Monitoring system for prostate surgery

Abstract

The invention provides a monitoring system for a prostate operation. The monitoring system comprises a tissue extrusion force acquisition unit, a dynamic pressure difference acquisition unit and a judgment unit, with the urethra as the Z axis, the tissue extrusion force obtaining unit enables the force sensor to move along the urethra, and the mapping relation between the tissue extrusion force F and the position of the Z axis is established; the dynamic pressure difference acquisition unit is used for establishing a mapping relation between a dynamic pressure difference delta Psensor and a Z-axis position by enabling a first pressure sensor to move along a urethra and detecting bladder pressure Pblank by a second pressure sensor; the dynamic pressure difference delta Psensor is the difference between the bladder pressure Pgrader and the fluid pressure intensity Psensor in the urethra; the determination unit makes a marker corresponding to the condition type candidate for a specific position of the urethral prostate on the basis of at least one of F and [Delta] Psensor. Therefore, the abnormal characterization position can be simply, conveniently and accurately positioned in the prostate operation, and different marks are given for different disease types.

Description

Technical Field

[0001] The present application relates to a monitoring system for prostate surgery, which can easily and accurately locate abnormal manifestations during prostate surgery and assign different marks to different types of symptoms. Background Art

[0002] Dysuria is a common urinary tract disorder involving multiple physiological processes, from bladder storage and urination to urethral drainage. Dysuria involves multiple factors, including bladder emptying efficiency, detrusor muscle contraction, bladder pressure assessment, urinary flow rate measurement, and urethral obstruction assessment. Prostatic hyperplasia (BPH) is a major contributing factor in middle-aged and elderly men. Proliferating tissue can compress the urethra, increasing drainage resistance and leading to urinary difficulty. Therefore, the influence of the prostate must be fully considered when analyzing urinary function.

[0003] Currently, minimally invasive surgeries for lower urinary tract obstructive diseases such as benign prostatic hyperplasia rely primarily on the surgeon's experience combined with intraoperative cystoscopic visual inspection or conventional cystoscopic and ultrasound imaging to determine the location of the lesion and the depth of ablation. There is a lack of real-time, continuous surgical evaluation indicators such as mechanics and dynamics. Although preoperative urodynamic examinations can provide bladder pressure-flow curves, they are only a one-time measurement during the urination phase and cannot provide real-time feedback on changes in local resistance during surgery. Traditional urethral pressure measurement technology can locate the obstructed segment, but the operation is complicated, difficult to perform repeatedly during surgery, and difficult to display synchronously with intraoperative images.

[0004] Therefore, in the prior art, there is a technical problem of how to simply and accurately locate the position of abnormal manifestations during prostate surgery and assign different markers to different types of symptoms. Summary of the Invention

[0005] The purpose of the present application is to provide a monitoring system for prostate surgery that can easily and accurately locate the position of abnormal characteristics during prostate surgery and assign different marks to different types of symptoms. In order to achieve the above purpose, one solution of the present application is a monitoring system for prostate surgery, which includes a tissue squeezing force acquisition unit, a dynamic pressure difference acquisition unit, and a determination unit; with the urethra as the Z axis, the tissue squeezing force acquisition unit establishes a mapping relationship between the tissue squeezing force F and the Z axis position by moving the force sensor along the urethra; the dynamic pressure difference acquisition unit detects the intra-bladder pressure, i.e., the bladder pressure P, by moving the first pressure sensor along the urethra and the second pressure sensor. bladder , establish a dynamic pressure difference ΔP sensor The mapping relationship with the Z-axis position; the dynamic pressure difference ΔP sensor The bladder pressure P bladder The fluid pressure P in the urethra sensor The determination unit is based on F, ΔP sensorAt least one of the above methods marks a specific location of the prostatic urethra corresponding to a candidate disease type.

[0006] In a preferred embodiment, at any position on the Z axis, when F is greater than a predetermined pressure threshold, the determination unit assigns a first pressure mark to the position.

[0007] In a preferred embodiment, at any position on the Z axis, when ΔP sensor When the pressure difference is greater than the predetermined first pressure difference threshold, the determination unit assigns a first pressure difference mark to the position; when ΔP sensor When the pressure difference is less than the first pressure difference threshold and is greater than a predetermined second pressure difference threshold, the determination unit assigns a second pressure difference mark to the position.

[0008] In a preferred embodiment, when ΔP sensor When the increase in the pressure within a predetermined distance along the Z axis is greater than a predetermined pressure difference jump threshold, the determination unit assigns a third pressure difference mark to the position.

[0009] In a preferred embodiment, at any position on the Z axis, based on at least F and ΔP sensor The determination unit assigns a disease label corresponding to a specific disease candidate to the position.

[0010] In a preferred embodiment, if at any position on the Z axis, F corresponds to the first pressure mark, ΔP sensor The determination unit assigns a first symptom mark associated with a first symptom to the position in response to the first pressure difference mark.

[0011] In a preferred embodiment, if at any position on the Z axis, F corresponds to the first pressure mark, ΔP sensor The determination unit assigns a second symptom mark associated with a second symptom to the position in response to the second pressure difference mark.

[0012] In a preferred embodiment, if at any position on the Z axis, F corresponds to the first pressure mark, ΔP sensor If there is no corresponding pressure difference mark, the determination unit assigns a third symptom mark associated with the third symptom to the position.

[0013] In a preferred embodiment, if at any position on the Z axis, F does not have the corresponding first pressure mark, ΔP sensor The determination unit assigns a fourth symptom mark associated with a fourth symptom to the position in response to the third pressure difference mark.

[0014] In a preferred embodiment, it further comprises a urodynamic function acquisition unit; after urination, the bladder is filled and stabilized, and the urodynamic function acquisition unit is based on the bladder pressure P bladderThe bladder pressure change rate is obtained by mapping it with the urination time t.

[0015] In a preferred embodiment, the bladder pressure P is established when the prostate tissue has no substantial lesions. bladder and urination time t; at least based on the relationship curve, judging whether the bladder pressure change rate obtained by the urodynamic function acquisition unit is within a preset normal range.

[0016] In a preferred embodiment, if the bladder pressure change rate exceeds the normal range, the determination unit assigns an abnormal mark; if at any position on the Z axis, F corresponds to the first pressure mark, ΔP sensor There is no corresponding pressure difference mark, and the bladder pressure change rate corresponds to the abnormal mark, and the determination unit assigns a fifth disease mark associated with the fifth disease to the position.

[0017] The monitoring system for prostate surgery in this application integrates force / pressure sensing and graphical analysis, and can continuously quantify bladder emptying function and urethral resistance distribution before, during and after surgery. It can not only easily and accurately locate the abnormal position of the prostatic urethra, but also assign different markers to different types of symptoms, greatly improving the efficiency of minimally invasive ablation or resection surgery. BRIEF DESCRIPTION OF THE DRAWINGS

[0018] To more clearly illustrate the present application, the accompanying drawings are described and illustrated below. It is apparent that the drawings described below only illustrate certain aspects of some exemplary embodiments of the present application, and it is readily apparent to those skilled in the art that other drawings can be derived from these drawings without inventive effort.

[0019] Figure 1 Schematic diagram of tissue extrusion force before treatment.

[0020] Figure 2 Schematic diagram of tissue extrusion force after treatment.

[0021] Figure 3 This is a schematic diagram of the dynamic pressure difference before treatment.

[0022] Figure 4 This is a schematic diagram of the dynamic pressure difference after treatment.

[0023] Figure 5 This is a schematic diagram of the changes in bladder pressure during urination.

[0024] Figure 6 It is a schematic diagram of the implementation process. DETAILED DESCRIPTION

[0025] Various exemplary embodiments of the present application are described in detail below with reference to the accompanying drawings. The description of the exemplary embodiments is merely illustrative and in no way limits the present application and its application or use. The present application can be implemented in many different forms and is not limited to the embodiments described herein. These embodiments are provided to make the present application thorough and complete and to fully convey the scope of the present application to those skilled in the art. It should be noted that unless otherwise stated, the relative arrangement of the components and steps, numerical expressions, numerical values, etc. described in these embodiments should be interpreted as merely exemplary and not as limiting.

[0026] The words “include” or “comprising” and similar words used in this application mean that the elements before the word include the elements listed after the word, and do not exclude the possibility of also including other elements.

[0027] All terms (including technical or scientific terms) used in this application have the same meaning as those understood by ordinary technicians in the field to which this application belongs, unless otherwise specifically defined. It should also be understood that terms defined in general dictionaries should be understood to have the meaning consistent with their meaning in the context of the relevant technology, and should not be interpreted in an idealized or extremely formal sense, unless explicitly defined in this article.

[0028] Components, parameters such as specific models of components, relationships between components, and control circuits that are not described in detail in this section may be considered to be technologies, methods, and equipment known to ordinary technicians in the relevant fields, but where appropriate, such technologies, methods, and equipment should be considered as part of the specification.

[0029] It should be noted that although the operations of the method of the present application are described in a particular order, this does not require or imply that the operations must be performed in that particular order, or that all of the operations shown must be performed to achieve the desired results. Rather, the steps depicted in this application may be performed in a different order. Additionally or alternatively, certain steps may be omitted, multiple steps may be combined into a single step, and / or a single step may be broken down into multiple steps.

[0030] F, ΔP sensor , bladder pressure change rate

[0031] The monitoring system for prostate surgery of the present application is described below. The monitoring system for prostate surgery of the present application comprises a tissue squeezing force acquisition unit, a dynamic pressure difference acquisition unit, and a determination unit.

[0032] During treatment, with the urethra as the Z axis, the tissue extrusion force acquisition unit establishes a mapping relationship between the tissue extrusion force F and the Z axis position by moving the force sensor along the urethra;

[0033] The dynamic pressure difference acquisition unit moves the first pressure sensor along the urethra and the second pressure sensor detects the pressure P in the bladder. bladder , establish a dynamic pressure difference ΔP sensor The mapping relationship with the Z-axis position; the dynamic pressure difference ΔP sensor is the intravesical pressure P bladder The fluid pressure P in the urethra sensor difference;

[0034] The determination unit is based on F, ΔP sensor At least one of the above methods marks a specific location of the prostatic urethra corresponding to a candidate disease type.

[0035] As a preferred method, the present application adopts a composite force / pressure sensor to move along the urethra, that is, the composite force / pressure sensor is used to replace the aforementioned force sensor and the first pressure sensor, and F, Z, and ΔP are obtained synchronously during the movement. sensor Mapping relationship with Z.

[0036] Next, combine Figure 1-5 Regarding F and ΔP in this application sensor and the rate of change of bladder pressure. Figure 1 This is a diagram of tissue compression force before treatment. Figure 2 This is a diagram of tissue extrusion force after treatment. Figure 3 This is a diagram of the dynamic pressure difference before treatment. Figure 4 This is a diagram of the dynamic pressure difference after treatment. Figure 5 This is a diagram showing the change of bladder pressure over time during urination.

[0037] like Figure 1 As shown in the figure, the horizontal axis represents the position of the composite force / pressure sensor along the urethral axis (Z axis) in millimeters, and the vertical axis represents the F value, which corresponds to the normal pressure intensity when the sensor contacts the surrounding prostate tissue. Plotting the F value against the corresponding Z axis position creates an F–Z scatter plot, which visually displays the force distribution characteristics along the Z axis within the urethral lumen, thereby assisting in determining prostate tissue characteristics such as mechanical stiffness, degree of fibrosis, and residual tissue structural integrity. F represents the actual compressive force measured at a specific location along the Z axis, not a cumulative value.

[0038] For example, Figure 1 、 Figure 2 Based on the multiple scattered points of FZ measurement, the FZ curve is fitted to reflect the mapping relationship between the two, or only the scatter plot of FZ can be established. Figure 1 、 Figure 2 The origin of the Z axis is the internal urethral opening (bladder neck opening). In fact, the FZ curve can also be established with the urethral membranous part (external sphincter) as the origin of the Z axis, which will not be repeated here.

[0039] When a specific location of the prostatic urethra encounters abnormalities such as stenosis or prostate sclerosis, the F value of that specific location increases significantly, and the scattered points or curves form a protrusion at that specific location, such as Figure 1 The protrusions at coordinates 10 and 25 on the horizontal axis can help visually judge the changes in local mechanical load. When the above-mentioned lesions are relieved, the scatter distribution or curve trend of FZ is relatively flat, such as Figure 2 shown.

[0040] Continue to read Figure 1 , at a specific position on the Z axis, when F is above a predetermined pressure threshold, the determination unit assigns a first pressure mark to the position. The pressure threshold is adjusted according to the actual patient situation and based on measured data, and is determined for a single patient by collecting multiple data. For example, Figure 1 The pressure value corresponding to point C is the pressure threshold.

[0041] It can be understood that when F is above a predetermined pressure threshold, it indicates that the tissue compression force at that specific location of the prostatic urethra is excessive, corresponding to the corresponding lesion type characteristics. When F is less than the predetermined pressure threshold, the tissue compression force is generally considered to be within the normal range, and it is necessary to combine other parameter indicators to comprehensively determine the presence and type of lesion. In this case, the determination unit may not assign a pressure mark to the location, or may assign other marks, such as a second pressure mark, to indicate that the tissue compression force at the specific location is within the normal range. This application only uses the example of not assigning a mark to the location in this case for explanation.

[0042] like Figure 3 、 Figure 4 As shown, the horizontal axis is the position of the composite force / pressure sensor in the urethra axis, unit is mm, and the vertical axis is ΔP sensor Among them, the origin of the Z axis is the internal urethral opening (bladder neck opening), and in fact, the origin of the Z axis can also be established with the urethral membranous part (external sphincter) as the origin. sensor -Z mapping relationship, no further details are given here. For example, Figure 3 、 Figure 4 Based on the measurement of ΔP sensor -Z multiple scattered points fitted ΔP sensor -Z curve, or you can just build ΔP sensor -Z scatter plot to reflect the mapping relationship between the two.

[0043] Under normal conditions, ΔP sensor The curve changes smoothly, such as Figure 4 As shown in Figure 2, when the sensor passes through an area with increased resistance, the curve will show a sharp jump, corresponding to the abnormal resistance point. By marking these jumps on the curve, it is possible to locate the possible obstruction segment.

[0044] When the sensor passes through the lesion section where the resistance in the urethra is significantly increased, ΔP sensor -Z curve will show a sudden change, which corresponds to the location of abnormal high resistance area. Similar to the method of determining the obstruction point by preoperative pressure measurement, this application shows ΔP in the curve graph. sensor The curve that changes with urethral position is used to indicate the change in flow resistance of liquid through the prostatic urethra.

[0045] Because it is inevitable that liquid will flow out of the bladder along the urethra during the operation, when the liquid in the bladder is too little, it may be necessary to infuse some liquid to fill the bladder. In other words, the pressure in the bladder P bladder It is unstable, so the real-time bladder pressure P is taken bladder and the real-time fluid pressure P in the urethra sensor The difference ΔP sensor For reference.

[0046] It can be understood that as the horizontal axis increases, the distance between the composite force / pressure sensor and the bladder neck becomes greater, and the measured ΔP sensor The value of is the cumulative value of the flow resistance and will not decrease. For example, when ΔP is within a certain interval of the Z axis sensor There was no significant enlargement, suggesting that there were no hyperplastic glands in this area that could cause dysuria.

[0047] Continue to read Figure 3 , at a specific position on the Z axis, when ΔP sensor When the pressure difference is greater than the predetermined first pressure difference threshold, the determination unit assigns a first pressure difference mark to the position; when ΔP sensor When the pressure difference is less than the first pressure difference threshold and is greater than a predetermined second pressure difference threshold, the determination unit assigns a second pressure difference mark to the position; when ΔP sensor When the pressure difference is less than the second pressure difference threshold, the determination unit may not assign a mark to the position, or may assign other pressure difference marks. Here, no mark is assigned as an example for explanation.

[0048] The first pressure difference threshold, the second pressure difference threshold, and the pressure difference jump threshold are adjusted according to the patient's actual situation and based on the measured data, and are determined by collecting multiple data for a single patient. For example, the pressure value corresponding to point A in the figure is the first pressure difference threshold, and the pressure value corresponding to point B is the second pressure difference threshold.

[0049] Further preferably, when ΔP sensor When the increase in the specified distance along the Z axis is greater than the predetermined pressure difference jump threshold, the determination unit assigns a third pressure difference mark to the position. The pressure difference jump threshold is usually used to measure the dynamic pressure difference ΔP sensor For example, Figure 3ΔP appears at positions 10-15 and 25-30 on the horizontal axis sensor This indicates that these two locations require special attention during surgical ablation.

[0050] For example, the pressure difference trip threshold can be calculated according to ΔP sensor -The derivative of the Z curve is d(ΔP sensor ) / d Z To understand, d(ΔP sensor ) / d Z When the pressure difference exceeds the preset threshold, it is considered that ΔP sensor Sudden change occurs, or it can be understood that when the slope of the curve changes too quickly within the specified position interval, it is considered that ΔP sensor It is understandable that here we only use the derivative or slope as an example to illustrate its principle. In fact, the aforementioned "specified distance of the Z axis" and the corresponding pressure difference jump threshold are determined according to the actual detection conditions of the patient. As long as ΔP sensor General fluctuations and substantial mutations are sufficient, not limited to the aforementioned derivatives and slopes.

[0051] Further preferably, the monitoring system for prostate surgery of the present application further comprises a urodynamic function acquisition unit to obtain bladder pressure P bladder Specifically, the bladder is filled and then urinated, and the urinary dynamic function acquisition unit is based on the bladder pressure P bladder The bladder pressure change rate is obtained by mapping it with the urination time t.

[0052] Specifically, after the bladder is filled to a stable pressure, the perfusion is stopped and the patient is allowed to urinate naturally or through drainage through a urinary catheter, and the intravesical pressure P is recorded. bladder The curve of change with time t.

[0053] As a first example of the bladder pressure change rate, the bladder pressure change rate can be defined as the pressure drop amplitude ΔP (ΔP = P start -P end The ratio of bladder pressure change rate (ΔP / T) to the total time T used for urination reflects the overall bladder emptying efficiency. However, this formula simply divides the difference in bladder pressure at the start and end of urination by the urination time, which is prone to significant errors.

[0054] As a second example of the rate of change of bladder pressure, we can use Figure 5 The P shown bladder -t curve to reflect the urinary dynamic function of the bladder. Figure 5 As shown, the horizontal axis is the urination time t after the bladder is filled to the point where the pressure stabilizes, and the vertical axis is the bladder pressure P bladder The solid line in the figure is the P value under normal urethra condition. bladder-t curve, it can be seen that the bladder pressure P at the beginning of urination bladder Higher, and the P per unit time in the first half of urination bladder The change is faster. After about 20 seconds, due to the small amount of residual urine, the P per unit time in the second half of urination is bladder Changes are slow, reflecting normal urodynamic function in the absence of urethral pathology.

[0055] Figure 5 The scattered lines in the figure reflect the P when urinary tract disease causes urination disorder. bladder -t relationship, it can be seen that due to the existence of urination disorder, the whole process of urination P bladder Compared with the normal state, P per unit time is higher. bladder Compared with the normal state, it decreases more slowly, that is, the slope of the first half of the curve is lower than that in the normal state. bladder It is difficult to drop to the low pressure value after the normal end of urination, and it always remains at a high level.

[0056] Figure 5 The short dashed line in the figure reflects the bladder pressure P bladder Fluctuation, that is, when urinary tract disease causes urination disorder, P bladder The relationship between P and t fluctuates based on the above scatter plot. bladder -t curve comparison, see the measured P bladder -t curve with normal P bladder The degree of deviation from the -t baseline (solid line in the figure) can be used to determine whether the bladder pressure and the rate of change of bladder pressure are normal.

[0057] As a preferred method, the bladder pressure P when the prostate tissue has no substantial lesions is pre-established. bladder and urination time t; at least based on the relationship curve, determine whether the bladder pressure and bladder pressure change rate obtained by the urodynamic function acquisition unit are within a preset normal range; if the bladder pressure change rate exceeds the normal range, the determination unit assigns an abnormal mark accordingly. The bladder pressure change rate here exceeds the normal range, that is, the measured P bladder The -t curve deviates from the normal curve beyond a preset range, which needs to be determined based on clinical experience and the patient's actual situation. If the rate of change of bladder pressure does not exceed the normal range, it can be marked as normal or not, which will not be further described here.

[0058] Surgical procedure

[0059] Next, combine Figure 6 Describe the implementation process. Figure 6 It is a schematic diagram of the implementation process.

[0060] The main steps include:

[0061] 1. Preoperative preparation and calibration: Before the operation, perform routine bladder instillation, stimulate bladder pressure and keep it stable, and record P bladder . Calibrate the sensor zero point and reference pressure.

[0062] 2. Preoperative measurement: After the bladder instillation is stable, let the patient urinate naturally or through urinary catheter drainage, and record the bladder pressure P bladder The changes in bladder pressure and bladder pressure change rate over time t were used to first evaluate the preoperative bladder emptying ability and determine the overall urethral urination effect.

[0063] 3. Tissue compression force scanning: A composite force / pressure sensor is inserted into the urethra and slowly moved toward the bladder via a sliding mechanism. The tissue compression force F at each Z position is simultaneously recorded to obtain F–Z data. An FZ scatter plot or FZ curve is then drawn to preliminarily locate abnormalities such as prostate stenosis, prostatic hyperplasia, or localized prostate nodular fibrosis and hyperplasia.

[0064] 4. Dynamic pressure difference scanning: Real-time recording of bladder pressure P during the movement of the composite force / pressure sensor bladder and the fluid pressure at the current position Z of the sensor to calculate the dynamic pressure difference ΔP sensor , and plot ΔP sensor – Z curve. By analyzing the sudden change of pressure difference in the curve, the abnormal resistance area is marked.

[0065] 5. Surgical ablation: Combine the above measurement results and intraoperative imaging to plan the surgery, and perform electroresection or ablation treatment on the confirmed obstruction or abnormality. During the surgery, the degree of change of local F can be observed to judge the ablation effect, and the local ΔP can be observed. sensor The degree of change determines the effectiveness of prostate tissue resection. Specifically, because the urethra diameter is limited, the composite force / pressure sensor is usually integrated into the active part of the sheath. During the ablation process, to avoid interference between the composite force / pressure sensor and the ablation device, the composite force / pressure sensor is usually kept close to the ablation device. The doctor can perform the ablation, then push the composite force / pressure sensor to the abnormality-indicating location for measurement, then perform the ablation again, and then measure again, repeating this cycle to obtain a more real-time ablation effect.

[0066] 6. Intraoperative retest: Perform steps 3 and 4 again after surgery and compare with preoperative data, focusing on F and ΔP sensor The mutation area is checked to confirm whether the urination resistance has been effectively reduced; if the data shows that the resistance is still high, further treatment of the area is considered.

[0067] 7. Postoperative evaluation: After the surgery, repeat measurements are performed to obtain bladder pressure and the rate of change of bladder pressure. The improvement in bladder emptying ability after surgery is evaluated and compared with preoperative data to verify the efficacy of the surgery.

[0068] Symptom markers

[0069] Next, the symptom marking logic of the determination unit will be described.

[0070] In the embodiment of the present application, F represents the mechanical compression strength of the prostate tissue, ΔP sensor It represents the change in fluid dynamic resistance in the urethra, and bladder pressure and the rate of change of bladder pressure reflect the efficiency of bladder emptying. The combination of the three can construct a multidimensional judgment model with greater clinical value, which is convenient for intelligent classification of intraoperative status and formulation of intervention strategies.

[0071] As a preferred method, the present application uses at least F and ΔP at a specific position on the Z axis. sensor The determination unit assigns a disease label corresponding to a specific disease candidate to the position.

[0072] Preferably, if at a specific position on the Z axis, F corresponds to the first pressure mark, ΔP sensor Corresponding to the first pressure difference mark, the determination unit assigns a first symptom mark related to the first symptom to the position. sensor Both are too high. The first symptom marker corresponds to a typical "structural + fluid" double obstruction in the urethra, indicating that glandular hyperplasia is causing substantial compression. The fluid requires greater bladder pressure to drive it, making emptying difficult. During surgery, adequate mechanical resection and channel dilation should be performed to ensure pressure channel release. In this case, the rate of change of bladder pressure is usually beyond the normal range.

[0073] Specifically, this lesion is usually manifested by an increase in the volume of the prostate gland and a dense tissue structure. The hyperplastic gland exerts significant mechanical pressure on the urethra, resulting in increased resistance to urine discharge and obvious dynamic abnormalities. In the measurement, the tissue squeezing force F is significantly increased, reflecting the strong tissue reaction force when the instrument passes through during the operation; the dynamic pressure difference ΔP sensor The three parameters are highly consistent, often forming key areas for surgical intervention and assessment of surgical outcomes, suggesting the need for complete ablation and resection to restore normal urinary tract patency.

[0074] Preferably, if at a specific position on the Z axis, F corresponds to the first pressure mark, ΔP sensorCorresponding to the second pressure difference mark, the determination unit assigns a second symptom mark associated with the second symptom to the position. sensor Moderate, indicating that tissue nodules or fibrosis increase the resistance of the device, but do not significantly affect the flow resistance. The second symptom marker corresponds to abnormal characteristics such as fibrosis and nodules in the prostate area. Among them, a high F value indicates that the tissue texture is hard and the device propulsion resistance is large; but ΔP sensor Moderate, indicating that although the structure of this area is dense, the resistance to fluid flow is limited, indicating that it is not the main factor causing urine flow interruption.

[0075] In this case, usually P bladder -t curve deviates from the normal P bladder The -t curve is mild and urodynamic function is moderate, indicating that overall urinary motility, while disturbed, has not yet reached a high resistance state. During surgery, the depth of resection should be carefully considered to avoid excessive resection that may damage urinary control structures.

[0076] Preferably, if at a specific position on the Z axis, F corresponds to the first pressure mark, ΔP sensor There is no corresponding pressure difference mark, and the determination unit assigns the third symptom mark related to the third symptom to this position. sensor A low value indicates dense prostate tissue but no obstruction of urinary flow. The third marker corresponds to early prostate hyperplasia, but no obstruction of urinary flow. Observation or local minimally invasive intervention is recommended to prevent excessive resection from impairing urinary control. In this case, the rate of change of bladder pressure is usually within the normal range and can be used as an aid in diagnosis.

[0077] Preferably, if at a specific position on the Z axis, F has no corresponding first pressure mark, ΔP sensor Corresponding to the third pressure difference mark, the determination unit assigns a fourth symptom mark associated with the fourth symptom to the position. sensor The mutation indicates that the source of local flow resistance in the urethra is not the reaction force of tissue compression, but the narrow lumen. The fourth symptom marker corresponds to the stenosis of the prostate. Its pathological basis is mostly the fibrosis and contraction of the urethral epithelium or connective tissue, which causes a sudden decrease in the flow rate of the fluid and a sharp increase in the pressure difference. During monitoring, ΔP sensor The curve may show a sharp mutation, and the F value curve may be stable or slightly fluctuating. This is because the stenosis tissue itself has no obvious elastic resistance and only constitutes a physical bottleneck. Clinically, such manifestations can be seen in postoperative scars, congenital anatomical variations, etc. In this case, the rate of change of bladder pressure is usually beyond the normal range and may fluctuate. During surgery, the ΔP sensor -Z mutation point and bladder pressure change rate fluctuation segment are used to further locate the stenosis, and surgical decision-making is made in combination with other clinical information.

[0078] Preferably, if at a specific position on the Z axis, F corresponds to the first pressure mark, ΔP sensor There is no corresponding pressure difference mark, and the bladder pressure change rate corresponds to the abnormal mark, and the determination unit assigns the fifth symptom mark related to the fifth symptom to the position. sensor Mild elevation or fluctuation, the rate of change of bladder pressure exceeds the normal range, and the fifth symptom marker indicates that although structural resistance exists, fluid conduction is dynamically affected, such as functional abnormalities or peripheral edema. It is recommended to combine other diagnostic comprehensive analysis to confirm the surgical plan or surgical effect evaluation.

[0079] Preferably, if there is no corresponding first pressure mark for F at a specific position on the Z axis, that is, the F value is not too high, but only fluctuates slightly, but ΔP sensor The bladder pressure suddenly increases, and the rate of change of the bladder pressure increases suddenly and then stabilizes: During the operation, the instantaneous feedback when the pressure is released here can be observed and recorded as the key node, which is used as the "inflection point of surgical effectiveness" for intraoperative navigation and postoperative review. Specifically, this combination is a relatively typical clinical manifestation. Based on clinical experience or preoperative reference data, a "warning threshold" mechanism can be set in advance: such as ΔP sensor When the falling threshold is set or the rate of change of bladder pressure suddenly exceeds the rising threshold, it is marked as a possible release point; this moment reflects that after the device passes through or releases the high-resistance lesion area, the local tissue pressure is released, the fluid channel is restored, and the bladder emptying mechanism responds quickly and manifests as a sudden increase in the rate of change of bladder pressure, that is, the previous insufficient urinary dynamic function is transformed into a sudden strong urinary dynamic function, reflecting the emptying mechanism from holding urine to sudden gushing and then to normal urination.

[0080] Preferably, if at a specific position on the Z axis, F has no corresponding first pressure mark, ΔP sensor There is no corresponding pressure difference mark, and the bladder pressure change rate has no corresponding abnormal mark, that is, F is low, ΔP is low, and the bladder pressure change rate is normal. The judgment unit determines that there is no substantial lesion in the tissue at this location, and the passage is clear, avoiding intervention to reduce trauma.

[0081] The above combination relationship is expressed in the form of a graph stack: FZ curve (characterizing the structural hardness), ΔP sensor -Z curve (reflects the sudden change of resistance channel), P bladder -t curve (indicating bladder voiding efficiency). If the three peaks are synchronized or logically aligned, it is a typical "pathogenic triad," indicating the need for focused intraoperative intervention and follow-up. Conversely, if the peaks are misaligned or the parameters diverge, it should be considered a functional abnormality or atypical lesion, suitable for delayed treatment or dynamic evaluation.

[0082] In addition, the surgeon can calculate the bladder pressure change rate according to the curve of the change rate at different stages of the operation and the relationship between F and ΔP. sensorWhether the changes of P are synchronized can be used to judge whether the surgical effect is taking shape: If P bladder -t curve continues to return to the normal baseline, and F, ΔP sensor If both showed a trend of sustained relief, it indicated that the intervention was effective; bladder -t curve fluctuates repeatedly, and needs to be combined with FZ / ΔP sensor -Z-map mismatch area analysis to determine whether there are problems such as "missed resection", "residual compression" or "distal end not relieved".

[0083] In addition, it is further preferred to combine FZ and ΔP sensor -Z dynamic distribution map for spatial registration:

[0084] If ΔP sensor It rises before the F peak, which may indicate stenotic back pressure;

[0085] If the F peak and the ΔP peak appear synchronously, it indicates that the resistance is concentrated in the core, and targeted resection during surgery is most effective;

[0086] If F continues to be high and ΔP sensor Frequent fluctuations may indicate abnormal sensor contact or stress-traction artifacts during surgery.

[0087] If ΔP sensor Multiple point mutations without a clear peak in F usually indicate the presence of multiple discrete stenosis points, and intervention measures such as resection should be precisely located.

[0088] These subdivision combinations not only improve the sensitivity of abnormal characterization type identification, but also provide surgeons with point-by-point reference decision support, forming a more intelligent intraoperative feedback mechanism.

[0089] Implementation evaluation and feedback

[0090] The monitoring system of this application can collect F and ΔP in real time. sensor The signal is linked to the change rate of bladder pressure to construct a dynamic feedback curve.

[0091] When the real-time F and ΔP sensor The significant decrease in F and the improvement in the rate of change of bladder pressure indicate that the current surgical intervention has a significant therapeutic effect. Such changes usually indicate that the structural obstruction of the prostate (reflected by high F) has been relatively fully cleared, and the fluid dynamic resistance (reflected by ΔP sensor The symptoms of urinary incontinence (as reflected by the bladder pressure) were significantly alleviated, and bladder voiding function began to recover (as reflected by an improvement in the rate of change of bladder pressure). At the surgical level, this pattern of simultaneous improvement in multiple parameters is the ideal goal for achieving surgical efficacy and can serve as an important reference signal for determining the surgical endpoint.

[0092] If F decreases but ΔP sensorThere was no significant change, indicating that the instrument had passed through some structural resistance areas during advancement, resulting in a decrease in tissue reaction force (F decreased). However, since the fluid dynamic pathway was still not significantly improved, ΔP sensor Remains constant or fluctuates slightly, commonly seen in:

[0093] 1) The deep prostate tissue may not be completely removed, still exerting internal pressure on the urinary tract and failing to form an effective channel;

[0094] 2) The bladder neck or fibrous structure has not been treated. Although the surgical area F has been released, the overall channel has not yet been completely opened. The ΔP sensor The spatial distribution of the atlas and the trend analysis of the bladder pressure change rate are used to determine whether further exploration or adjustment of the treatment strategy is needed to prevent missing the key source of resistance.

[0095] If ΔP sensor Decreased but F is still high, indicating that the removal of structural lesions has not been completed. Although the fluid resistance has been partially alleviated, there is still obvious tissue mechanical resistance in the surgical area.

[0096] 1) If the instrument is still significantly squeezed during advancement, it indicates that the prostate is still dense and may be a deep gland, fibrous band, or a residual nodule that has not been completely removed;

[0097] 2)ΔP sensor A decrease in the urinary tract indicates that the local channel has been partially opened to the fluid, but a sufficiently wide urinary channel has not yet been formed. Difficulty in urination or poor urine flow may still occur after surgery.

[0098] 3) This type of parameter combination requires special attention to the phenomenon of “false patency”, i.e., ΔP sensor The actual mechanical structure has not been fully cleared.

[0099] This mechanism can assist the surgeon in re-exploring and supplementing the clearance during surgery, and can also be used to re-measure the bladder pressure change rate and F / ΔP after surgery. sensor Trend comparison confirms whether the surgical effect meets the standard, which can be used for intraoperative navigation and immediate postoperative judgment on whether additional treatment is needed, thereby reducing residual risks and postoperative recurrence rates.

[0100] Compared with the scheme of this application, the existing intraoperative evaluation technology mainly relies on imaging observation, electrosurgical induction and surgeon experience, and lacks an objective quantitative description of resistance distribution; some postoperative single urodynamic examinations (such as maximum urine flow rate Q max , residual urine volume (PVR), etc.) to evaluate the surgical effect, but it cannot reflect the dynamic changes during the operation or locate the specific abnormal characteristics. Compared with the existing technology, this application has the following significant advantages:

[0101] Real-time: Existing evaluation methods mostly rely on single-time point detection before or after surgery, which cannot dynamically capture resistance changes. The present invention uses a composite force / pressure sensor to achieve real-time data collection and map generation during surgery, guiding immediate operational judgment during the surgery.

[0102] Spatial distribution perception: Traditional assessment lacks the ability to locate lesions in space; this application uses F and ΔP sensor Along the Z-axis distribution curve, a resistance profile is constructed to achieve accurate positioning and quantitative description of the resistance range.

[0103] Multi-parameter fusion: Single urodynamic parameter is easily affected by bladder function and has certain errors; the present invention combines F value (tissue mechanics), ΔP sensor The integration of fluid resistance and bladder pressure change rate (urodynamics) improves diagnostic accuracy and stability.

[0104] Quantification of surgical efficacy: The efficacy of existing surgeries mostly relies on subjective symptom scores or changes in simple indicators. This application can quantitatively compare the changing trends of three indicators before and after surgery to support quantitative efficacy determination and postoperative follow-up intervention decisions.

[0105] Intelligent intraoperative assistance: Traditional intraoperative judgment on whether to continue resection relies heavily on experience; this application uses abnormal segments on the atlas to indicate the location of potential lesions, helping surgeons make intelligent decisions, improve surgical integrity and reduce recurrence rates.

[0106] In summary, this application relates to a real-time monitoring system that integrates force / pressure sensing and graphical analysis, which can continuously quantify bladder emptying function and urethral resistance distribution before, during, and after surgery, and is used to guide minimally invasive ablation or resection surgery. sensor Mutation localization of abnormal resistance areas: The mutation point of the urethral lumen pressure difference curve is used to locate the high-resistance lesion area. Unlike the traditional static urethral pressure measurement method, it can identify the lesion site in real time during surgery. Assessment of postoperative bladder emptying ability based on the bladder pressure change rate: By defining the bladder pressure change rate related to the bladder urodynamic function, the postoperative bladder pressure drop rate can be quantified, and the improvement of the emptying function can be objectively evaluated. Decision-making based on real-time intraoperative images: Combine force and pressure data with intraoperative images (such as cystoscopy or ultrasound) to achieve multimodal evaluation. Physicians can refer to graphical data and visual images at the same time to more accurately judge the ablation effect and decide whether reoperation is needed, thereby enhancing the intelligence of intraoperative decision-making.

[0107] It should be understood that the specific embodiments described above are only used to explain the present application, and the scope of protection of the present application is not limited thereto. Any technical personnel familiar with the technical field, within the technical scope disclosed in the present application, can make changes, substitutions, and combinations based on the technical solutions and inventive concepts of the present application, which should be covered by the scope of protection of the present application.

Claims

1. A monitoring system for prostate surgery, characterized in that: It includes a tissue squeezing force acquisition unit, a dynamic pressure difference acquisition unit, and a determination unit; with the urethra as the Z axis, The tissue squeezing force acquisition unit establishes a mapping relationship between the tissue squeezing force F and the Z-axis position by moving the force sensor along the urethra; The dynamic pressure difference acquisition unit moves the first pressure sensor along the urethra and the second pressure sensor detects the bladder pressure, that is, the bladder pressure P bladder , establish a dynamic pressure difference ΔP sensor Mapping relationship with Z-axis position; The dynamic pressure difference ΔP sensor The bladder pressure P bladder The fluid pressure P in the urethra sensor difference; The determination unit is based on F, ΔP sensor At least one of them makes a disease mark corresponding to a disease type candidate for a specific position of the prostatic urethra.

2. The monitoring system for prostate surgery according to claim 1, wherein: When F is equal to or greater than a predetermined pressure threshold at any position on the Z axis, the determination unit assigns a first pressure mark to the position.

3. The monitoring system for prostate surgery according to claim 2, wherein: At any position on the Z axis, When ΔP sensor When the pressure difference is greater than a predetermined first pressure difference threshold, the determination unit assigns a first pressure difference mark to the position; When ΔP sensor When the pressure difference is less than the first pressure difference threshold and is greater than a predetermined second pressure difference threshold, the determination unit assigns a second pressure difference mark to the position.

4. The monitoring system for prostate surgery according to claim 3, wherein: When ΔP sensor When the increase in the pressure within a predetermined distance along the Z axis is greater than a predetermined pressure difference jump threshold, the determination unit assigns a third pressure difference mark to the position.

5. The monitoring system for prostate surgery according to claim 4, characterized in that: At any position on the Z axis, based on at least F and ΔP sensor The determination unit assigns a disease label corresponding to a specific disease candidate to the position.

6. The monitoring system for prostate surgery according to claim 5, characterized in that: If at any position on the Z axis, F corresponds to the first pressure mark, ΔP sensor When the first pressure difference mark corresponds to the position, the determination unit assigns a first symptom mark associated with the first symptom to the position.

7. The monitoring system for prostate surgery according to claim 5, characterized in that: If at any position on the Z axis, F corresponds to the first pressure mark, ΔP sensor When the second pressure difference mark corresponds to the position, the determination unit assigns a second symptom mark associated with the second symptom to the position.

8. The monitoring system for prostate surgery according to claim 5, characterized in that: If at any position on the Z axis, F corresponds to the first pressure mark, ΔP sensor If there is no corresponding pressure difference mark, the determination unit assigns a third symptom mark associated with the third symptom to the position.

9. The monitoring system for prostate surgery according to claim 5, characterized in that: If at any position on the Z axis, F is not marked, ΔP sensor When the third pressure difference mark corresponds to the position, the determination unit assigns a fourth symptom mark associated with a fourth symptom to the position.

10. The monitoring system for prostate surgery according to any one of claims 4 to 9, characterized in that: It also includes a unit for acquiring urodynamic function; After the bladder is filled and stabilized, urination is performed. The urinary dynamic function acquisition unit is based on the bladder pressure P bladder The bladder pressure change rate is obtained by mapping it with the urination time t.

11. The monitoring system for prostate surgery according to claim 10, characterized in that: Establish bladder pressure P when prostate tissue has no substantial lesions bladder and urination time t; at least based on the relationship curve, judging whether the bladder pressure change rate obtained by the urodynamic function acquisition unit is within a preset normal range.

12. The monitoring system for prostate surgery according to claim 11, characterized in that: If the bladder pressure change rate exceeds the normal range, the determination unit assigns an abnormal flag accordingly; If at any position on the Z axis, F corresponds to the first pressure mark, ΔP sensor If there is no flag and the bladder pressure change rate corresponds to the abnormal flag, the determination unit assigns a fifth symptom flag associated with a fifth symptom to the position.

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