Prostate ablation operation needle insertion position construction method and navigation system

Abstract

The invention discloses a prostate ablation operation needle insertion position construction method and a navigation system, and the method employs a three-dimensional model constructed by an MRI image, and determines the position of a needle insertion point and the number of inserted needles according to the ratio of the longitudinal axis distance between cystamen and verufugu to the diameter of a cylinder of single ablation needle ablation. If the upper and lower diameters of the prostate lateral lobes of the horizontal section corresponding to a single needle insertion point are smaller than 4cm, one needle is inserted into the horizontal plane; if the upper diameter and the lower diameter are greater than or equal to 4cm, entering two stitches; if the maximum diameter of the prostate lateral lobe at a certain longitudinal axis position in the horizontal direction is larger than 1 cm, a needle inserting point is additionally added, and if the length of the part protruding to the middle lobe of the bladder is larger than 1 cm, the needle inserting point is additionally added. The needle inserting point is utilized to enter a surgical navigation system, and the operation is accurately carried out in a unified mode under the guidance of the navigation system. A good treatment effect can be achieved when the hot steam ablation needle is punctured into a hyperplastic prostate near the urethra through the needle insertion point for ablation, the needle insertion point is constructed on the coronal section to ensure the ablation range, and the surgical risk is reduced.

Description

Technical Field

[0001] The present invention mainly relates to the technical field of a method for constructing a needle insertion point in prostate ablation surgery and a prostate ablation navigation system using this method, and specifically relates to a method for constructing a needle insertion position in prostate ablation surgery and a navigation system. Background Art

[0002] Prostate ablation technology is a minimally invasive treatment method for treating benign prostatic hyperplasia, and the prostate hot steam treatment device is the most common method. Transurethral prostate hot steam ablation is recognized as the most advanced surgical technique at home and abroad. This technique directly delivers high-temperature hot steam to the hyperplastic prostate tissue through an ablation probe, causing it to necrose and atrophy. Due to the advantages such as the short overall operation time, low anesthesia requirements, local anesthesia plus sedation can meet the operation requirements, and the operation through the urethra conforms to the operation habits of urologists, transurethral prostate hot steam ablation is becoming more and more widely used in clinical practice.

[0003] The prostate ablation device includes a delivery device that enters the hyperplastic position through the urethra. The delivery device includes an insertion catheter at the front end and a [not clear in the original, might be something missing here] at the rear end. The insertion catheter is provided with a cavity, and an ablation needle capable of extending into the hyperplastic tissue to release steam is arranged therein. The ablation needle is connected to a temperature-raising system at the rear end. Although it is becoming more and more common in clinical use, the biggest difficulty in performing transurethral prostate hot steam ablation using a prostate hot steam treatment device lies in the selection and determination of the needle insertion point. At present, in order to meet the needs of the vast majority of patients, a 15-needle hot steam ablation device is usually set for the prostate hot steam treatment device. However, ordinary patients only need 5-6 needles, and the needle insertion depth is determined. During use, generally, there is no need to consider the problem of insufficient ablation needles and needle insertion depth, but it is necessary to consider the risk of additional harm to patients caused by inaccurate needle insertion points and excessive ablation of normal tissues due to the number of needle insertions. In addition, at present, the hot steam ablation surgery more relies on the experience of doctors to complete the selection of the needle insertion point and the needle insertion range. However, this not only has a high dependence on the experience of doctors, but also the experience of each doctor is inconsistent, which will lead to various deviations in the treatment results.

[0004] Therefore, in view of the above technical problems, the present application provides a method for constructing a needle insertion position in prostate ablation surgery and a navigation system. Summary of the Invention

[0005] In view of the above problems, the present application discloses a method for constructing a needle insertion position in prostate ablation surgery. By constructing an accurate needle insertion point position, it provides guidance for clinicians and reduces the problems of excessive ablation and insufficient ablation.

[0006] The present application also discloses a prostate ablation surgery navigation system. By combining the above method with the constructed needle insertion points, it can accurately complete the surgery under visual guidance of the navigation system, ensuring the best surgical effect.

[0007] The present invention also discloses an electronic device, including a processor and a memory storing a computer program. When the processor executes the computer program, it implements the above method for constructing the needle insertion position of a prostate ablation surgery and the surgery navigation system.

[0008] A non-transitory computer-readable storage medium stores a computer program thereon. When the computer program is executed by a processor, it implements the above method for constructing the needle insertion position of a prostate ablation surgery and the surgery navigation system.

[0009] A computer program product includes a computer program. The computer program can be stored on a non-transitory computer-readable storage medium. When the computer program is executed by a processor, the computer can execute any of the above methods for constructing the needle insertion position of a prostate ablation surgery and the surgery navigation system.

[0010] A method for constructing the needle insertion position in prostate ablation surgery. Since prostate hyperplasia is a benign hyperplasia, it is not necessary to perform ablation in a 360° range during the operation. Instead, the needle is inserted as much as possible in the coronal section of the patient rather than the sagittal section because there are various important neurovascular structures and the rectum in the area corresponding to the sagittal section. If ablation is performed in the sagittal section, any improper ablation can cause great harm to the patient. Therefore, constructing the needle insertion point in the coronal section can ensure the safety of the operation. Thus, the image of the patient's prostate position is obtained through MRI, a three-dimensional image of the patient's prostate position is constructed, and the needle insertion point is set at the corresponding position in the coronal section of the three-dimensional image. The three-dimensional image includes not only the prostate area but also the positions of the bladder neck and the external urethral sphincter; the urethral size in the surgical state is reconstructed, and the longitudinal axis distance between the bladder neck and the seminal colliculus is obtained after reconstruction. The number of needle insertions is determined according to the ratio of the longitudinal axis distance to the diameter of the cylinder ablated by a single hot steam ablation needle. At the horizontal section at different longitudinal axis positions in the coronal section, the positions where the maximum size in the horizontal direction of the two prostate lateral lobes is greater than 1 cm are obtained, and needle insertion points are added at the positions where the maximum size is greater than 1 cm. Additionally, after determining the number of needle insertions and the corresponding needle insertion points according to the ratio of the longitudinal axis distance to the diameter of the cylinder ablated by a single hot steam ablation needle, the vertical diameter distance between the two prostate lateral lobes on the horizontal section corresponding to each needle insertion point position is analyzed. When the vertical diameter distance is less than twice the diameter of the cylinder ablated by the hot steam ablation needle, the needle insertion direction is the direction where the coronal section corresponding to the needle insertion point position intersects the horizontal section. If the vertical diameter of the prostate is greater than or equal to twice the diameter of the cylinder ablated by the hot steam ablation needle, two needle insertion directions are set on the horizontal section corresponding to the needle insertion point position, and the two needle insertion directions are symmetric with respect to the intersection line of the coronal section and the horizontal section corresponding to the needle insertion point position. If the middle lobe of the prostate protrudes into the middle lobe of the bladder by more than 1 cm, additional needle insertion points are added in the middle lobe part protruding into the bladder, and the angle and number of the additional needle insertion points are determined according to the thickness and depth of the middle lobe part protruding into the bladder. The needle insertion position is determined according to the above needle insertion points and needle insertion directions, and 3D navigation is performed to accurately ablate the hyperplastic prostate tissue. The needle insertion points constructed in the above manner are in the coronal section, and the number and direction of needle insertions at a single needle insertion point are determined depending on the vertical diameter distance of the prostate lateral lobes on the horizontal section and the situation of the middle lobe protruding into the bladder; the needle insertion points and needle insertion directions determined in this way can ensure the effective ablation of the hyperplastic tissue, can ablate the hyperplastic prostate on the basis of ensuring the safety of the patient's horizontal section, reduce the extrusion of the urethra, and solve the problem of urethral stricture.

[0011] The specific method is as follows: a method for constructing the needle insertion points for a prostate ablation surgery. 1) Obtain the MRI images of the patient's prostate region, and use the MRI images to reconstruct the three-dimensional model of the prostate hyperplasia region. The constructed three-dimensional model ranges from the bladder neck to the external sphincter position. 2) Obtain the longitudinal axis distance between the bladder neck and the seminal colliculus in the three-dimensional model; determine the number of needle insertions based on the ratio of the longitudinal axis distance to the diameter of the cylinder ablated by a single thermal steam ablation needle, and define the longitudinal axis ablation range for each needle. Select a point within the longitudinal axis ablation range of each needle as the needle insertion point. 3) Analyze the prostate conditions in the horizontal section at each longitudinal axis distance position. If the maximum horizontal diameter of the prostate lateral lobe is greater than 1 cm, add needle insertion points at the longitudinal axis positions where the horizontal maximum diameter is greater than 1 cm. 4) Determine the needle insertion positions using the needle insertion points. By the above method, on the basis of ensuring sufficient needle insertion ablation points in the longitudinal axis direction, problems caused by re-hyperplasia due to insufficient ablation caused by excessive local hyperplasia horizontal distance can be avoided.

[0012] Furthermore, simulate the three-dimensional model after inserting a catheter into the urethra in the surgical state in the three-dimensional model to obtain the modified three-dimensional model; this method can ensure the consistency between the constructed needle insertion points and the needle insertion points in the actual surgery.

[0013] Furthermore, set needle insertion points on the coronal section of the three-dimensional model, and construct needle insertion points on both sides of the urethra on the coronal section according to the characteristics of each side respectively.

[0014] Furthermore, set the needle insertion point at the midpoint position of the longitudinal axis ablation range of each needle. Analyze the vertical diameter distance between the two prostate lateral lobes on the horizontal section corresponding to the needle insertion point position. When the vertical diameter distance is less than twice the diameter of the cylinder ablated by the ablation needle, the needle insertion direction is the direction of the intersection line of the coronal section and the horizontal section corresponding to the needle insertion point position. If the vertical diameter of the prostate is greater than or equal to twice the diameter of the cylinder ablated by the ablation needle, set two needle insertion directions on the horizontal section corresponding to the needle insertion point position, and the two needle insertion directions are symmetric with respect to the intersection line of the coronal section and the horizontal section corresponding to the needle insertion point position. By this method, when the vertical diameter distance of the unilateral prostate lateral lobe is too large, the ablation degree can be increased by increasing the number of needle insertions at a single point, and because the vertical diameter distance corresponding to this point is large, it will not affect the tissues in the sagittal plane direction due to inclined ablation.

[0015] Furthermore, for the situation where the prostate protrudes into the bladder clinically, additional needle insertions can be made. Specifically, on the coronal plane, if the length of the middle lobe of the prostate protruding into the middle lobe of the bladder exceeds 1 cm, additional needle insertion points are added in the middle lobe part protruding into the bladder, and the angles and numbers of the additional needle insertion points are determined according to the thickness and depth of the middle lobe part protruding into the bladder, so as to maximize the ablation of the hyperplastic tissue.

[0016] Further, when simulating the insertion of a catheter into the urethra and reaching the bladder neck position, the corresponding longitudinal axis position of the center point of the needle outlet of the inserted catheter is defined as the initial position. The distance between each needle insertion point and the initial position is obtained, and the needle insertion position of the actual inserted catheter is constructed by combining the initial position and the distance between each needle insertion point and the initial position. This is used to guide the catheter to be withdrawn by a corresponding distance to find the corresponding needle insertion position, and the needle insertion angle is constructed at the needle insertion position. The bladder neck position is a relatively easy-to-determine position. Because when the catheter is inserted into this position, it will get stuck at this position. The determination of this position is simple, and it is easy to quickly determine the distance that the inserted catheter needs to be withdrawn based on the relationship between this position and other needle insertion points. Based on this distance, the needle insertion position can be quickly found, and the needle insertion can be completed at the needle insertion point. The operator only needs to observe the withdrawal distance. In this way, an accurate reference for finding the needle insertion point can be given, which is convenient for providing effective guidance to doctors and will not rely solely on experience. Once the distance is determined, the needle insertion point can be quickly determined by means of tracking or setting scales on the inserted catheter.

[0017] This application also discloses a prostate ablation surgery navigation system, which uses the needle insertion points constructed by the above method and further includes: an ablation instrument, a reference frame for being recognized by the navigation system, and the reference frame is arranged at the operation handle position of the delivery device; and a supporting structure for supporting the penis and scrotum and fixing their positions. The specific steps are as follows:

[0018] The positional relationship between the reference frame and the center point of the needle outlet of the inserted catheter is fixed. The needle insertion points constructed by using the needle insertion point construction method are presented in the three-dimensional image. The position of the center point of the inlet of the inserted catheter is obtained by tracking the position and angle changes of the reference frame on the operation handle.

[0019] The initial tracking position is the position where the catheter enters the bladder neck. Find and record the position and angle of the reference frame at the initial tracking position, and then find the angle of the center point of the needle outlet in the coronal section at the initial tracking position, and record the position and angle of the reference frame in this state.

[0020] Construct a virtual inserted catheter. After positioning the initial tracking position, the virtual inserted catheter is displayed in real time in the three-dimensional image, the center point of the needle outlet is highlighted on the virtual inserted catheter, and a virtual needle insertion direction line passing through the center point is constructed.

[0021] Real-time track the position and angle changes of the reference frame, and display the position and angle rotation of the virtual inserted catheter in the three-dimensional image of the patient in real time. When it is shown that the center point of the needle outlet is consistent with the longitudinal axis position of the needle insertion point on the display structure, stop withdrawing, and then fine-tune the angle of the reference frame by tracking to make the center point of the needle outlet in the coronal section, and then adjust the needle insertion direction to be consistent with the virtual needle insertion line. Then, the ablation needle is pushed out from the needle outlet into the prostate tissue for ablation.

[0022] Repeat the above steps to find each puncture point and its corresponding puncture direction one by one. After the ablation of the puncture points on one side is completed, start looking for the puncture direction of the puncture points on the other side and perform prostate ablation by rotating 180 degrees.

[0023] By fixedly setting the reference frame at the position of the operating handle and fixing the penis through a support, the accuracy of the tracking result can be effectively guaranteed, and the occurrence of the problem of unstable positions of each structure caused by hand-held operation can be avoided.

[0024] Technical effects

[0025] Construct puncture points on the three-dimensional model constructed in advance using MRI images. Determine the number of punctures by using the ratio of the longitudinal axis distance between the bladder neck and the seminal colliculus to the diameter of the cylinder ablated by a single ablation needle. Analyze the maximum size of the prostate lateral lobe in the horizontal direction and the situation of the middle lobe protruding into the bladder in the horizontal section within the ablation range of each needle along the longitudinal axis direction, and obtain the longitudinal axis position where the maximum size of the prostate lateral lobe is greater than, and increase the puncture points; for the puncture points selected in the above way, the determination of the number of punctures and the puncture direction of a single puncture point can accurately determine the puncture points. When the ablation needle is inserted into the hyperplastic prostate beside the urethra through the above puncture points for ablation, a better treatment effect can be achieved.

[0026] In addition, set puncture points at the midpoint position of the longitudinal axis ablation range of each needle, analyze the vertical diameter distance between the two prostate lateral lobes on the horizontal section corresponding to the puncture point position, and determine the number of punctures and the puncture direction on a single puncture point according to the vertical diameter distance; when there is a situation where the middle lobe protrudes into the bladder, according to the situation of the middle lobe protruding into the bladder, add additional puncture points in the part of the middle lobe protruding into the bladder. Through this method, the effective supplement of the number of punctures is carried out to ensure effective ablation.

[0027] By constructing puncture points on the coronal section and on both sides of the urethra, the ablation of hyperplastic tissue can be avoided to the greatest extent, and at the same time, secondary damage to important nerves, blood vessels and organs can be avoided.

[0028] By finding an initial position and the distance relationship between it and the puncture point, during the specific operation, it is very simple to insert the catheter into the initial position, maintain the center point of the needle outlet in the coronal section, and then accurately determine the puncture position by simply withdrawing the distance between the puncture point and the initial position. Greatly simplify the randomness of the surgical operation.

[0029] The puncture points constructed in this way are puncture points that meet the purpose of clinical universality. A set of standardized and standardized surgical methods can be constructed in this way, making the popularization and application of the ablation technology more unified and reducing unnecessary injuries.

[0030] By constructing a surgical navigation system, the initial position can be found on the basis of fixing the penis, and the spatial position of the reference frame can be defined at the initial position. In this way, only the changes in the longitudinal axis and the angular rotation need to be tracked subsequently to determine the true needle insertion position, making the accuracy of the entire operation stronger. BRIEF DESCRIPTION OF THE DRAWINGS

[0031] Figure 1 It is a flowchart of the needle insertion point construction method for Embodiment 1;

[0032] Figure 2 It is a schematic cross-sectional view of the coronal section of the three-dimensional model reconstructed for Embodiment 1;

[0033] Figure 3-A is a schematic structural diagram of the number of needle insertions and the needle insertion directions when the vertical diameter of the lateral lobe of the prostate is less than 4 cm under the horizontal section at one needle insertion point position of the three-dimensional model reconstructed for Embodiment 1;

[0034] Figure 3-B is a schematic structural diagram of the number of needle insertions and the needle insertion directions when the vertical diameter of the lateral lobe of the prostate is greater than 4 cm under the horizontal section at one needle insertion point position of the three-dimensional model reconstructed for Embodiment 1;

[0035] Figure 4 It is a schematic diagram of the middle lobe of the prostate protruding into the bladder;

[0036] Figure 5 It is a flowchart of the operation of the navigation system for Embodiment 2;

[0037] Figure 6 It is a schematic structural diagram of the reference frame in Embodiment 2;

[0038] Figure 7 It is a schematic structural diagram of the supporting structure in Embodiment 3;

[0039] DESCRIPTION OF THE MAIN REFERENCE NUMERALS

[0040] 11. NDI ball; 12. Joint part; 121. Arc-shaped anastomosis part; 122. Locking protrusion; 13. Connecting rod; 21. Curved panel; 22. Triangular support structure; 23. Telescopic rod; 24. Ball-and-socket structure; 25. Fixing band; 31. Urethra; 32. Lateral lobe of the prostate. DETAILED DESCRIPTION OF THE EMBODIMENTS

[0041] To make the objectives, technical solutions, and advantages of the present application clearer, the technical solutions of the present application will be clearly and completely described below in conjunction with specific embodiments of the present application and the corresponding drawings. Obviously, the described embodiments are only a part of the embodiments of the present application, rather than all of the embodiments. All other embodiments obtained by those of ordinary skill in the art based on the embodiments in the present application without creative efforts shall fall within the scope of protection of the present application.

[0042] In this text, "schematic" means "serving as an instance, example, or illustration", and any diagram or embodiment described as "schematic" in this text should not be construed as a more preferred or advantageous technical solution.

[0043] For the sake of simplicity of the drawings, only the parts related to the present application are schematically shown in each figure, and they do not represent the actual structure of the product as a whole. In addition, for the sake of simplicity and easy understanding of the drawings, among the components with the same structure or function in some figures, only one of them is schematically shown, or only one of them is labeled.

[0044] In this text, unless otherwise clearly specified and defined, the terms "first" and "second" are only used for descriptive purposes and cannot be construed as indicating or implying relative importance; unless otherwise specified or stated, the term "plural" means two or more; the terms "connection", "fixation", etc. should be understood in a broad sense. For example, "connection" can be a fixed connection, a detachable connection, an integral connection, or an electrical connection; it can be directly connected or indirectly connected through an intermediate medium. For those of ordinary skill in the art, the specific meanings of the above terms in the present application can be understood according to specific circumstances.

[0045] In this text, standard medical guidelines, reference planes, and descriptive terms are used. The sagittal plane divides the body into left and right symmetrical halves. The coronal plane divides the body into front and back parts. The transverse plane divides the body into upper and lower parts. These descriptive terms can be applied to living or inanimate bodies.

[0046] Example 1

[0047] A method for constructing the needle insertion position in prostate ablation surgery: 1) Obtain the MRI images of the patient's prostate region, and use the MRI images to reconstruct the three-dimensional model of the prostate hyperplasia region, and the constructed three-dimensional model extends from the bladder neck to the external sphincter position.

[0048] 2) Simulate the three-dimensional model after inserting a catheter into the urethra 31 in the surgical state to obtain a corrected three-dimensional model; this way can ensure the consistency between the constructed needle insertion point and the needle insertion point in the actual surgery. The subsequent results obtained are also more accurate results.

[0049] 3) Refer to Figure 2With 3-A and 3-B; obtain the longitudinal axis distance between the bladder neck and the seminal colliculus, defined as L1; determine the number of needle insertions according to the ratio of the longitudinal axis distance L1 to the diameter L2 of the cylinder ablated by a single ablation needle, and define the longitudinal axis ablation range of each needle. The midpoint position of the longitudinal axis ablation range of each needle is determined as the needle insertion point; set the needle insertion point on the coronal section of the three-dimensional model, and construct the needle insertion point on both sides of the urethra 31 on the coronal section according to the respective characteristics of both sides; analyze the vertical diameter distance L3 of the bilateral prostate lateral lobes 32 on the horizontal section corresponding to the position of the needle insertion point. When the vertical diameter distance L3 is less than twice the diameter L2 of the cylinder ablated by the hot steam ablation needle, the needle insertion direction is the direction of the intersection line of the coronal section and the horizontal section corresponding to the needle insertion point position. If the vertical diameter distance L3 of the prostate is greater than or equal to twice the diameter L2 of the cylinder ablated by the hot steam ablation needle, two needle insertion directions are set on the horizontal section corresponding to the needle insertion point position, and the two needle insertion directions are symmetric with respect to the intersection line of the coronal section and the horizontal section corresponding to the needle insertion point position. For example, when the diameter L2 of the cylinder ablated by the usual hot steam ablation needle = 2 cm and L3 < 4 cm, the needle insertion direction is the direction of the intersection line of the coronal section and the horizontal section corresponding to the needle insertion point position; when L3 is greater than or equal to 4 cm, two needle insertion directions are set on the horizontal section corresponding to the needle insertion point position, and the two needle insertion directions are symmetric with respect to the intersection line of the coronal section and the horizontal section corresponding to the needle insertion point position, and the included angle between the two directions is preferably equal to 90°. Because the prostate is located between the bladder neck and the seminal colliculus, the longitudinal axis distance L1 between the two determines the length of the hyperplastic area, which is the key factor for determining the needle insertion point. For each needle insertion point, the vertical diameter L3 of the horizontal section where this point is located determines whether a good ablation effect can be achieved with one needle. If it is less than 2 times of L2, one needle needs to be ablated. If it is greater than 2 times of L2, it needs to be increased to two needles to ensure the ablation effect. Through the above effective direction setting, the effective ablation volume can be maximally ensured at the position of a single needle insertion point, the treatment effect can be guaranteed, and when the vertical diameter is relatively large, ablation with two needles will not cause damage to other tissues in the sagittal plane.

[0050] 4) Refer to Figure 3-B; simultaneously analyze the maximum horizontal diameter L4 of the prostate lateral lobe 32 in the horizontal direction on the horizontal section within the ablation range of each needle along the longitudinal axis direction. If the maximum horizontal diameter L4 of the prostate lateral lobe 32 in the horizontal direction is greater than 1 cm, add a needle insertion point at the longitudinal axis position where the maximum horizontal diameter L4 in the horizontal direction is greater than 1 cm. Through the determination of the newly added needle insertion point position in this step, the problem of insufficient ablation caused by the too large horizontal width of the prostate can be avoided, because the amount of residual gland in clinical practice determines the possibility of recurrence of hyperplasia. Adding this needle can avoid the occurrence of the above problems; more specifically, analyze the maximum horizontal diameter of the prostate lateral lobe 32 in the horizontal direction on the horizontal section corresponding to each longitudinal axis position frame by frame, and the interval distance between every two analysis positions is 1-2 mm. This kind of distance analysis can obtain relatively accurate needle insertion sites and numbers.

[0051] 5) Reference Figure 4 As shown in the schematic diagram of the structure where the middle lobe protrudes into the bladder. In the three-dimensional image, there is a situation where the middle lobe of the prostate protrudes into the bladder. From the coronal plane perspective, the vertical distance of the part of the middle lobe protruding into the bladder is defined as L5, and the horizontal distance is defined as L6, where L6 corresponds to the thickness. If L5 exceeds 1 cm, an additional needle insertion point is added in the middle lobe. If L6 is greater than 2 cm, the needle is inserted perpendicular to the direction of the urethra 31 in the coronal plane. If L6 is less than or equal to 2 cm, the needle is inserted at an angle of 45 - 90° to the urethra 31 in the coronal plane to avoid excessive ablation damage to the tissue.

[0052] Because there is less tissue on both sides of the urethra 31 corresponding to the coronal section, ablation on this plane will not cause too much secondary damage to other intestines, nerves, and blood vessels. Therefore, choosing the coronal section for ablation is an efficient and safe method. And by setting one or two needles at the single needle insertion point position, the ablation effect can be guaranteed. Adding one more needle at the position of the prostate lateral lobe 32 with a larger horizontal distance can further reduce the probability of recurrence.

[0053] More specifically, the distance between the two needle insertion points on the same side is greater than 1 cm; this setting can avoid excessive overlap of the ablation area and ensure the removal of more hyperplastic tissue.

[0054] More specifically, when simulating the insertion of the catheter into the urethra 31 and reaching the bladder neck position, the corresponding longitudinal axis position of the center point of the needle outlet of the inserted catheter is defined as the initial position. The distance between each needle insertion point and the initial position is obtained, and the needle insertion positions of the actual inserted catheter are constructed by combining the initial position and the distances between each needle insertion point and the initial position. After the inserted catheter enters the initial position, by setting the center point of the needle outlet of the inserted catheter on the coronal section, and retracting the inserted catheter along the longitudinal axis, after retracting the corresponding distance, stop at this needle insertion position, and extend the ablation needle into the hyperplastic tissue for ablation. The reason why the above method is feasible is that the bladder neck position is a relatively easy-to-determine position. Because when the inserted catheter enters this position, it will get stuck at this position. The determination of this position is simple, and it is easy to quickly determine the distance that the inserted catheter needs to be retracted based on the relationship between this position and other needle insertion points. Based on this distance, the needle insertion position can be quickly found, and the needle can be inserted at the needle insertion point. The operator only needs to observe the retraction distance.

[0055] The specific operation method is as follows. The operator needs to insert the catheter of the ablation instrument through the urethra 31 into the prostate position and terminate it after reaching the narrow bladder neck position to find the initial position. Then, adjust the position of the needle insertion port so that the center of the needle insertion port is set on the coronal section. Know the distance that the insertion catheter needs to be retracted through the distance between the needle insertion point and the initial position. Then, determine the actual retraction distance by using the scale at the rear end of the insertion catheter. Stop moving after reaching the accurate retraction distance, and extend the ablation needle through the needle insertion port to the needle insertion point. When reaching a specific needle insertion point, it is necessary to rotate the angle of the insertion catheter to adjust the needle insertion angle. During the adjustment process, the center of the needle outlet does not change. It is still through a single needle insertion point to insert needles in different directions. One or two needles can be inserted. After the ablation of a single point is completed, repeat the above operations in sequence until the needle insertion ablation of the needle insertion points at both urethral orifices 31 on the coronal section is completed. In this way, the ablation of the hyperplastic prostate tissue in the coronal section area can be effectively and safely completed, the urethra 31 can be decompressed, and thus the problems of frequent urination, urgency of urination, and incomplete urination caused by prostate hyperplasia can be alleviated. Moreover, this method can be a surgical method that meets clinical requirements and can be replicated on a large scale. Through this method, a thermal steam ablation surgical path that meets the personalized requirements of patients and also conforms to the unified standard principle can be constructed, making this kind of surgery have unity and standardization, and is no longer affected by the personal experience of the operator. And the method for constructing the needle insertion point in the whole operation is simple and effective, and the determination of the needle insertion position is also very simple.

[0056] Example 2

[0057] Reference Figure 5 ; When applying the needle insertion points constructed by the method of Example 1 to the prostate ablation surgery navigation system, in addition to constructing the needle insertion points, a special supporting system is also required. Specifically, it is a prostate ablation surgery navigation system, and the system also includes: an ablation instrument, which is a thermal steam ablation instrument in the prior art, such as the Rezūm thermal steam ablation instrument; the Rezūm thermal steam ablation instrument includes a rigid insertion catheter, an outlet is arranged on the insertion catheter, a thermal steam ablation needle is arranged in the insertion catheter, and the thermal steam ablation needle enters the needle insertion point through the outlet and then enters the prostate lateral lobe 32 for ablation. The surgical navigation system also includes an insertion reference frame for being recognized by the navigation system, and the reference frame is arranged at the operation handle position of the conveying device; a supporting structure for supporting the penis and scrotum and fixing their positions; and a navigation recognition structure for tracking and recognizing the position of the reference frame. The specific steps are as follows:

[0058] The positional relationship between the reference frame and the center point of the needle insertion port of the insertion catheter is fixed. The needle insertion points constructed by using the needle insertion point construction method are used to present the needle insertion points in the three-dimensional image; the position of the center point of the entrance of the insertion catheter is obtained by tracking the position and angle changes of the reference frame on the operation handle;

[0059] The initial tracking position is the position where the catheter is inserted into the bladder neck. Find and record the position and angle of the reference frame at the initial tracking position, and then find the angle of the center point of the needle outlet in the coronal section at the initial tracking position, and record the position and angle of the reference frame in this state.

[0060] Construct a virtual insertion catheter. After positioning the initial position, the virtual insertion catheter is displayed in real time in the three-dimensional image, and the center point of the needle outlet is highlighted on the virtual insertion catheter.

[0061] Track the position and angle changes of the reference frame in real time, and display the position and angle rotation of the virtual insertion catheter in the three-dimensional image of the patient in real time; when the center point of the needle inlet on the display structure is consistent with the longitudinal axis position of the needle inlet point, stop retracting, and then fine-tune the angle of the reference frame through tracking to make the center point of the needle outlet in the coronal section; then push the ablation needle out of the needle inlet into the prostate tissue for ablation;

[0062] Repeat the above steps to find each needle inlet point one by one. After the ablation of the needle inlet points on one side is completed, start looking for the needle inlet points on the other side and performing hot steam ablation by rotating 180 degrees.

[0063] By fixedly setting the reference frame at the position of the operating handle and fixing the penis through a support, the accuracy of the tracking result can be effectively guaranteed, and the problem of unstable positions of various structures caused by hand-held operation can be avoided.

[0064] Reference Figure 6 ; NDI balls 11 recognized by the navigation system are arranged on the reference frame. Four NDI balls 11 are arranged on one reference frame to form a quadrilateral without a symmetry axis. A joint part 12 combined with the operating handle is arranged on the reference frame. The joint part 12 includes an arc-shaped fitting part 121 and locking protrusions 122 combined with the fitting part on both sides. Locking holes are arranged on the locking protrusions 122, and locking nuts are arranged in the locking holes, and the locking nuts are not shown in the figure. The reference frame further includes a connecting rod 13 connecting the joint part 12 and the setting plate where the NDI balls 11 are located. The connecting rod 13 is provided with a right-angle bend, so that the plane formed by the 4 NDI balls 11 on it is parallel to the longitudinal axis direction of the support rod. Through this setting, the NDI balls 11 can be tracked from the side, and on the basis of ensuring the effective positional relationship between the operating handle and the coronal section, the NDI balls 11 can also be recognized by the navigation system.

[0065] Reference Figure 7; The supporting structure includes a support frame with angle adjustment and telescopic functions at the bottom, and a curved panel 21 for supporting the penis and fitting with part of the penis at the upper part; a fixing strap 25 is arranged on the curved panel 21 for fixing the position of the penis. The curved panel 21 is connected to the support frame through a ball and socket structure 24, and an angle locking structure is arranged on the outside. There is a triangular support structure 22 and a telescopic rod 23 at the bottom of the support frame. Through the above settings, the support stability of the support frame can be ensured. Specifically, locking structures are arranged at each moving position, and when the appropriate height and angle are reached, the position relationship is locked to ensure the stability of the position relationship during the surgical operation.

[0066] The above is only the specific implementation manner of the present application. Under the above teaching of the present application, those skilled in the art can make other improvements or deformations on the basis of the above embodiments. Those skilled in the art should understand that the above specific description is only a better explanation of the purpose of the present application, and the protection scope of the present application should be subject to the protection scope of the claims.

Claims

1. A method for constructing a needle insertion position for prostate ablation surgery, characterized in that: 1) Obtain MRI images of the patient's prostate region and use the MRI images to reconstruct a three-dimensional model of the prostate hyperplasia region, where the constructed three-dimensional model extends from the bladder neck to the external sphincter; 2) Obtain the longitudinal distance between the bladder neck and the verumontanum, determine the number of needle insertions based on the ratio of the longitudinal distance to the diameter of the cylinder ablated by a single hot steam ablation needle, define the longitudinal ablation range of each needle, and select a point within the longitudinal ablation range of each needle as the needle insertion point; 3) Analyze the prostate condition in the horizontal section at each longitudinal axis distance position. If the maximum horizontal diameter of the prostate lateral lobe is greater than 1 cm, add a needle insertion point at the longitudinal axis position where the maximum horizontal diameter is greater than 1 cm; 4) Use the insertion point to determine the needle insertion position.

2. The construction method according to claim 1, characterized in that: Simulate the three-dimensional model after inserting the catheter into the urethra under surgical conditions to obtain a revised three-dimensional model; Preferably, a needle entry point is set in the urethra on the coronal section of the three-dimensional model, and needle entry points are constructed on both sides of the urethra on the coronal section according to the characteristics of each side; Preferably, the distance between the two needle insertion points in the longitudinal direction of the same side is greater than 1 cm.

3. The construction method according to claim 2, characterized in that: The needle insertion point is set at the midpoint of the longitudinal ablation range of each needle, and the upper and lower diameter distance of the prostate lateral lobes on both sides on the horizontal section corresponding to the needle insertion point is analyzed. When the upper and lower diameter distance is less than twice the diameter of the cylinder ablated by the hot steam ablation needle, the needle insertion direction is the direction of the intersection line of the coronal section and the horizontal section corresponding to the needle insertion point. If the upper and lower diameters of the prostate are greater than or equal to twice the diameter of the cylinder ablated by the hot steam ablation needle, two needle insertion directions are set on the horizontal section corresponding to the needle insertion point, and the two needle insertion directions are symmetrical with the intersection line of the coronal section and the horizontal section corresponding to the needle insertion point.

4. The construction method according to claim 1, characterized in that: In the coronal plane, if the protrusion of the middle lobe of the prostate into the middle lobe of the bladder exceeds 1 cm, an additional needle insertion point is added in the middle lobe of the bladder, and the angle and number of the additional needle insertion points are determined according to the thickness and depth of the middle lobe of the bladder.

5. The construction method according to claim 3, characterized in that: When simulating the insertion of the catheter into the urethra and reaching the bladder neck in the three-dimensional image, the corresponding longitudinal axis position of the center point of the needle outlet of the inserted catheter is defined as the initial position, and the distance between each needle insertion point and the initial position is obtained. The actual needle insertion position of the catheter is constructed by combining the initial position and the distance between each needle insertion point and the initial position, and the needle insertion angle is constructed at the needle insertion position.

6. A prostate ablation surgery navigation system, characterized in that: The needle insertion point constructed by the method according to any one of claims 1 to 5 further comprises: Ablation devices, A reference frame, used for being identified by the navigation system, and the reference frame is set at the position of the operating handle of the conveying device; The supporting structure is used to support the penis and fix the position of the penis; the specific steps are: The positional relationship between the reference frame and the center point of the needle entry port for inserting the catheter is fixed, and the needle entry point constructed by the needle entry point construction method makes the needle entry point appear in the three-dimensional image; the position of the center point of the entry port for inserting the catheter is obtained by tracking the position and angle change of the reference frame on the operating handle; The initial tracking position is the position where the catheter is inserted into the bladder neck. Find and record the position and angle of the reference frame at the initial tracking position. Then find the angle of the center point of the needle outlet in the coronal section at the initial tracking position and record the position and angle of the reference frame in this state. A virtual insertion catheter is constructed, and after the initial position is located, the virtual insertion catheter is displayed in real time in the three-dimensional image, the center point of the needle port is highlighted on the virtual insertion catheter, and a virtual line of the needle insertion direction passing through the center point is constructed; The position and angle changes of the reference frame are tracked in real time, and the position and angle rotation of the virtual inserted catheter are displayed in the patient's three-dimensional image in real time; when the center point of the needle entry port shown on the display structure is consistent with the longitudinal axis position of the needle entry point, the withdrawal is stopped, and the angle of the reference frame is fine-tuned by tracking so that the center point of the needle exit port is on the coronal section, and then the needle insertion direction is adjusted to be consistent with the virtual needle insertion line; finally, the ablation needle is pushed out from the needle entry port into the prostate tissue for ablation.

7. The surgical navigation system according to claim 6, characterized in that: An NDI ball recognized by the navigation system is set on the reference frame. At least three NDI balls that are not in the same straight line are set on one reference frame. Preferably, a coupling portion coupled to the operating handle is provided on the reference frame, the coupling portion comprises an arc-shaped anastomotic portion and locking protrusions coupled to the anastomotic portion on both sides, a locking hole is provided on the locking protrusion, and a locking nut is provided in the locking hole; Preferably, the reference frame further comprises a connecting rod connecting the joint portion and the setting plate where the NDI balls are located, and the connecting rod is provided with a right-angle bend so that the plane formed by the four NDI balls on it is parallel to the longitudinal axis direction of the support rod; Preferably, the supporting structure includes a support frame with angle adjustment and telescopic functions at the bottom, and a curved panel for supporting the penis and partially matching the penis at the top; a fixing belt is also provided on the curved panel for fixing the position of the penis; Preferably, the curved panel and the support frame are connected via a ball head, and an angle locking structure is provided on the outside.

8. An electronic device, comprising a processor and a memory storing a computer program, wherein when the processor executes the computer program, the method for constructing a needle insertion position for a prostate ablation surgery as described in any one of claims 1 to 5 and the surgical navigation system as described in any one of claims 6 to 7 are implemented.

9. A non-transitory computer-readable storage medium having a computer program stored thereon, which, when executed by a processor, implements a method for constructing a needle insertion position for a prostate ablation surgery as described in any one of claims 1-5 and a surgical navigation system as described in any one of claims 6-7.

10. A computer program product, comprising a computer program, which can be stored on a non-transitory computer-readable storage medium. When the computer program is executed by a processor, the computer can execute a method for constructing a needle position for a prostate ablation surgery as described in any one of claims 1-5 and a surgical navigation system as described in any one of claims 6-7.

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