Multi-Resolution Foveated Laparoscope for Safer Minimally Invasive Surgery

多分辨率中心凹腹腔镜可实现更安全的微创手术

• 批准号: 8879140
• 负责人: Hong Hua
• 金额: $ 49.55万
• 依托单位: UNIVERSITY OF ARIZONA
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-07-01 至 2018-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8879140
• 关键词: Address; Appendectomy; Area; Arts; Awareness; Boxing; Calibration; Cholecystectomy; Clinical; Color; Comparative Study; Complex; Computer software; Conflict (Psychology); Couples; Coupling; Development; Devices; Diagnosis; Diagnostic; Diagnostic Neoplasm Staging; Disease; Early Diagnosis; Effectiveness; Elements; Endoscopy; Ensure; Evaluation; Eye Movements; Foundations; Genetic Crossing Over; Geometry; Goals; Grant; Grouping; Hand; Health; Health Care Costs; Human; Human Resources; Hysterectomy; Image; Image Analysis; Image Enhancement; Laparoscopes; Laparoscopic Surgical Procedures; Laparoscopy; Lead; Length; Length of Stay; Light; Lighting; Medical; Methods; Nephrectomy; Operative Surgical Procedures; Optics; Outcome; Pain; Patient Care; Patients; Peripheral; Positioning Attribute; Postoperative Pain; Procedures; Recovery; Research; Resolution; Retina; Risk; Scanning; Screening for cancer; Sorting - Cell Movement; Space Perception; Staging; Structure; Surgeon; Surgical Instruments; Surgical Specialties; System; Task Performances; Techniques; Technology; Testing; Time; Training; Translating; Vision; Work; abdominal wall; base; clinical application; comparative; cost; design; digital; ergonomics; flexibility; fovea centralis; image processing; imaging probe; improved; in vivo; innovation; instrument; instrumentation; interest; medical specialties; minimally invasive; molecular imaging; novel; operation; patient safety; prototype; research clinical testing; research study; therapeutic target; tool

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.

描述（由申请人提供）：内窥镜在微创手术（MIS）领域彻底改变了患者护理，最近被应用于高分辨率分子成像，用于检测早期疾病。腹腔镜检查是MIS手术的基础，在几个专业中常规进行，并已证明优于等同的开放手术，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主要的局限性。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视图和广角概览以进行空间定向和情景感知时，该缺点引入了问题。目前，这种限制是通过手动将整个腹腔镜移入和移出来解决的，并且需要第二个受过训练的助手。它还引入了人体工程学冲突，特别是最近开发的单孔入路手术，腹腔镜和工作器械紧密组合。数字变焦已经尝试解决广角和高放大率视图的需求，但受到分辨率损失的限制。这项建议是对这一紧迫挑战的回应。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）在一个完全集成的仪器中同时实时获得手术区域的广角和高倍图像;（2）在近距离工作距离下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能力自动扫描高放大率探头并将其接合到术野的任何子区域; 高分辨率探针的光学放大，而不需要物理地推进或撤回探针;以及（5）保持低轮廓以最小化与手术器械的接口。我们克服了现有腹腔镜的局限性，通过光学耦合广角系统与主动凹，高分辨率探头。在低放大率下，腹腔镜将以与标准腹腔镜相当的空间分辨率对具有视场（FOV）的大手术野进行成像，从而提供“体育场视图”。我们称之为“中心凹”视野的子区域然后将以显著更高的放大率成像，以可视化更详细的结构用于诊断或手术治疗。光学放大率的水平和中央凹视野的位置都可以通过实时光学跟踪和变焦能力来光学地确定。在本项目中，我们的目标是（1）开发原型系统，（2）开发使能实用软件;和（3）测试我们提出的多分辨率中心凹腹腔镜的成像质量和任务性能能力，用于采用模拟腹腔镜任务和复杂的体内临床测试的MIS手术。所提出的方法是创新的，因为它将光学耦合广角探头与主动凹，高分辨率图像探头，提供连续可调的感兴趣区域和光学放大。优势是相当明显的。它保留了广角、低分辨率腹腔镜的优点，并具有同时嵌入式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当前标准腹腔镜的紧凑性。如果成功的话，我们设想一个集成的多分辨率腹腔镜将影响MIS的诊断，临床和技术方面。我们提出的多分辨率凹腹腔镜独特的成本和分辨率优势，确保这样的手术器械可以迅速转化为一系列临床应用。