validation; Vision; Visual; blind; body cavity; cost; design; direct application; experience; flexibility; improved; instrument; instrumentation; knowledge base; local drug delivery; medical specialties; minimally invasive; multidisciplinary; neurosurgery; new technology; public health relevance; research study; standard of care; technology development; tool

DESCRIPTION (provided by applicant): Minimally-invasive endoscopic techniques are the standard of care in many specialties. Surgical endoscopy has allowed small incisions to replace large radical surgical approaches, resulting in improved outcomes and reduced operating times. Image guidance, the next technological advancement, provides intra- operative confirmation of surgical anatomy, and also reduces operative time and cost. Image guidance improves surgical performance by precisely mapping surgical anatomy to pre-operative images. Real time overlay of surgical tools onto pre-operative images allows for improved targeting of surgical coordinates. The anatomic constraints of many body cavities, particularly those filled with fat, have limited application of these technologies. Image guidance will facilitate the solution of minimally-invasive flexible endoscopy. Real time display of surgical position is accomplished by measuring and then registering, image space and surgical space. With image guidance we will be able to safely reach remote surgical targets. Traditional image guidance maps rigid tools onto pre-operative images. Many body areas are not well accessed with rigid instruments but could be reached with a flexible endoscope. A tracked flexible endoscope would benefit a wide spectrum of medical and surgical disciplines. An endoscope shows a clear, but myopic, image of the area immediately in front of the camera - it gives no information regarding relative spatial or anatomic relationships. We plan to solve the myopia problem and provide the needed information of where the endoscope is and what it is looking at. This technology will allow for direct treatment of remote targets, best reached with a flexible endoscope. We propose a minimally invasive, image guided endoscopic approach to a surgical target in a fat filled cavity. In order to determine the potential of translating this technology for patient care, we will 1) determine the Target Registration Error and 2) compare performance of image guided endoscopy to non-image guided endoscopy in a surgical model of orbital endoscopy (outcome measures include total time of surgery, time to the optic nerve target, and accuracy of target localization). With the experiments proposed in this study, we will allow for imaged guided flexible endoscopic treatments. PUBLIC HEALTH RELEVANCE: The proposed image-guided flexible endoscope will allow for minimally invasive surgical and medical interventions. Development of this new technology is particularly relevant to the emerging concepts of smaller surgical wounds with less disruption of native anatomy. Access to remote locations will allow for a treatment paradigm shift in many medical disciplines.

描述（由申请人提供）：微创内窥镜技术是许多专业的标准治疗。外科内窥镜允许小切口取代大的根治性手术方法，从而改善结果并减少手术时间。影像引导是下一个技术进步，它提供了手术解剖的术中确认，也减少了手术时间和成本。图像引导通过将手术解剖结构精确映射到术前图像来提高手术性能。手术工具在术前图像上的真实的覆盖允许改进手术坐标的瞄准。许多体腔的解剖学限制，特别是那些充满脂肪的体腔，限制了这些技术的应用。图像引导将有助于解决微创柔性内窥镜。手术位置的真实的实时显示是通过测量然后配准图像空间和手术空间来实现的。通过图像引导，我们将能够安全地到达远程手术目标。传统的图像引导将刚性工具映射到术前图像上。许多身体区域不能很好地用刚性器械进入，但可以用柔性内窥镜进入。跟踪柔性内窥镜将使广泛的医疗和外科学科受益。内窥镜显示了一个清晰的，但近视，图像的区域直接在前面的相机-它没有提供有关相对空间或解剖关系的信息。我们计划解决近视问题，并提供所需的信息，内窥镜在哪里，它正在看什么。这项技术将允许直接治疗远程目标，最好用柔性内窥镜达到。我们提出了一种微创的，图像引导的内窥镜方法，在一个充满脂肪的腔中的手术目标。为了确定将该技术转化为患者护理的潜力，我们将1）确定目标配准误差和2）在眼眶内窥镜手术模型中比较图像引导内窥镜与非图像引导内窥镜的性能（结局指标包括手术总时间、到达视神经目标的时间和目标定位的准确性）。通过本研究中提出的实验，我们将允许成像引导的灵活内窥镜治疗。 公共卫生相关性：申报的图像引导柔性内窥镜将允许微创手术和医疗干预。这项新技术的发展与新出现的较小手术伤口的概念特别相关，对原生解剖结构的破坏较小。进入偏远地区将使许多医学学科的治疗模式发生转变。