A monitoring system for prostate surgery

Abstract

This application provides a monitoring system for prostate surgery, comprising a tissue pressure acquisition unit, a dynamic pressure difference acquisition unit, and a judgment unit; with the urethra as the Z-axis, the tissue pressure acquisition unit establishes a mapping relationship between the tissue pressure F and the Z-axis position by moving a force sensor along the urethra; the dynamic pressure difference acquisition unit detects bladder pressure P by moving a first pressure sensor along the urethra and a second pressure sensor. bladder Establish dynamic pressure difference ΔP sensor Mapping relationship with Z-axis position; dynamic pressure difference ΔP sensor Bladder pressure P bladder The fluid pressure P in the urethra sensor The difference; the decision unit is based on F and ΔP. sensor At least one of these methods involves marking specific locations in the prostatic urethra corresponding to candidate disease types. This allows for easy and accurate localization of abnormal features during prostate surgery, and the assignment of different markings to different disease types.

Description

Technical Field

[0001] This application relates to a monitoring system for prostate surgery that can easily and accurately locate abnormal features during prostate surgery and assign different labels to different disease types. Background Technology

[0002] Urinary dysfunction is a common urinary system disease involving multiple physiological processes, from bladder storage and urination to urethral discharge. Difficulty urinating involves several aspects, including bladder emptying efficiency, detrusor muscle contraction function, bladder pressure assessment, urine flow rate measurement, and urethral obstruction assessment. In middle-aged and elderly men, benign prostatic hyperplasia (BPH) is a significant contributing factor; enlarged tissue can compress the urethra, increasing resistance to urination and thus leading to urinary obstruction. Therefore, the influence of prostatic factors must be fully considered when analyzing urinary function.

[0003] Currently, minimally invasive surgery for lower urinary tract obstructive diseases such as benign prostatic hyperplasia mainly relies on the surgeon's experience combined with intraoperative visual cystoscopy or conventional cystoscopy and ultrasound imaging to determine the location and ablation depth of the lesion. It lacks real-time, continuous biomechanical and dynamic evaluation indicators. While preoperative urodynamic testing can provide bladder pressure-flow curves, it is only a single measurement during voiding and cannot provide real-time feedback on changes in local resistance during surgery. Traditional urethral manometry techniques can locate the obstruction segment, but the procedure is complex, difficult to repeat during surgery, and difficult to synchronize with intraoperative imaging.

[0004] Therefore, in the existing technology, there is a technical challenge of how to easily and accurately locate abnormal features during prostate surgery and assign different labels to different disease types. Summary of the Invention

[0005] The purpose of this application is to provide a monitoring system for prostate surgery that can easily and accurately locate abnormal features and assign different labels to different disease types. To achieve the above objective, one solution of this application is a monitoring system for prostate surgery, comprising a tissue pressure acquisition unit, a dynamic pressure difference acquisition unit, and a judgment unit; with the urethra as the Z-axis, the tissue pressure acquisition unit establishes a mapping relationship between tissue pressure F and the Z-axis position by moving a force sensor along the urethra; the dynamic pressure difference acquisition unit detects the intrabladder pressure, i.e., bladder pressure P, by moving a first pressure sensor along the urethra and using a second pressure sensor. bladder Establish dynamic pressure difference ΔP sensor The mapping relationship with the Z-axis position; the dynamic pressure difference ΔP sensor The pressure P of the bladder bladder The fluid pressure P in the urethra sensor The difference; the determination unit is based on F and ΔP sensorAt least one of them, a specific location in the prostatic urethra is marked with a marker corresponding to a candidate disease type.

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

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

[0008] In a preferred embodiment, when ΔP sensor When the increase in pressure within a specified distance along the Z-axis is above a predetermined differential pressure jump threshold, the determination unit assigns a third differential pressure mark to that location.

[0009] In a preferred embodiment, at any location along the Z-axis, at least based on F and ΔP sensor Based on a specific combination, the determination unit assigns a symptom label to the location corresponding to a specific symptom candidate.

[0010] In a preferred embodiment, if at any position on the Z-axis, F corresponds to the first pressure mark, ΔP sensor Corresponding to the first differential pressure mark, the determination unit assigns a first symptom mark related to the first symptom to the location.

[0011] In a preferred embodiment, if at any position on the Z-axis, F corresponds to the first pressure mark, ΔP sensor Corresponding to the second differential pressure mark, the determination unit assigns a second symptom mark related to the second symptom to the location.

[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 differential pressure marker, the determination unit assigns a third symptom marker related to the third symptom to the location.

[0013] In a preferred embodiment, if at any position on the Z-axis, F has no corresponding first pressure mark, ΔP sensor Corresponding to the third differential pressure mark, the determination unit assigns a fourth symptom mark related to the fourth symptom to the location.

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

[0015] In a preferred embodiment, bladder pressure P is established when the prostate tissue is free of substantial lesions. bladder The relationship curve between the bladder pressure and the urination time t; at least based on this relationship curve, it is determined whether the rate of change of bladder pressure acquired by the urodynamic function acquisition unit is within a preset normal range.

[0016] In a preferred embodiment, if the rate of change of bladder pressure exceeds the normal range, the determination unit assigns an abnormal mark accordingly; if at any position on the Z-axis, F corresponds to the first pressure mark, ΔP sensor If there is no corresponding pressure difference marker and the rate of change of bladder pressure corresponds to the abnormal marker, the determination unit assigns a fifth symptom marker related to the fifth symptom to the location.

[0017] The monitoring system for prostate surgery proposed in this application integrates force / pressure sensing and graphical analysis. It can continuously quantify bladder emptying function and urethral resistance distribution before, during and after surgery. It can easily and accurately locate the abnormal features of the prostate urethra and assign different labels to different disease types, which greatly improves the efficiency of minimally invasive ablation or resection surgery. Attached Figure Description

[0018] To more clearly illustrate this application, the accompanying drawings will be described and explained below. Obviously, the drawings described below only illustrate certain aspects of some exemplary embodiments of this application, and those skilled in the art can obtain other drawings based on these drawings without any inventive effort.

[0019] Figure 1 This is a diagram illustrating the tissue compression force before treatment.

[0020] Figure 2 This is a diagram illustrating the tissue compression force after treatment.

[0021] Figure 3 This is a diagram showing 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 diagram illustrating the changes in bladder pressure during urination.

[0024] Figure 6 This is a schematic diagram of the implementation process. Detailed Implementation

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

[0026] As used in this application, the words “including” or “comprising” or similar terms mean that the element preceding the word covers the element listed after the word, and do not exclude the possibility that it may also cover other elements.

[0027] All terms used in this application (including technical or scientific terms) have the same meaning as understood by one of ordinary skill in the art to which this application pertains, unless otherwise specifically defined. It should also be understood that terms defined in general dictionaries should be interpreted as having meanings consistent with their meanings in the context of the relevant art, and not as being interpreted with idealized or highly formalized meanings, unless explicitly defined herein.

[0028] For components, specific model numbers and other parameters of components not described in detail in this section, the interrelationships between components and control circuits, these may be considered as techniques, methods and devices known to those skilled in the art, but where appropriate, such techniques, methods and devices should be considered part of the specification.

[0029] It should be noted that although the operations of the method described in this application are given a specific order, this does not require or imply that these operations must be performed in that specific order, or that all of the operations shown must be performed to achieve the desired result. On the contrary, the steps described in this application may be performed in a different order. Additionally or alternatively, certain steps may be omitted, multiple steps may be combined into one step, and / or one step may be broken down into multiple steps.

[0030] F, ΔP sensor Three indicators: bladder pressure change rate

[0031] The monitoring system for prostate surgery described in this application is as follows. The monitoring system for prostate surgery of this application includes a tissue pressure acquisition unit, a dynamic pressure difference acquisition unit, and a judgment unit.

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

[0033] The dynamic differential pressure acquisition unit detects the intrabladder pressure P by moving the first pressure sensor along the urethra and using the second pressure sensor. bladder Establish dynamic pressure difference ΔP sensor The mapping relationship with the Z-axis position; the dynamic pressure difference ΔP sensor The pressure P in the bladder bladder The fluid pressure P in the urethra sensor difference;

[0034] The determination unit is based on F and ΔP. sensor At least one of them, a specific location in the prostatic urethra is marked with a marker corresponding to a candidate disease type.

[0035] As a preferred embodiment, this application employs a composite force / pressure sensor that moves along the urethra, replacing the aforementioned force sensor and first pressure sensor, and simultaneously acquiring F, Z, and ΔP during the movement. sensor The mapping relationship with Z.

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

[0037] like Figure 1 As shown, the horizontal axis represents the position of the composite force / pressure sensor along the urethral axis (Z-axis), in mm, and the vertical axis represents the value of F, corresponding to the normal pressure intensity when the sensor contacts the surrounding prostate tissue. Plotting the F values ​​against the corresponding Z-axis positions in an F-Z scatter plot visually displays the force distribution characteristics along the Z-axis of the urethral lumen, thus aiding in the assessment of the mechanical stiffness, degree of fibrosis, and integrity of residual tissue structure of the prostate tissue. Note that F is the actual compressive force measured at a specific location on the Z-axis, not an accumulated value.

[0038] For example, Figure 1 , Figure 2 An FZ curve is fitted based on multiple scatter points of the measured FZ to reflect the mapping relationship between the two; alternatively, only a scatter plot of FZ can be created. Figure 1 , Figure 2 The origin of the FZ curve is the internal urethral orifice (bladder neck). In fact, the origin of the FZ curve can also be the membranous urethra (external sphincter), but this will not be elaborated here.

[0039] When a specific location in the prostatic urethra encounters stricture or prostatic sclerosis, the F-value at that location significantly increases, and the scatter plot or curve forms a protrusion at that location, such as... Figure 1 The protrusions at coordinates 10 and 25 on the horizontal axis are shown in this diagram, which helps to visually assess changes in local mechanical load. When the aforementioned lesions are relieved, the scatter plot or curve trend of FZ becomes relatively flat, such as... Figure 2 As shown.

[0040] Continue reading Figure 1 At a specific location on the Z-axis, when F exceeds a predetermined pressure threshold, the determination unit assigns a first pressure marker to that location. This pressure threshold is adjusted based on the patient's actual condition and measured data, and is determined for a single patient by collecting multiple data points. For example, Figure 1 The pressure value corresponding to point C is used as the pressure threshold.

[0041] It is understandable that when F is above a predetermined pressure threshold, it indicates excessive tissue compression in the prostatic urethra at that specific location, corresponding to the characteristics of a specific lesion type. When F is below the predetermined pressure threshold, it is generally considered that the tissue compression is within the normal range. Other parameters are needed to comprehensively determine the presence and type of lesion. In this case, the determination unit may not assign a pressure marker to that location, or it may assign another marker, such as a second pressure marker, to indicate that the tissue compression at that specific location is within the normal range. This application only illustrates this by assuming that no marker is assigned to that location in this case.

[0042] like Figure 3 , Figure 4 As shown, the horizontal axis represents the axial position of the composite force / pressure sensor in the urethra, in mm, and the vertical axis represents ΔP. sensor The value of ΔP. Here, the origin of the Z-axis is the internal urethral orifice (bladder neck), but it can also be established with the membranous urethra (external sphincter) as the origin of the Z-axis. sensor The mapping relationship of -Z will not be elaborated here. For example, Figure 3 , Figure 4 Based on measurement ΔP sensor ΔP is fitted from multiple scatter points of -Z. sensor -Z curve, or only ΔP can be established. sensor -Z scatter plot to reflect the mapping relationship between the two.

[0043] Under normal conditions, ΔP sensor The curve changes gently, such as Figure 4 As shown, when the sensor passes through a region of sudden increase in resistance, the curve will show a steep jump, corresponding to the point of abnormal resistance. By marking these jumps on the curve, possible obstruction sections can be located.

[0044] When the sensor passes through the lesion segment where the resistance in the urethra is significantly increased, ΔP sensor The Z-curve will show a sudden change, corresponding to the location of an abnormally high resistance region. Similar to the method of locating the obstruction point by preoperative pressure measurement, this application displays ΔP in the curve. sensor The curve, which varies with the position of the urethra, is used to indicate changes in flow resistance of fluid through the prostatic urethra.

[0045] Because fluid inevitably leaks from the bladder along the urethra during the procedure, if the bladder is too dry, it may be necessary to infuse more fluid to fill it. In other words, the bladder pressure P... bladder It is unstable, so the real-time intrabladder pressure P is taken. bladder and the real-time fluid pressure P in the urethra sensor The difference ΔP sensor For reference only.

[0046] It is understandable that as the horizontal axis increases, the distance between the position of the composite force / pressure sensor and the bladder neck increases, and the measured ΔP... sensor The value 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 The absence of significant enlargement suggests that there are no proliferating glands in this segment that would cause difficulty in urination.

[0047] Continue reading Figure 3 At a specific location on the Z-axis, when ΔP sensor When the pressure difference exceeds a predetermined first differential pressure threshold, the determination unit assigns a first differential pressure mark to the location; when ΔP sensor When the differential pressure is less than the first differential pressure threshold and greater than the predetermined second differential pressure threshold, the determination unit assigns a second differential pressure mark to the location; when ΔP sensor When the differential pressure is less than the second differential pressure threshold, the determination unit may not assign a mark to the position, or it may assign other differential pressure marks. Here, we will only take not assigning a mark as an example.

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

[0049] More preferably, when ΔP sensor When the increase in differential pressure within a specified distance along the Z-axis exceeds a predetermined differential pressure jump threshold, the determination unit assigns a third differential pressure mark to that location. This differential pressure jump threshold is typically used to measure the dynamic differential pressure ΔP. sensor The mutation situation. For example Figure 3ΔP appeared at positions 10–15 and 25–30 on the horizontal axis. sensor The dramatic increase indicates that these two location areas require special attention during surgical ablation.

[0050] For example, the differential pressure jump threshold can be determined according to ΔP. sensor The derivative of the -Z curve is d(ΔP) sensor ) / d Z To understand, d(ΔP) sensor ) / d Z If the pressure difference jump threshold is exceeded, it is considered that ΔP sensor A sudden change occurs, or it can be understood as the slope of the curve changing too rapidly within a specified position interval, i.e., ΔP is considered to be... sensor A sudden change occurs. This is understandable; the explanation here only uses the derivative or slope as an example. In reality, the aforementioned "prescribed distance on the Z-axis" and the corresponding differential pressure jump threshold depend on the patient's actual testing situation, as long as ΔP can be distinguished. sensor Ordinary fluctuations and substantial abrupt changes are acceptable, and are not limited to the aforementioned derivative and slope cases.

[0051] More preferably, the monitoring system for prostate surgery of this application further includes a urodynamic function acquisition unit to acquire bladder pressure P. bladder And the rate of change of bladder pressure. Specifically, after bladder instillation is stabilized and urination is performed, the urodynamic function acquisition unit is based on bladder pressure P. bladder The rate of change of bladder pressure is obtained by mapping the relationship with the urination time t.

[0052] Specifically, after the bladder is full and the pressure stabilizes, the instillation is stopped, and the patient is allowed to urinate naturally or through a catheter. The intrabladder pressure P is recorded. bladder The curve showing the change over time t.

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

[0054] As a second example of the rate of change of bladder pressure, it can be used Figure 5 P shown bladder The t-curve is used to reflect the urodynamic function of the bladder. For example... Figure 5 As shown, the horizontal axis represents the time t for urination after the bladder is full and the pressure stabilizes, and the vertical axis represents the intrabladder pressure P. bladder The solid line in the figure represents the P-line in the normal state of the urethra. bladderThe -t curve shows the bladder pressure P at the beginning of urination. bladder Higher levels of P per unit time during the first half of urination. bladder The changes are rapid; after about 20 seconds, due to less residual urine, the P value per unit time in the second half of urination decreases. bladder The changes are slow, which reflects normal urodynamic function in the absence of urethral disease.

[0055] Figure 5 The scatter line in the image reflects the P value when urinary obstruction is caused by urethral disease. bladder The -t relationship shows that due to the presence of urination obstruction, P is affected throughout the entire urination process. bladder The values ​​are higher than normal, with P per unit time. bladder The decline is slower compared to the normal state, meaning the slope of the first half of the curve is lower than in the normal state. This is due to higher residual urine levels. bladder It is difficult for the pressure to drop to the low level that occurs after a normal urination, and it remains at a high level.

[0056] Figure 5 The short dashed line in the figure reflects the intrabladder pressure P. bladder Fluctuations, i.e., when urethral disease causes urinary obstruction, P bladder The -t relationship fluctuated based on the aforementioned scatter plot. Therefore, by comparing it with the normal P... bladder Compare the -t curves and observe the measured P values. bladder -t curve and normal P bladder The degree of deviation from the 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 approach, bladder pressure P is pre-established when there are no substantial lesions in the prostate tissue. bladder The relationship curve between bladder pressure and voiding time t is used; based at least on this relationship curve, it is determined whether the bladder pressure and bladder pressure change rate acquired 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 label accordingly. Here, the bladder pressure change rate exceeding the normal range refers to the measured P... bladder The -t curve deviates from the normal curve by more than a preset range, which needs to be determined based on clinical experience and the patient's actual condition. If the rate of change in bladder pressure does not exceed the normal range, a normal label can be assigned, or no label can be assigned; this will not be elaborated further here.

[0058] Surgical procedure

[0059] Next, combined Figure 6 The implementation process is explained. Figure 6 This is a schematic diagram of the implementation process.

[0060] The main steps include:

[0061] 1. Preoperative preparation and calibration: Bladder instillation is routinely performed preoperatively to stimulate and stabilize bladder pressure, and P is recorded. bladder Calibrate the sensor's zero point and reference pressure.

[0062] 2. Preoperative measurement: After the bladder irrigation has stabilized, allow the patient to urinate naturally or drain urine through a catheter, and record the bladder pressure P. bladder The preoperative bladder emptying capacity was initially assessed by measuring bladder pressure and the rate of change of bladder pressure over time t, thus determining the overall urethral emptying effect.

[0063] 3. Tissue Compression Force Scan: A composite force / pressure sensor is inserted into the urethra and slowly moved towards the bladder via a sliding mechanism. Simultaneously, the tissue compression force F at each location Z is recorded, obtaining F–Z data. An F–Z scatter plot or F–Z curve is plotted to preliminarily locate areas of stenosis or benign prostatic hyperplasia in the prostate, or abnormal features such as localized prostatic nodules and fibrosis.

[0064] 4. Dynamic differential pressure scanning: Real-time recording of intrabladder pressure P during the movement of the composite force / pressure sensor. bladder Calculate the dynamic pressure difference ΔP based on the fluid pressure at the current sensor location Z. sensor And plot ΔP sensor –Z curve. By analyzing the locations of abrupt pressure changes in the curve, abnormal resistance regions are marked.

[0065] 5. Surgical Ablation: Based on the above measurement results and intraoperative imaging, surgical planning is performed, and electrocautery or ablation is conducted on the confirmed obstruction or abnormal area. The degree of local F change can be observed during the operation to assess the ablation effect, and local ΔP is also monitored. sensor The degree of change is used to assess the effectiveness of prostate tissue resection. Specifically, because the urethra has a limited diameter, the compound force / pressure sensor is usually integrated into the movable part of the sheath. During ablation, to avoid interference between the compound force / pressure sensor and the ablation device, the sensor is usually positioned close to the device. The doctor can perform an ablation action, then move the sensor to the abnormal location to measure, repeat the ablation, and then measure again, in a cycle to obtain a more real-time ablation result.

[0066] 6. Intraoperative retesting: Steps 3 and 4 are repeated after surgery, and the data are compared with the preoperative data, with a focus on F and ΔP. sensor Identify areas of change to confirm whether urination resistance has been effectively reduced; if data shows that resistance remains high, consider further treatment for that area.

[0067] 7. Postoperative assessment: After the operation, bladder pressure and the rate of change of bladder pressure were repeatedly measured to evaluate the improvement of bladder emptying capacity after the operation and to verify the efficacy of the operation by comparing it with the preoperative data.

[0068] Symptom markers

[0069] Next, the symptom labeling logic of the judgment unit will be explained.

[0070] In the embodiments of this application, F represents the mechanical compressive strength of the prostate tissue, ΔP sensor The bladder pressure and the rate of change of bladder pressure represent changes in hydrodynamic resistance within the urethra, while bladder pressure and the rate of change of bladder pressure reflect bladder emptying efficiency. Combining these three factors can construct a more clinically valuable multidimensional judgment model, facilitating intelligent classification of intraoperative status and the formulation of intervention strategies.

[0071] As a preferred approach, this application, at a specific location along the Z-axis, is based at least on F and ΔP. sensor Based on a specific combination, the determination unit assigns a symptom label corresponding to the specific symptom candidate to that location.

[0072] Preferably, if at a specific position on the Z-axis, F corresponds to the first pressure mark, ΔP sensor Corresponding to the first differential pressure marker, the determination unit assigns a first symptom marker related to the first symptom to this location. The corresponding F and ΔP values ​​at this location are... sensor Both are too high. The primary symptom corresponds to a typical dual obstruction of the urethra, involving both structural and fluid components. This suggests that glandular hyperplasia is causing substantial compression, requiring greater bladder pressure to drive the fluid, making emptying difficult. Sufficient mechanical resection and urethral dilation should be performed intraoperatively to ensure pressure release. In this case, the rate of change of bladder pressure usually exceeds the normal range.

[0073] Specifically, this lesion typically manifests as an enlarged prostate gland with dense tissue structure. The enlarged gland exerts significant mechanical pressure on the urethra, leading to increased resistance during urine expulsion and resulting in marked dynamic abnormalities. In measurements, the tissue compression force F shows a significant increase, reflecting the strong tissue reaction force experienced by instruments during surgery; the dynamic pressure difference ΔP... sensor Elevated bladder pressure indicates significant resistance as fluid flows through the area; simultaneously, the rate of change of bladder pressure also exceeds the normal range, suggesting that the bladder requires a greater pressure change to overcome the obstruction during emptying. High consistency among these three parameters often constitutes a key area for surgical intervention and evaluation of surgical outcomes, indicating the need for complete ablation 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 differential pressure mark, the determination unit assigns a second symptom mark related to the second symptom to this location. Here, the corresponding F is high, but ΔP... sensor A moderate F-value suggests increased instrument resistance due to tissue nodules or fibrosis, but does not significantly affect flow resistance. The secondary symptom marker corresponds to abnormal features such as fibrosis and nodules in the prostate region. A high F-value indicates a hard tissue texture and high instrument advance resistance; however, ΔP... sensor The moderate level indicates that although the structure of this area is dense, it has limited resistance to fluid flow, suggesting that it is not the main factor causing the interruption of urine flow.

[0075] In this case, P is usually bladder -t curve deviates from normal P bladder The -t curve is relatively mild, indicating moderate urodynamic function. This suggests that while overall urination dynamics are affected, they have not yet reached a high-resistance state. The depth of resection should be carefully considered during surgery to avoid excessive resection that could damage the 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 differential pressure marker, so the determination unit assigns a third symptom marker related to the third symptom to this location. The corresponding F is high, but ΔP is low. sensor A low reading suggests that the prostate tissue is dense but does not obstruct blood flow. The third symptom marker corresponds to early prostatic hyperplasia, where no obstruction of the bladder pathway has yet formed. Observation or minimally invasive local intervention is recommended to prevent excessive resection that could lead to urinary continence impairment. In this case, the rate of change in bladder pressure is usually within the normal range and can be used as an auxiliary diagnostic tool.

[0077] Preferably, if at a specific position on the Z-axis, F does not have a corresponding first pressure mark, ΔP sensor Corresponding to the third differential pressure marker, the determination unit assigns a fourth symptom marker related to the fourth symptom to this location. Here, the corresponding F change is small, but ΔP... sensor The mutation suggests that the source of local flow resistance in the urethra is not the reaction force of tissue compression, but rather the narrowing of the lumen. The fourth symptom marker corresponds to prostatic stenosis. Its pathological basis is often fibrotic contraction of the urethral epithelium or connective tissue, causing a sudden decrease in fluid velocity accompanied by a sharp increase in pressure gradient. During monitoring, ΔP... sensor The curve may show a sharp abrupt change, while the F-value curve may be stable or slightly fluctuating, because the narrowed tissue itself has no significant elastic resistance, only constituting a physical bottleneck. Clinically, this manifestation can be seen in postoperative scarring, congenital anatomical variations, etc. In such cases, the rate of change of bladder pressure usually exceeds the normal range and may fluctuate. Intraoperatively, ΔP can be considered. sensor -Z mutation point and bladder pressure change rate fluctuation segment further locate the stenosis, and combine with other clinical information for surgical assessment.

[0078] Preferably, if at a specific position on the Z-axis, F corresponds to the first pressure mark, ΔP sensor If there is no corresponding pressure differential marker, and the rate of change in bladder pressure corresponds to the abnormal marker, the determination unit assigns a fifth symptom marker related to the fifth symptom to this location. This corresponds to excessively high F and ΔP. sensor Mild elevation or fluctuation, bladder pressure change rate exceeding the normal range, and the fifth symptom marker indicating that although structural resistance exists, fluid conduction is dynamically affected, such as functional abnormalities or surrounding edema, it is recommended to combine other diagnoses for comprehensive judgment before confirming surgical planning or evaluating surgical outcomes.

[0079] Preferably, if at a specific position on the Z-axis, F does not have a corresponding first pressure mark, meaning the value of F is not too high but only fluctuates slightly, but ΔP sensor A sudden increase in bladder pressure followed by a rapid increase in the rate of change and subsequent stabilization: The instantaneous feedback upon release of pressure at this point can be observed intraoperatively, and this critical point can be recorded as the "inflection point for surgical efficacy," used for intraoperative navigation and postoperative review. Specifically, this combination is a relatively typical clinical manifestation, and an "early warning threshold" mechanism can be set in advance based on clinical experience or preoperative reference data, such as ΔP. sensor When the set drop threshold or the sudden increase threshold of bladder pressure change exceeds the sudden increase threshold, it is marked as a possible release point; this moment reflects the release of local tissue pressure and restoration of fluid channels after the instrument passes through or releases the high-resistance lesion area. The bladder emptying mechanism responds rapidly and is manifested as a sudden increase in the rate of bladder pressure change, that is, from the previous insufficient urodynamic function to the sudden strong urodynamic 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 does not have a corresponding first pressure mark, ΔP sensor If there is no corresponding pressure differential marker and the rate of change of bladder pressure does not have a corresponding abnormal marker (i.e., low F, low ΔP, and normal rate of change of bladder pressure), the determination unit determines that there is no substantial lesion in the tissue at this location, indicating that it is a patent passage and intervention should be avoided to reduce trauma.

[0081] The aforementioned combination relationship is expressed in the form of a layered graph as follows: FZ curve (characterizing structural stiffness), ΔP sensor -Z curve (reflecting abrupt change in resistance channel), P bladder -t curve (representing bladder emptying efficiency). If the peak values ​​of the three parameters are synchronized or logically consistent, it indicates a typical "three key pathogenic factors," suggesting the need for focused intraoperative intervention and subsequent follow-up. Conversely, if the peak values ​​are misaligned or the parameters are inconsistent, it should be judged as a functional abnormality or atypical lesion, suitable for delayed treatment or dynamic evaluation.

[0082] In addition, the surgeon can use the curves showing the rate of change of bladder pressure at different stages of the operation, along with F and ΔP, to determine the relationship between these parameters. sensorWhether the changes are synchronized can be used to determine whether the surgical effect is forming: if P bladder The -t curve continues to regress towards the normal baseline, and F and ΔP sensor If all show a continuous mitigation trend, it indicates that the intervention is effective; if P bladder The -t curve fluctuates repeatedly and needs to be considered in conjunction with FZ / ΔP. sensor -Z map mismatch region analysis may reveal issues such as "missed cuts", "residual compression" or "unresolved distal ends".

[0083] Furthermore, and more preferably, FZ and ΔP can be combined. sensor Spatial registration of the dynamic distribution map of -Z:

[0084] If ΔP sensor An increase before the F peak may indicate narrow back pressure;

[0085] If the F peak and the ΔP peak appear simultaneously, it indicates the core of resistance concentration, and targeted resection during surgery is most effective.

[0086] If F remains high and ΔP sensor Frequent fluctuations should raise suspicion of abnormal sensor contact or artificial stress during surgery.

[0087] If ΔP sensor The presence of multiple mutations without a clear peak in F usually indicates the presence of multiple discrete stenotic points, requiring precise localization and resection or other interventions.

[0088] These detailed combinations not only improve the sensitivity of abnormal characterization 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 be based on the real-time collected F and ΔP sensor The signal is linked to the rate of change in bladder pressure to construct a dynamic feedback curve.

[0091] When F and ΔP are real-time during surgery sensor A significant decrease, accompanied by an improvement in the rate of change of bladder pressure, indicates that the current surgical intervention has a significant therapeutic effect. Such changes typically indicate that structural obstruction of the prostate (reflected by high F) has been adequately cleared, and hydrodynamic resistance (reflected by ΔP) has decreased. sensor The symptoms were also significantly relieved, and bladder emptying function began to recover (as reflected by the improved rate of change in bladder pressure). At the surgical level, this multi-parameter simultaneous improvement mode is the ideal goal for achieving surgical efficacy and can serve as an important reference signal for judging the surgical endpoint.

[0092] If F decreases but ΔP sensorNo significant changes were observed, suggesting that the device had traversed some structural resistance areas during its advancement, leading to a decrease in tissue reaction force (F decrease). However, since the hydrodynamic pathway has not been significantly improved, ΔP... sensor Remaining unchanged or fluctuating slightly is common in:

[0093] 1) Deep prostate tissue may not have been completely removed, still exerting internal pressure on the urinary tract and failing to form an effective passage;

[0094] 2) The bladder neck or fibrous structures have not yet been addressed. Although F in the surgical area has been relieved, a complete patency of the overall pathway has not yet been established. ΔP should be considered during the procedure. sensor Analysis of the spatial distribution of the map and the trend of bladder pressure change rate can help determine whether further exploration or adjustment of the treatment strategy is needed to prevent overlooking key resistance sources.

[0095] If ΔP sensor The fluid resistance decreased, but the flow rate (F) remained high, indicating that structural lesion removal was not yet complete. Although fluid resistance had been partially relieved, significant tissue mechanical resistance remained in the surgical area. Specifically, this manifested as follows:

[0096] 1) The instrument is still significantly compressed during advancement, indicating that the prostate is still dense and may be a deep gland, fibrous band, or nodule residue that was not completely removed.

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

[0098] 3) Special attention should be paid to the phenomenon of "false patency" in this type of parameter combination, that is, the ΔP may be reduced due to tissue traction or temporary dilation of the cavity. sensor The object was mistakenly lowered, but the actual mechanical structure was not fully cleared.

[0099] This mechanism can assist surgeons in intraoperative re-exploration and assessment of additional clearance, and can also be used postoperatively by re-measuring the rate of bladder pressure change and F / ΔP. sensor Trend comparison confirms whether the surgical efficacy has been achieved, which can then be used for intraoperative navigation and immediate postoperative assessment to determine whether supplementary treatment is needed, thereby reducing residual risks and postoperative recurrence rates.

[0100] Compared to the approach proposed in this application, existing intraoperative assessment techniques mainly rely on imaging observation, electrocautery inductors, and surgeon experience, lacking an objective quantitative description of resistance distribution; some procedures rely on a single postoperative urodynamic test (such as maximum urinary flow rate Q). max While methods such as residual urine volume and postoperative respiration (PVR) can assess surgical outcomes, they cannot reflect dynamic changes during surgery or pinpoint specific abnormalities. This application offers the following significant advantages over existing technologies:

[0101] Real-time performance: Existing assessment methods are mostly single-time-point detections before or after surgery, which cannot dynamically capture changes in resistance; this invention uses a composite force / pressure sensor to achieve real-time data acquisition and map generation during surgery, guiding immediate operational judgments during the procedure.

[0102] Spatial distribution perception: Traditional assessment lacks the ability to spatially locate lesions; this application uses F and ΔP sensor By constructing a resistance profile along the Z-axis distribution curve, the resistance range can be accurately located and quantitatively described.

[0103] Multi-parameter fusion: Single urodynamic parameters are easily affected by bladder function and have a certain degree of error; this invention integrates F-value (tissue mechanics) and ΔP. sensor By integrating fluid resistance and the rate of change of bladder pressure (urodynamics), the accuracy and stability of diagnosis can be improved.

[0104] Quantification of surgical efficacy assessment: Existing surgical efficacy assessments mostly rely on subjective symptom scores or changes in simple indicators; this application allows for quantitative comparison of the trends of three indicators before and after surgery, supporting quantitative assessment of efficacy and decision-making for postoperative follow-up interventions.

[0105] Intelligent intraoperative assistance: Traditional intraoperative decisions rely heavily on experience to determine whether to continue resection; this application uses abnormal segments in the atlas to indicate the location of potential lesions, which helps surgeons make intelligent decisions, improves surgical integrity, and reduces recurrence rate.

[0106] In summary, this application relates to a real-time monitoring system integrating force / pressure sensing and graphical analysis, which can continuously quantify bladder emptying function and urethral resistance distribution before, during, and after surgery, to guide minimally invasive ablation or resection procedures. Specifically, based on ΔP... sensor Abnormal resistance areas can be located by identifying abrupt changes in the urethral pressure gradient curve. Unlike traditional static urethral pressure measurement methods, this allows for real-time intraoperative identification of the lesion site. Postoperative bladder emptying capacity can be assessed based on the rate of change of bladder pressure: By defining the rate of change of bladder pressure related to urodynamic function, the rate of bladder pressure decrease after surgery can be quantified, objectively assessing the improvement in emptying function. Intraoperative real-time image-assisted decision-making: Combining force and pressure data with intraoperative images (such as cystoscopy or ultrasound) enables multimodal assessment. Physicians can simultaneously refer to graphical data and visual images to more accurately determine the ablation effect and decide whether reoperation is necessary, enhancing the intelligence of intraoperative decision-making.

[0107] It should be understood that the specific embodiments described above are only used to explain this application, and the scope of protection of this application is not limited thereto. Any changes, substitutions, or combinations made by those skilled in the art within the scope of the technology disclosed in this application, based on the technical solution and inventive concept of this application, should be covered within the scope of protection of this application.

Claims

1. A monitoring system for prostate surgery, characterized in that, Includes a tissue compression pressure acquisition unit, a dynamic pressure difference acquisition unit, and a judgment unit; with the urethra as the Z-axis, The tissue compression force acquisition unit establishes a mapping relationship between tissue compression force F and Z-axis position by moving the force sensor along the urethra. The dynamic pressure difference acquisition unit detects the intrabladder pressure, i.e., bladder pressure P, by moving the first pressure sensor along the urethra and using the second pressure sensor. bladder Establish dynamic pressure difference ΔP sensor Mapping relationship with Z-axis position; The dynamic pressure difference ΔP sensor The pressure P of the bladder bladder The fluid pressure P in the urethra sensor difference; The determination unit is based on tissue compression force F and dynamic pressure difference ΔP. sensor Specific locations in the prostatic urethra are marked with disease markers corresponding to the candidate disease types. At any position on the Z-axis, when F is above a predetermined pressure threshold, the determination unit assigns a first pressure mark to that position. At any position on the Z-axis, When ΔP sensor When the pressure difference exceeds a predetermined first differential pressure threshold, the determination unit assigns a first differential pressure mark to the location. When ΔP sensor When the differential pressure is less than the first differential pressure threshold but greater than a predetermined second differential pressure threshold, the determination unit assigns a second differential pressure mark to that location. When ΔP sensor When the increase in differential pressure within a specified distance along the Z-axis exceeds a predetermined differential pressure jump threshold, the determination unit assigns a third differential pressure marker to that location. At any position along the Z-axis, based on the tissue compression force F and the dynamic pressure difference ΔP sensor The combination of markers, the determination unit assigns a symptom marker corresponding to a specific symptom candidate to the location.

2. The monitoring system for prostate surgery according to claim 1, characterized in that, If at any position on the Z-axis, F corresponds to the first pressure mark, ΔP sensor In the case of the first differential pressure mark, the determination unit assigns a first symptom mark related to the first symptom to the location.

3. The monitoring system for prostate surgery according to claim 1, characterized in that, If at any position on the Z-axis, F corresponds to the first pressure mark, ΔP sensor In the case of the second differential pressure mark, the determination unit assigns a second symptom mark related to the second symptom to the location.

4. The monitoring system for prostate surgery according to claim 1, characterized in that, If at any position on the Z-axis, F corresponds to the first pressure mark, ΔP sensor In the absence of a corresponding differential pressure marker, the determination unit assigns a third symptom marker related to the third symptom to the location.

5. The monitoring system for prostate surgery according to claim 1, characterized in that, If at any position on the Z-axis, F is unmarked, ΔP sensor In the case of the third differential pressure mark, the determination unit assigns a fourth symptom mark related to the fourth symptom to the location.

6. The monitoring system for prostate surgery according to any one of claims 1-5, characterized in that, It also includes a urodynamic function acquisition unit; After bladder instillation is stabilized, urination is performed. The urodynamic function acquisition unit is based on bladder pressure P. bladder The rate of change of bladder pressure is obtained by mapping the relationship with the urination time t.

7. The monitoring system for prostate surgery according to claim 6, characterized in that, Establish bladder pressure P when there is no substantial lesion in the prostate tissue bladder The relationship curve between the bladder pressure and the urination time t; at least based on this relationship curve, it is determined whether the rate of change of bladder pressure acquired by the urodynamic function acquisition unit is within a preset normal range.

8. The monitoring system for prostate surgery according to claim 7, characterized in that, If the rate of change of bladder pressure exceeds the normal range, the determination unit assigns an abnormal label accordingly; If at any position on the Z-axis, F corresponds to the first pressure mark, ΔP sensor If there is no marker and the rate of change of bladder pressure corresponds to the abnormal marker, the determination unit assigns a fifth symptom marker related to the fifth symptom to that location.

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