Intelligent bladder temperature regulation and control system and method for plasma electric resection operation

Abstract

The invention relates to the technical field of medical instruments, in particular to an intelligent bladder temperature regulation and control system and method.The method comprises the steps that whether the bladder temperature is unbalanced or not is judged on the basis of the real-time temperature difference between the perfusate temperature Tin of a liquid inlet pipeline and the perfusate temperature Tout of a liquid discharging pipeline, and when the real-time temperature difference exceeds a temperature rise threshold value, temperature control intervention is started; the perfusate temperature control module is controlled by the temperature control unit to heat the perfusate, so that the bladder is accelerated to rise to a stable state, perfusion is performed at a dynamic temperature, the duration of the bladder in a low-temperature environment is shortened, and the probability of contraction and spasm of smooth muscles of the bladder can be effectively reduced.

Description

Technical Field

[0001] This invention relates to the field of medical device technology, and in particular to an intelligent bladder temperature control system and method for plasma electroresection surgery. Background Technology

[0002] Plasma electroresection is a minimally invasive surgical procedure that uses a bipolar plasma electroresection system to remove tissue. It is mainly used to treat urinary system diseases such as benign prostatic hyperplasia, bladder tumors, and urethral stricture. Its principle is to use high-frequency current to create plasma in saline solution, precisely cutting the diseased tissue while simultaneously achieving hemostasis. It is characterized by minimal trauma, less bleeding, and rapid recovery. Continuous instillation of sterile irrigation fluid into the bladder is necessary. Its core functions include: first, rinsing the surgical field, removing tissue debris and bleeding, and ensuring the surgeon can clearly observe the operating area; second, maintaining a moderately full bladder to provide operating space for the electrosurgical instruments and avoid collateral damage caused by excessive bladder wall adhesion; and third, removing heat from the surgical area through fluid circulation, reducing the risk of thermal damage to surrounding normal tissues from the electrosurgical energy. The large amount of fluid circulation during the operation, combined with the low temperature environment in the operating room and the inhibitory effect of anesthetic drugs, can easily lead to intraoperative hypothermia. Hypothermia can also cause bladder smooth muscle contraction and spasm, which not only causes severe pain for the patient but may also pull on the surgical wound and cause secondary bleeding. At the same time, the contracted bladder will reduce the operating space and increase the risk of instruments accidentally injuring the bladder wall. Currently, heated normal saline is generally used for intraoperative instillation.

[0003] Currently, most clinical procedures use a fixed-temperature perfusion mode, which involves a preset single infusion temperature, generally between 35-37°C, for continuous perfusion. During perfusion, due to exogenous or endogenous factors such as intraoperative bleeding and increased anesthetic dosage, the bladder temperature may drop unexpectedly, increasing the probability of bladder smooth muscle contraction and spasm. It is impossible to adjust the temperature in a timely manner according to the bladder temperature. At present, the resectoscopes used in transurethral resection of bladder tumors are being miniaturized, with the trend being to gradually reduce the diameter of Fr26 to Fr24, Fr22, or even smaller, in order to be more suitable for Asian populations. Therefore, it is very difficult to directly detect the bladder temperature during the operation.

[0004] To address this, a smart bladder temperature control system and method for plasma electroresection surgery is proposed. This system can determine whether the bladder temperature is unbalanced based on the real-time temperature difference between the infusion fluid temperature in the inlet tubing and the infusion fluid temperature in the outlet tubing, and accelerate the bladder temperature recovery to a stable state after imbalance. Summary of the Invention

[0005] The purpose of this invention is to provide an intelligent bladder temperature control system and method for plasma electroresection surgery, to solve the problems mentioned in the background art. The specific technical solution is as follows:

[0006] To achieve the above and other related objectives, the first objective of this invention is to provide a method for intelligent temperature control of the bladder during plasma electroresection surgery, comprising the following steps:

[0007] Step 1: Obtain the filling fluid temperature T of the inlet pipeline through the first detection module. in The temperature T of the injection fluid in the drainage pipeline is obtained through the second detection module. out ;

[0008] Step 2: Set the temperature threshold Upper limit of injection fluid temperature Cooling threshold and the lower limit of the temperature of the perfusion fluid Calculate real-time temperature difference Determine the real-time temperature difference Does it exceed the temperature rise threshold? Or below the cooling threshold ;

[0009] Step 3: The temperature control unit adjusts the temperature based on the real-time temperature difference. With temperature rise threshold Cooling threshold The relationship between the two controls is used to control the temperature of the injection fluid by the temperature control module. > At that time, the temperature control unit controls the injection fluid temperature control module to heat the injection fluid, and the temperature during the heating process does not exceed the upper limit of the injection fluid temperature. ,when < At that time, the temperature control unit controls the injection fluid temperature control module to perform a cooling operation on the injection fluid, ensuring that the cooling temperature does not fall below the lower limit of the injection fluid temperature. ;

[0010] Step 4: The temperature control unit controls the infusion fluid temperature control module to gradually bring the temperature of the infusion fluid back to T after temperature adjustment. in When the perfusion fluid temperature returns to T in At that time, recalculate the temperature difference. ,like Complete the temperature adjustment process; otherwise, repeat steps 1, 2, and 3.

[0011] Preferably, in step 3, the temperature control unit controls the injection fluid temperature control module to adjust the temperature of the injection fluid in two ways: a fixed temperature adjustment mode and an intelligent temperature adjustment mode.

[0012] Preferably, the fixed temperature control mode includes: setting a fixed temperature rise value and a fixed temperature drop value, when > At that time, the temperature control unit controls the injection fluid temperature control module to raise the temperature of the injection fluid to a fixed temperature value at a fixed heating rate. At that time, the temperature control unit controls the injection fluid temperature control module to reduce the temperature of the injection fluid to a fixed cooling value at a fixed cooling rate.

[0013] Preferably, the intelligent temperature control mode dynamically adjusts the inlet liquid temperature based on the extent to which the real-time temperature difference exceeds the threshold, thereby obtaining the adjusted inlet liquid temperature T. in-adjust The calculation formula for the heating operation is as follows:

[0014] ;

[0015] In the formula: This refers to the temperature increment step, which is an integer multiple of the control precision of the injection fluid temperature control module. This represents the maximum allowable temperature difference under steady-state conditions. The coefficient of temperature rise;

[0016] The calculation formula for cooling operations is as follows:

[0017] ;

[0018] In the formula: The cooling step size.

[0019] Preferably, the temperature rise threshold From the collected bladder capacity Pipeline heat dissipation and basic stable temperature difference Temperature threshold To determine this, the calculation formula is as follows:

[0020] ;

[0021] In the formula: For the standard adult bladder capacity collected, This is the capacity influence coefficient during temperature rise, with a value ranging from 0.5 to 1.2. The heat dissipation influence coefficient during heating, with a value ranging from 0.5 to 1.2, represents the bladder capacity. Actual patient capacity, tubing heat dissipation This refers to the heat dissipation efficiency of the circulating sheath in the electrosurgical resection mirror. Piping heat dissipation as a reference ; Basic stable temperature difference ;

[0022] Cooling threshold The calculation formula is:

[0023] ;

[0024] In the formula: The value is the capacity influence coefficient during cooling, ranging from 0.5 to 1.2. This is the heat dissipation influence coefficient during cooling, with a value range of 0.5-1.2.

[0025] The second objective of this invention is to provide an intelligent bladder temperature control system for plasma electroresection surgery, comprising:

[0026] The first temperature detection module is used to monitor the filling fluid temperature T in the inlet pipeline. in ;

[0027] The second temperature detection module is used to monitor the temperature T of the filling fluid in the drainage pipeline. out ;

[0028] The injection fluid temperature control module is used to heat or cool the injection fluid.

[0029] Temperature control unit, the temperature control unit is used to adjust the temperature T of the inlet pipe. in and the temperature T of the drainage pipeline out To adjust the operation of the perfusion fluid temperature control module, the temperature control unit is used to execute one of the methods described above.

[0030] The present invention provides an intelligent bladder temperature control system and method for plasma electroresection surgery, which has the following beneficial effects:

[0031] 1. This invention is based on the injection fluid temperature T of the inlet pipeline. in Temperature T of the injection fluid in the drainage pipeline out Real-time temperature difference To determine if there is a temperature imbalance in the bladder, when the real-time temperature difference... Exceeding the temperature threshold When the temperature is high, the temperature control intervention is activated. The temperature control unit controls the temperature control module of the infusion fluid to raise the temperature of the infusion fluid so that the bladder can quickly recover to a stable state. Dynamic temperature infusion reduces the duration of the bladder in a low temperature environment, which can effectively reduce the probability of bladder smooth muscle contraction and spasm.

[0032] 2. Based on the collected bladder capacity Pipeline heat dissipation and basic stable temperature difference Temperature threshold This allows for the generation of adaptive temperature thresholds based on bladder capacity and the type of electrosurgical unit. It is suitable for use by different patients, avoiding the problem of accidental temperature rise in patients with large bladder capacity and the problem of delayed triggering in patients with small bladder capacity. Attached Figure Description

[0033] To more clearly illustrate the technical solutions in the embodiments of the present invention or the prior art, the drawings used in the description of the embodiments or the prior art will be briefly introduced below. Obviously, the drawings described below are only some embodiments of the present invention. For those skilled in the art, other drawings can be obtained from these drawings without creative effort.

[0034] Figure 1 This is a flowchart of the method described in this invention;

[0035] Figure 2 This is a system block diagram of the system described in this invention. Detailed Implementation

[0036] The following detailed description, in conjunction with the accompanying drawings and specific embodiments, provides a further detailed explanation of the intelligent bladder temperature control system for plasma electroresection surgery proposed in this invention. The advantages and features of this invention will become clearer from the following description. It should be noted that the accompanying drawings are all in a very simplified form and use non-precise proportions, and are only used to facilitate and clarify the illustration of the embodiments of this invention.

[0037] In the description of this invention, the terms "first" and "second" are used for descriptive purposes only and should not be construed as indicating or implying relative importance or implicitly specifying the number of indicated technical features. Thus, a feature defined as "first" or "second" may explicitly or implicitly include one or more of that feature. In the description of this invention, "a plurality of" means at least two, such as two, three, etc., unless otherwise explicitly specified.

[0038] It should be noted that the illustrations provided in the following embodiments are only schematic representations of the basic concept of the present invention. Therefore, the illustrations only show the components related to the present invention and are not drawn according to the actual number, shape and size of the components in the actual implementation. In the actual implementation, the state, quantity and proportion of each component can be arbitrarily changed, and the layout of the components may also be more complex.

[0039] The core idea of ​​this invention lies in: based on the injection fluid temperature T of the inlet pipeline in Temperature T of the injection fluid in the drainage pipeline out Real-time temperature difference To determine if there is a temperature imbalance in the bladder, when the real-time temperature difference... Exceeding the temperature threshold When the temperature is high, the temperature control intervention is activated. The temperature control unit controls the temperature control module of the infusion fluid to raise the temperature of the infusion fluid so that the bladder can quickly recover to a stable state. Dynamic temperature infusion reduces the duration of the bladder in a low temperature environment, which can effectively reduce the probability of bladder smooth muscle contraction and spasm.

[0040] like Figure 1-2 As shown, a smart bladder temperature control system for plasma electroresection surgery includes:

[0041] The first temperature detection module is used to monitor the filling fluid temperature T in the inlet pipeline. in In some embodiments, the first temperature detection module uses a medical-grade PT100 temperature sensor, which is installed on the inlet pipe using a tube clamp. The measurement range is 0–50℃; the accuracy is ±0.1℃; the response time is ≤1s; the probe diameter is 1.5mm; it is IP68 waterproof; and it can be autoclaved.

[0042] The second temperature detection module is used to monitor the temperature T of the filling fluid in the drainage pipeline. out In some embodiments, the second temperature detection module uses a medical-grade PT100 temperature sensor.

[0043] The perfusion fluid temperature control module is used to heat or cool the perfusion fluid. In some embodiments, the perfusion fluid temperature control module adopts the ZOLL Thermogard XP liquid temperature control system, with a temperature control range of 20–42℃, an adjustment accuracy of ±0.2℃, support for PID + fuzzy control, a heating rate of ≥5℃ / min, a cooling method of semiconductor refrigeration, and a flow rate adaptability of 10–500ml / min.

[0044] Temperature control unit, the temperature control unit is used to adjust the temperature T of the inlet pipe. in and the temperature T of the drainage pipeline out To adjust the operation of the perfusion fluid temperature control module; in some embodiments, the temperature control unit adopts the Delta REX-C100 medical-grade temperature controller, with the following control method: adaptive PID; input: PT100 / thermocouple; output: SSR / PWM; display: LED with 0.1℃ resolution; supports Modbus communication; power supply: AC85–265V, adapted for dual temperature sensor signal acquisition, embedded with a custom temperature control algorithm, and a communication interface for easy system linkage; the temperature control unit is configured as follows:

[0045] S1: Set the temperature threshold Calculate real-time temperature difference According to real-time temperature difference Determine whether temperature control intervention is needed. ,when > During this process, the temperature control unit controls the infusion fluid temperature control module to raise the temperature of the infusion fluid, using either a fixed temperature adjustment mode or an intelligent temperature raising mode. The bladder mucosa has a rich blood supply; therefore, the bladder temperature is strongly correlated with the patient's body temperature. In the operating room, the room temperature is low, and anesthesia also plays a role. Even with continuous infusion of warmed infusion fluid, the bladder temperature can still drop if the patient experiences hypothermia or other unstable conditions. As the bladder temperature decreases, it absorbs more heat from the infusion fluid, resulting in a real-time temperature difference. If the temperature of the injection fluid in the inlet pipeline increases, it is necessary to adjust the temperature of the injection fluid in time.

[0046] S2: When the fixed temperature control mode is selected, a fixed temperature rise value is set. > At this time, the temperature control unit controls the infusion fluid temperature control module to raise the temperature of the infusion fluid to a fixed value at a fixed heating rate. The fixed temperature adjustment mode can accelerate the bladder's return to a stable state, but it still has some drawbacks. When the fixed temperature value is set too low, the heating rate is slow; when the fixed temperature value is set too high, the temperature difference... Slightly exceeding the temperature rise threshold At the same time, it is easy to overheat, which may lead to risks such as thermal damage to the bladder mucosa and vasodilation and bleeding.

[0047] When the intelligent heating mode is selected, the inlet liquid temperature is dynamically adjusted based on the extent to which the real-time temperature difference exceeds the threshold, thus obtaining the adjusted inlet liquid temperature T. in-adjust ,

[0048] ;

[0049] In the formula: This refers to the temperature increment step, which is an integer multiple of the control precision of the injection fluid temperature control module. This represents the maximum allowable temperature difference under steady-state conditions. The upper limit of the set infusion fluid temperature is used to prevent the temperature from becoming too high. As a temperature rise coefficient, the greater the temperature difference, the higher the temperature rise coefficient.

[0050] During the procedure, when the patient's condition is stable, the infusion rate and temperature are constant, and the bladder temperature also remains stable. However, when the patient experiences exogenous or endogenous instability, and the bladder temperature decreases, the temperature difference... If the threshold is exceeded, dynamic adjustment of the inlet temperature will be triggered, and the adjusted inlet temperature T will be... in-adjust Adjust according to the heating coefficient; the larger the temperature difference, the higher the adjusted inlet temperature T. in-adjust The value will also increase, but will not exceed the set upper limit of the infusion fluid temperature. ;

[0051] Both the fixed temperature control mode and the intelligent temperature rise mode can help the bladder recover to a stable state more quickly. Compared with the fixed temperature control mode, the intelligent temperature rise mode can make more precise adjustments as needed.

[0052] S3: The temperature control unit controls the infusion fluid temperature control module to raise the temperature of the infusion fluid to T. in-adjust This is to accelerate the recovery of the patient's bladder temperature to a stable state, thereby reducing the probability of bladder contraction and bladder spasm;

[0053] S4: The temperature control unit controls the perfusion fluid temperature control module to raise the temperature to T. in-adjust The infusion fluid was gradually reduced to T. in When the perfusion fluid temperature returns to T in At that time, recalculate the temperature difference. ,like Still greater than the temperature rise threshold Then repeat steps S1, S2, and S3 until... .

[0054] In some surgical scenarios, the electrosurgical unit operates continuously for extended periods, generating heat faster than the irrigation fluid can remove it, potentially leading to excessively high bladder temperatures. Although this is relatively rare, it still needs to be considered. Some embodiments also include setting a cooling threshold. and the lower limit of the temperature of the perfusion fluid Cooling threshold ,when < When the cooling mode is activated, the temperature control unit controls the injection fluid temperature control module to cool the injection fluid. In cooling mode, the inlet temperature is dynamically adjusted according to the extent to which the real-time temperature difference exceeds the threshold, thus obtaining the adjusted inlet temperature T. in-adjust The calculation formula is as follows:

[0055] ;

[0056] In the formula: The cooling step size.

[0057] Since bladder capacity directly determines the heat exchange area and duration between the instillation fluid and the bladder mucosa, a larger capacity results in higher heat exchange efficiency, leading to a higher baseline temperature difference under steady-state conditions. If a fixed temperature rise threshold is used... Patients with large bladder capacity are prone to falsely triggered warming, meaning the baseline temperature difference is close to the fixed threshold. Patients with small bladder capacity, however, experience delayed intervention, meaning intervention is only implemented when the temperature difference exceeds the threshold, by which time bladder cooling has already occurred. Furthermore, some heat is lost as the instillation fluid flows within the circulating sheath. Therefore, in some embodiments of this invention, the warming threshold is... From the collected bladder capacity Pipeline heat dissipation and basic stable temperature difference Temperature threshold To confirm:

[0058] ;

[0059] In the formula: For the standard adult bladder capacity collected, This is the capacity influence coefficient, with a value ranging from 0.5 to 1.2. The heat dissipation influence coefficient has a value range of 0.5-1.2.

[0060] Bladder capacity Pipeline heat dissipation and basic stable temperature difference All samples were collected before surgery, and a pre-perfusion calibration procedure was performed in the early stages of surgery.

[0061] Bladder capacity Preoperative testing equipment is used to detect the volume, such as using an ultrasound probe to obtain a three-dimensional image and calculate the actual volume after filling.

[0062] Pipe cooling The heat dissipation efficiency of the irrigation fluid in the circulating sheath of different models of electrosurgical resuscitation scopes was calculated preoperatively. Piping heat dissipation as a reference ;

[0063] Basic stable temperature difference Infuse the bladder with physiological saline at a constant temperature of 37℃ and a uniform rate of 30 ml / min until the bladder is full to its standard capacity. Afterward, perfusion was maintained for 5 minutes, and the average temperature difference between the influent and outfluent during this period was collected as the mean. .

[0064] Similarly, cooling threshold The calculation formula is:

[0065] ;

[0066] In the formula: The value is the capacity influence coefficient during cooling, ranging from 0.5 to 1.2. This is the heat dissipation influence coefficient during cooling, with a value range of 0.5-1.2.

[0067] Finally, it should be noted that the above embodiments are only used to illustrate the technical solutions of the present invention and are not intended to limit it. Although the present invention has been described in detail with reference to preferred embodiments, those skilled in the art should understand that modifications or equivalent substitutions can be made to the technical solutions of the present invention without departing from the spirit and scope of the technical solutions of the present invention.

Claims

1. A method for intelligent temperature control of the bladder during plasma electroresection surgery, characterized in that: Includes the following steps: Step 1: Obtain the filling fluid temperature T of the inlet pipeline through the first detection module. in The temperature T of the injection fluid in the drainage pipeline is obtained through the second detection module. out ; Step 2: Set the temperature threshold Upper limit of injection fluid temperature Cooling threshold and the lower limit of the temperature of the perfusion fluid Calculate real-time temperature difference Determine the real-time temperature difference Does it exceed the temperature rise threshold? or below the cooling threshold ; Step 3: The temperature control unit adjusts the temperature based on the real-time temperature difference. With temperature rise threshold Cooling threshold The relationship between the two controls is used to control the temperature of the injection fluid by the temperature control module. > At that time, the temperature control unit controls the injection fluid temperature control module to heat the injection fluid, and the temperature during the heating process does not exceed the upper limit of the injection fluid temperature. ,when < At that time, the temperature control unit controls the injection fluid temperature control module to perform a cooling operation on the injection fluid, ensuring that the cooling temperature does not fall below the lower limit of the injection fluid temperature. ; Step 4: The temperature control unit controls the infusion fluid temperature control module to gradually bring the temperature of the infusion fluid back to T after temperature adjustment. in When the perfusion fluid temperature returns to T in At that time, recalculate the temperature difference. ,like Complete the temperature adjustment process; otherwise, repeat steps 1, 2, and 3.

2. The intelligent temperature control method for bladder surgery using plasma electroresection as described in claim 1, characterized in that, In step 3, the temperature control unit controls the injection fluid temperature control module to adjust the temperature of the injection fluid in two ways: fixed temperature adjustment mode and intelligent temperature adjustment mode.

3. The intelligent temperature control method for bladder surgery using plasma electroresection as described in claim 2, characterized in that, Fixed temperature control modes include: setting a fixed temperature increase value and a fixed temperature decrease value, when... > At that time, the temperature control unit controls the injection fluid temperature control module to raise the temperature of the injection fluid to a fixed temperature value at a fixed heating rate. At that time, the temperature control unit controls the injection fluid temperature control module to reduce the temperature of the injection fluid to a fixed cooling value at a fixed cooling rate.

4. The intelligent temperature control method for bladder surgery using plasma electroresection as described in claim 2, characterized in that, The intelligent temperature control mode dynamically adjusts the inlet liquid temperature based on the extent to which the real-time temperature difference exceeds a threshold, thus obtaining the adjusted inlet liquid temperature T. in-adjust The calculation formula for the heating operation is as follows: ； In the formula: This refers to the temperature increment step, which is an integer multiple of the control precision of the injection fluid temperature control module. This represents the maximum allowable temperature difference under steady-state conditions. This refers to the temperature rise coefficient; The calculation formula for cooling operations is as follows: ； In the formula: The cooling step size.

5. The intelligent temperature control method for bladder surgery using plasma electroresection as described in claim 1, characterized in that, Temperature rise threshold From the collected bladder capacity Pipeline heat dissipation and basic stable temperature difference Temperature threshold To determine this, the calculation formula is as follows: ； In the formula: For the standard adult bladder capacity collected, This is the capacity influence coefficient during temperature rise, with a value ranging from 0.5 to 1.

2. The heat dissipation influence coefficient during heating, with a value ranging from 0.5 to 1.2, represents the bladder capacity. Actual patient capacity, tubing heat dissipation This refers to the heat dissipation efficiency of the circulating sheath in the electrosurgical resection mirror. Piping heat dissipation as a reference Basic stable temperature difference ; Cooling threshold The calculation formula is: ； In the formula: The value is the capacity influence coefficient during cooling, ranging from 0.5 to 1.

2. This is the heat dissipation influence coefficient during cooling, with a value range of 0.5-1.

2.

6. A smart bladder temperature control system for plasma electroresection surgery, characterized in that, include: The first temperature detection module is used to monitor the filling fluid temperature T in the inlet pipeline. in ; The second temperature detection module is used to monitor the temperature T of the filling fluid in the drainage pipeline. out ; The injection fluid temperature control module is used to heat or cool the injection fluid. Temperature control unit, the temperature control unit is used to adjust the temperature T of the inlet pipe. in and the temperature T of the drainage pipeline out The temperature control unit is used to adjust the operation of the perfusion fluid temperature control module and to perform the method described in any one of claims 1-5.

Images