Multi-Resolution Foveated Laparoscope for Safer Minimally Invasive Surgery

描述(由申请人提供)：内窥镜在微创手术(MIS)领域为患者护理带来了革命性的变化，最近被应用于高分辨率分子成像，以检测早期疾病。腹腔镜术是管理信息系统手术的基础，通常在几个专科进行，并且已经显示出与同等的开腹手术相比的优势，包括减少疼痛，缩短恢复时间和住院时间，以及降低成本。然而，目前的腹腔镜技术有许多重大的局限性。其中一个限制是无法通过单个集成探头同时获取广角和高分辨率图像。当外科医生需要详细的特写和广角视角来进行空间定位和情境感知时，这一缺陷就会带来问题。目前，这一限制是通过手动将整个腹腔镜移入和移出来解决的，并且需要第二个训练有素的助手。它还介绍了人体工程学方面的冲突，特别是最近发展起来的单端口访问程序，将腹腔镜和工作器械紧密地组合在一起。数字变焦一直试图解决广角和高倍率视图的需求，但受到由此造成的分辨率损失的限制。这项提议回应了这一紧迫的挑战。通过利用光学技术的进步，我们的目标是开发一种创新的腹腔镜，它可以(1)在一个完全集成的单一仪器中同时获得手术区域的广角和高倍率图像；(2)在近距离工作时产生比传统腹腔镜高3倍以上的超高空间分辨率；(3)通过感兴趣区域跟踪功能自动将高倍率探头扫描并接合到外科领域的任何子区域；(4)改变 高分辨率探头的光学放大，而不需要物理地推进或收回探头；以及(5)保持低调，以最大限度地减少与手术器械的接口。我们通过光学耦合广角系统和主动凹陷的高分辨率探头，克服了现有腹腔镜的局限性。在较低的放大倍数下，腹腔镜将以相当于标准腹腔镜的空间分辨率的视野(FOV)成像一个大的手术野，从而提供一个“体育场视野”。视野的一个子区域，我们称之为“凹陷”视野，将以显著更高的放大倍数成像，以可视化更详细的结构，用于诊断或手术治疗。光学放大程度和凹陷视野的位置都可以通过实时光学跟踪和变焦功能进行光学测量。在这个项目中，我们的目标是(1)开发原型系统，(2)开发使能实用软件；(3)测试我们建议的多分辨率凹陷腹腔镜的成像质量和任务执行能力，用于采用模拟腹腔镜任务和复杂的体内临床测试的管理信息系统程序。建议的方法是创新的，因为它将广角探头与主动凹陷的高分辨率图像探头光学耦合，从而提供连续可调的感兴趣区域和光学放大。其优势是相当明显的。它保留了广角低分辨率腹腔镜的优点，并具有同时嵌入高分辨率成像的能力。在提供显著先进的成像能力的同时，这种多分辨率腹腔镜还将保持目前标准腹腔镜的紧凑性。如果成功，我们可以预见，一种集成的多分辨率腹腔镜将对管理信息系统的诊断、临床和技术方面产生影响。我们建议的多分辨率凹凹腹腔镜独特的成本和分辨率优势确保了这种手术器械可以迅速转化为大量临床应用。

DESCRIPTION (provided by applicant): Endoscopy has revolutionized patient care in the domain of minimally invasive surgery (MIS) and recently been applied to high-resolution molecular imaging for detection of early-stage disease. Laparoscopy is the foundation of MIS procedures, routinely performed in several specialties, and has demonstrated advantages over equivalent open procedures that include reduced pain, shorter recovery time and hospital stay time, and reduced costs. The current laparoscopic technologies, however, have a number of major limitations. One limitation is the inability to acquire both wide-angle and high-resolution images simultaneously through a single integrated probe. This shortcoming introduces issues when surgeons require both detailed close-up views and wide-angle overviews for spatial orientation and situational awareness. Currently, this limitation is addressed by manually moving the entire laparoscope in and out and requires a second trained assistant. It also introduces ergonomic conflicts, especially now with the recent development of single port access procedures with close grouping of the laparoscope and working instruments. Digital zooming has been attempted to address the need for both wide angle and high-magnification views but has been limited by the resulting loss of resolution. This proposal responds to this pressing challenge. By leveraging the advancements of optical technologies, we aim to develop an innovative laparoscope that can (1) simultaneously obtain both wide-angle- and high-magnification images of a surgical area in real-time in a single, fully integrated instrument; (2) yield ultra-high spatial resolution more than 3 times better than a conventional laparoscope at a close-up working distance; (3) automatically scan and engage the high-magnification probe to any sub-region of the surgical field through region-of-interest tracking capabilities; (4) vary the optical magnification of the high-resolution probe without the need of physically advancing or withdrawing the probe; and (5) maintain a low profile to minimize interfaces with surgical instruments. We overcome the limitations of existing laparoscopes by optically coupling a wide-angle system with an actively foveated, high-resolution probe. At a low magnification, the laparoscope will image a large surgical field with a field of view (FOV) with spatial resolution equivalent to a standard laparoscope, providing a "stadium view". A sub-region of the field, which we call the "foveated" field, will then be imaged at a significantly higher magnification to visualize more detailed structure for diagnosis or surgical treatment. Both the level of optical magnification and the position of the foveated field can be optically through real-time optical tracking and zooming capabilities. In this project, we will aim to (1) develop prototype systems, (2) develop enabling utility software; and (3) test the imaging quality and task performance capabilities of our proposed multi-resolution foveated laparoscope for use in MIS procedures employing both simulated laparoscopic tasks and complex in vivo clinical testing. The proposed approach is innovative because it will optically couple a wide-angle probe with an actively foveated, high-resolution image probe that provides both continuously adjustable region of interest and optical magnification. The advantages are quite obvious. It preserves the benefits of a wide-angle, low resolution laparoscope and with the capability of simultaneous, embedded high-resolution imaging. While providing significantly advanced imaging capabilities, this multi-resolution laparoscope will also preserve the compactness of current, standard laparoscopes. If successful, we envision that an integrated multi-resolution laparoscope will impact the diagnostic, clinical, and technical aspects of MIS. The unique cost and resolution advantages of our proposed multi-resolution foveated laparoscope ensure that such a surgical instrument can be quickly translated into a host of clinical applications.