A partial nephrectomy system and apparatus based on an optical magnetic navigation system

Abstract

The embodiment of the specification provides a kidney partial resection system and device based on an optical magnetic navigation system, and relates to the field of intelligent medical treatment. The system comprises: an imaging and planning module configured to receive a kidney enhanced medical image of a subject, reconstruct a three-dimensional model of a kidney containing a tumor, kidney blood vessels and a collecting system according to the image; at least two magnetic positioning marker pre-fixing points are planned on the surface of the three-dimensional model, and the magnetic positioning marker pre-fixing points are determined according to the anatomical characteristics of the kidney tissue; an optical and magnetic positioning subsystem, a navigation control module configured to receive a real-time position signal of the magnetic positioning marker, and the actual fixing position of the magnetic positioning marker corresponds to the pre-fixing point; according to the corresponding relationship of at least one pair of "pre-fixing point-actual fixing position" and the position of the optical positioning marker, spatial registration is performed to establish a mapping relationship between the three-dimensional model and the kidney tissue in operation. The application solves the problem of intraoperative occlusion, adapts to the dynamic displacement of the kidney, and performs accurate planning and tracking based on anatomical characteristics.

Description

Technical Field

[0001] This invention relates to the field of intelligent medical care, and more specifically, to a partial nephrectomy system and apparatus based on an optical-magnetic navigation system. Background Technology

[0002] Partial nephrectomy (NSS) has gradually become the gold standard treatment for localized renal cell carcinoma. It aims to completely remove the tumor while preserving as much normal renal parenchyma as possible, thereby reducing the risk of postoperative complications such as renal insufficiency and uremia. It is especially suitable for patients with solitary kidney, bilateral renal cell carcinoma, and those with chronic kidney disease.

[0003] However, even though the clinical application of partial nephrectomy has evolved from traditional open surgery to minimally invasive laparoscopic and robot-assisted surgery, with continuously reduced surgical trauma and faster postoperative recovery, the core challenges remain unchanged: the kidney's complex anatomy, the delicate and variable course of renal arterial and venous branches, and the difficulty in accurately determining the spatial relationship between the collecting system (renal pelvis, ureter, etc.) and the tumor, especially for complex tumors such as endophytic, central, and multifocal tumors, make intraoperative tumor boundary localization difficult, timing of renal pedicle occlusion uncertain, and the precision of resection margin control and wound reconstruction directly determine surgical safety, tumor radicalization, and long-term renal function prognosis. Existing navigation-based surgeries mainly include purely optical navigation and purely electromagnetic navigation, or a simple combination of both; however, these navigation technologies all have significant limitations in partial nephrectomy. 1. Pure optical navigation is easily blocked by surgical instruments, assistant arms or surrounding tissues (such as fat, intestines, etc.), resulting in signal loss and inability to continuously track the blocked kidney; 2. Although pure electromagnetic navigation is not affected by line of sight obstruction, it is easily interfered with by metal objects (such as operating tables, electrosurgical units, etc.), resulting in positioning drift and making it difficult to meet the accuracy requirements of resting vascular anatomy. 3. While existing optical-magnetic composite navigation systems can partially compensate for interference, they are mostly simple signal superpositions with cumbersome registration procedures. They often rely on surface markers or skeletal landmarks and cannot accurately reflect the deformation and real-time displacement of soft tissue organs during partial nephrectomy caused by respiratory movements, changes in pneumoperitoneal pressure, and instrument traction. Furthermore, the fixation methods of markers in existing navigation schemes are arbitrary and lack standardized point selection principles based on anatomical features, easily leading to the accumulation of registration errors. When the accumulated error exceeds 1.5 mm, it is highly likely to mislead surgical operations and increase the risk of accidental injury to blood vessels and collecting systems. Summary of the Invention

[0004] The present invention aims to at least solve one of the technical problems existing in the prior art. To this end, the present invention provides a partial nephrectomy system and device based on a photomagnetic navigation system to solve the problem of intraoperative obstruction, adapt to the dynamic displacement of the kidney, and perform precise planning and tracking based on anatomical features.

[0005] The first aspect of this application discloses a partial nephrectomy system based on an optical-magnetic navigation system, comprising: The imaging and planning module is configured to receive enhanced medical images of the kidneys of the subject, reconstruct a three-dimensional model of the kidney including the tumor, renal vessels and urinary tract collecting system based on the images, and plan at least two pre-fixation points for magnetic positioning markers on the surface of the three-dimensional model, the pre-fixation points being determined based on the anatomical features of the kidney tissue; The optical positioning subsystem is configured to establish and maintain a spatial coordinate system based on optical positioning markers on the body surface, and to track the position of visible surgical instruments in the spatial coordinate system. The magnetic positioning subsystem is configured to generate a positioning magnetic field and a signal that tracks the real-time position of a magnetic positioning marker fixed to kidney tissue. The navigation control module is configured as follows: Receive the real-time position signal of the magnetic positioning marker, and the actual fixed position of the magnetic positioning marker corresponds to the pre-fixed point; Based on at least one pair of "pre-fixation point - actual fixation position" correspondences and the positions of the optical positioning markers, spatial registration is performed to establish a mapping relationship between the three-dimensional model and the intraoperative kidney tissue; based on the mapping relationship, surgical navigation information is generated and updated.

[0006] A second aspect of this application discloses a partial nephrectomy device based on a photomagnetic navigation system, the device comprising: Memory, used to store computer programs. A processor for executing the computer program to implement the functions of the system described in the first aspect of this application; And the hardware devices of the optical positioning subsystem and the magnetic positioning subsystem that are communicatively connected to the processor.

[0007] This application has the following beneficial effects: 1. This application discloses a division of labor between optical-magnetic navigation and magnetic navigation, with optical positioning subsystem responsible for overall tracking and magnetic navigation for local tracking. It clarifies that the optical positioning subsystem is responsible for establishing a stable global coordinate system and tracking visible instruments, while the magnetic positioning subsystem is specifically responsible for tracking the kidney obscured by tissue. This collaborative working mode of "optical positioning for overall tracking and magnetic tracking for local tracking" solves the problems of easy obscuration or drift in partial nephrectomy (because partial nephrectomy requires maximizing the preservation of normal kidney tissue, which is prone to deformation during surgery), significantly improving the dynamic tracking accuracy of the kidney and tumor, and accurately reflecting the dynamic displacement of the normal kidney during partial nephrectomy.

[0008] 2. This application is the first to propose a method for partial nephrectomy where marker fixation points are planned on a 3D model based on the characteristic anatomical structures of the kidney (such as the poles and hilum), and rigidly fixed at the corresponding positions during surgery. The closed loop of "virtual planning - physical fixation - real-time mapping" in this scheme ensures the integrated linkage between the markers and the kidney, realistically reflecting the dynamic displacement of the kidney. Furthermore, the point selection principles for pole fixation in this scheme have significant advantages compared to traditional random fixation or fixation solely on the body surface: the large span between the poles creates a long baseline, effectively resisting rotational errors and improving the accuracy of angle measurements; the poles represent the overall axial movement of the kidney, most accurately reflecting the overall displacement trend of the kidney; and it avoids the hilum and collecting system, reducing the risk of bleeding and urine leakage during fixation.

[0009] 3. This application combines a three-target registration strategy of “renal markers (core) + body surface markers (benchmark) + ultrasound feature points (verification)”, which significantly reduces registration error and improves the robustness and accuracy of the system. Attached Figure Description

[0010] To more clearly illustrate the technical solutions in the embodiments of the present invention, the accompanying drawings used in the description of the embodiments will be briefly introduced below. Obviously, the accompanying drawings described below are only some embodiments of the present invention. For those skilled in the art, other drawings can be obtained based on these drawings without creative effort.

[0011] Figure 1 This is a schematic diagram of a partial nephrectomy system based on an optical-magnetic navigation system provided in the first aspect of the present invention; Figure 2 This is a schematic diagram of a partial nephrectomy device based on an optical-magnetic navigation system provided in an embodiment of the present invention; Figure 3 This is a schematic diagram of the architecture of an exemplary computing device provided in an embodiment of the present invention. Detailed Implementation

[0012] To enable those skilled in the art to better understand the present invention, the technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings.

[0013] In some of the processes described in the specification, claims, and accompanying drawings of this invention, multiple operations appearing in a specific order are included. However, it should be clearly understood that these operations may not be executed in the order they appear herein, or may be executed in parallel. The operation numbers, such as 101, 102, etc., are merely used to distinguish different operations and do not represent any execution order. Furthermore, these processes may include more or fewer operations, and these operations may be executed sequentially or in parallel. It should be noted that the descriptions such as "first," "second," etc., in this document are used to distinguish different messages, devices, modules, etc., and do not represent a sequential order, nor do they limit "first" and "second" to different types.

[0014] The technical solutions of the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings. Obviously, the described embodiments are only some embodiments of the present invention, and not all embodiments. Based on the embodiments of the present invention, all other embodiments obtained by those skilled in the art without creative effort are within the scope of protection of the present invention.

[0015] Figure 1 This is a schematic diagram of a partial nephrectomy system based on an optical-magnetic navigation system provided in an embodiment of the present invention. Specifically, it includes: The imaging and planning module 101 is configured to receive enhanced medical images of the kidneys of the subject, reconstruct a three-dimensional model of the kidney including the tumor, renal vessels and urinary tract collecting system based on the images, and plan at least two pre-fixation points for magnetic positioning markers on the surface of the three-dimensional model, the pre-fixation points being determined based on the anatomical features of the kidney tissue. In some embodiments, the terms “subject” or “test subject” or “sample” as used herein refer to any animal (e.g., a mammal), including but not limited to humans, non-human primates, rodents, etc., which will become the recipient of a particular treatment. Generally, the terms “subject” and “patient” are used interchangeably herein when referring to human subjects. Preferably, the subject is a human.

[0016] In some embodiments, the pre-fixation points are selected from the upper pole of the kidney, the lower pole of the kidney, the surface region of the renal artery, the renal pelvis region, and the normal renal parenchyma region with avascular structures surrounding the tumor.

[0017] In some embodiments, the pre-fixation points of the at least two magnetic positioning markers are respectively selected from the upper and lower poles of the three-dimensional model, assuming that pre-fixation point A and pre-fixation point B are located at the upper and lower poles respectively. In simple terms, the "upper pole" and "lower pole" on the kidney model are the "top" and "bottom" of the kidney. Anatomically, the kidney is bean-shaped, and its long axis is inclined (higher inside and lower outside). Therefore, the "upper pole" refers to the most prominent part of the kidney towards the head (upper), and the "lower pole" is the most prominent part towards the foot (lower).

[0018] In some embodiments, the enhanced renal imaging includes images of the renal artery phase, venous phase, and excretory phase. These three "phases" refer to scans performed at different time points after contrast agent injection to observe the state of the contrast agent reaching different sites. Renal artery phase (or cortical phase): Approximately 25-35 seconds after contrast agent injection, the contrast agent has just reached the blood supply arteries of the kidney. During this phase, the renal cortex (outer layer) will significantly enhance and brighten, while the medulla (inner layer) and urine collection ducts have not yet enhanced. The focus is on observing the blood supply to the renal artery and renal tumor. Most renal tumors (such as renal cell carcinoma) have a rich blood supply and will show rapid and significant enhancement during this phase, contrasting with normal renal tissue for clear detection and evaluation. Renal venous phase (or parenchymal phase): Approximately 70-90 seconds after contrast agent injection, the contrast agent has filled the entire renal parenchyma (including the cortex and medulla), and the kidney becomes uniformly bright. Simultaneously, contrast-rich blood begins to flow back to the heart via the renal vein. This phase allows for comprehensive observation of the kidney's morphology, the overall appearance of the tumor, and vascular structures such as the renal vein and inferior vena cava. This phase allows assessment of whether the tumor has invaded the major veins of the kidney. The excretory phase (or renal pelvis phase, delayed phase): Approximately 3-5 minutes or even longer after contrast agent injection, the kidneys have filtered the contrast-containing blood into urine. The contrast agent enters the renal pelvis, calyces, and ureters with the urine, making these normally watery tubular structures clearly visible and bright. Meanwhile, the enhancement of the renal parenchyma begins to decrease. During this phase, the collecting system can be clearly visualized, allowing observation of whether the kidney's excretory function is normal. Some lesions (such as cysts) do not enhance during the excretory phase, while the enhancement characteristics of tumors vary at different stages; a comprehensive assessment provides a more accurate diagnosis.

[0019] The collecting system, also known as the urinary collecting system, refers to the tubular structures inside the kidneys responsible for collecting and transporting urine. It mainly consists of two parts: the renal calyces and the renal pelvis. The renal pelvis collects urine from all the renal calyces and drains it into the bladder through the ureters.

[0020] The optical positioning subsystem 102 is configured to establish and maintain a spatial coordinate system based on optical positioning markers on the body surface and to track the position of visible surgical instruments in the spatial coordinate system; it is used to capture optical reflection markers attached to bony landmarks on the patient's body surface (such as costovertebral angles and iliac crests) and surgical instruments equipped with optical reflection balls (such as laparoscopes, ultrasound probes, and dissecting forceps), and its function is to establish and maintain a "world coordinate system" that does not change with the movement of the kidney.

[0021] The magnetic positioning subsystem 103 is configured to generate a positioning magnetic field and track the real-time position of a magnetic positioning marker fixed to kidney tissue. Specifically, it includes a low-intensity magnetic field generator and a high-sensitivity magnetic sensor. The magnetic positioning marker can be firmly anchored to the kidney parenchyma. The marker has a built-in magnetic induction coil that can generate a specific signal in the magnetic field.

[0022] In some more specific embodiments, the imaging and planning module, the optical positioning subsystem, and the magnetic positioning subsystem are all completed during the preoperative preparation and intraoperative installation steps, specifically: 1. Patient image acquisition and 3D model construction: Acquire enhanced CT / MRI images of the patient's kidneys (including renal arterial, venous, and excretory phases) to ensure clear coverage of the kidneys, tumors, renal arteries and veins, and collecting system; import the images into a photomagnetic navigation workstation, and automatically segment to generate a 1:1 three-dimensional model; the surgeon uses the model to mark the tumor boundaries, safe resection lines, etc., and clarifies the kidney marker fixation points (prioritizing avascular normal renal parenchyma, routinely one, in complex cases two placed at opposite poles).

[0023] Objective: To provide accurate anatomical reference, clarify marker fixation location and surgical target, and lay the foundation for subsequent registration and tumor resection.

[0024] 2. Debugging of the optical-magnetic navigation system and preparation of equipment: Deploy a photomagnetic navigation system (infrared optical camera + low-intensity magnetic field generator); install and calibrate photomagnetic composite trackers on all intraoperative instruments (error < 0.5 mm); prepare a kidney-specific wired / wireless magnetic marker (wired preferred), and check its signal and anchoring end for integrity.

[0025] Objective: To ensure the proper functioning of the navigation system, instruments, and markers, avoid intraoperative navigation failure, provide accurate anatomical references for intraoperative navigation, clarify the marker fixation position and core surgical targets, plan the surgical path in advance, reduce blind intraoperative operations, and lay the foundation for subsequent marker registration and precise tumor resection.

[0026] 3. Patient positioning and fixation with surface markers: Assist the patient in assuming the surgical position (lateral decubitus, with the affected side facing up), and use a positioning pad to fix the trunk and limbs to ensure no significant displacement during the operation; fix 1-2 photoelectric and magnetic integrated surface markers at bony landmarks such as the costovertebral angle and iliac crest on the patient's affected side, ensuring they are not loose, as reference benchmarks for intraoperative registration, and assist in calibrating the spatial coordinates of the kidney marker; at the same time, mark the surgical incision area (affected abdomen, select 3-4 puncture points according to the tumor location, avoiding blood vessels, nerves and skin breaks).

[0027] It is known that the aforementioned surface markers can be categorized into optical reflective markers (typically made of highly reflective materials, capable of reflecting specific wavelengths of light such as infrared light, for optical positioning devices to capture and identify), electromagnetic induction markers (with built-in electromagnetic induction devices, capable of interacting with magnetic positioning systems, determining their position and orientation through changes in the electromagnetic field), and hybrid markers (combining the advantages of optical and magnetic positioning technologies). The optical positioning subsystem has been activated, capturing the surface markers and establishing an initial spatial coordinate system. At this point, the kidney tissue is not yet exposed, but its approximate position relative to the body surface is known.

[0028] Objective: To fix the patient's position and avoid the impact of intraoperative positional changes on navigation accuracy; to establish spatial associations through surface markers and mark the opening area to provide clear guidance for subsequent surgical incisions and implantation of auxiliary instruments, thereby reducing opening deviation.

[0029] 4. Surgical incision procedure (laparoscopic puncture incision) Based on the preoperatively marked puncture points, combined with the laparoscopic field of view and the preoperative navigation model, 2-3 auxiliary puncture sites (5-10mm) are made sequentially on the affected side of the abdomen, and different auxiliary instruments are implanted accordingly. Ensure that the spacing between the puncture sites is reasonable and avoid mutual interference between instrument operations.

[0030] Objective: To establish a laparoscopic surgical channel, expose the surgical field through pneumoperitoneum, provide operating space for subsequent implantation of auxiliary instruments, kidney exposure and marker fixation, ensure precise and sterile incision, and avoid damage to other organs in the abdominal cavity.

[0031] 5. Install kidney markers Guided by the navigation system, the forceps gently stabilize the kidney tissue to prevent displacement. The surrounding tissue of the renal hilum is carefully dissected to initially expose the course of the renal hilum vessels, clarify the tumor location, and reconfirm the pre-marked marker fixation points (normal renal parenchyma areas without vessels or tumors, far from the renal hilum and collecting system), ensuring the points are clear and unobstructed. According to the pre-operative plan, the operator locates the corresponding anatomical positions (such as the upper and lower poles) on the actual kidney during the operation and rigidly fixes the magnetic positioning markers to the pre-set fixation points using minimally invasive anchoring or suturing. At this point, the magnetic positioning markers become integrated with the kidney, and any movement of the kidney (breathing, traction) is immediately transmitted to the magnetic positioning markers.

[0032] Objective: To fully expose the kidney and surrounding anatomical structures, clarify the marker fixation points, provide a clear surgical field for precise marker fixation, and avoid damage to renal blood vessels, collecting system, or tumors during fixation.

[0033] A dual fixation method combining minimally invasive anchoring and suture reinforcement is employed to directly fix the magnetic marker to pre-defined locations on the kidney. At least two markers are implanted at both poles of the kidney to prevent positioning deviations due to displacement. In this embodiment, the selection principle for marker fixation points or pre-defined kidney locations is generally to locate them at both ends of the kidney, finding a distinctive, easily identifiable, and stable installation location, such as the surface of the renal artery, the tumor site, the renal pelvis region, the upper pole of the kidney, and the lower pole of the kidney.

[0034] The navigation control module 104, acting as the system's brain, is responsible for data reception, fusion, coordinate transformation, etc., and is configured as follows: Receive the real-time position signal of the magnetic positioning marker, and the actual fixed position of the magnetic positioning marker corresponds to the pre-fixed point; Based on at least one pair of "pre-fixation point - actual fixation position" correspondences and the positions of the optical positioning markers, spatial registration is performed to establish a mapping relationship between the three-dimensional model and the intraoperative kidney tissue; based on the mapping relationship, surgical navigation information is generated and updated.

[0035] In some embodiments, the spatial registration performed in the navigation control module specifically includes: To obtain the location of the auxiliary registration point on the surface of the kidney using an intraoperative ultrasound probe equipped with a locator. The positions of the auxiliary registration points, the actual fixed positions of the magnetic positioning markers, and the positions of the surface optical positioning markers are matched and calculated with the corresponding points in the three-dimensional model to complete the registration.

[0036] In some embodiments, the navigation control module is further configured to: calculate in real time the distance between the tracked visible surgical instrument and the tumor boundary, renal vessels, or urinary tract collection system in the three-dimensional model; and control the system to generate an early warning signal when the distance is less than a preset safety threshold.

[0037] In some embodiments, the navigation control module is further configured to: During tumor resection along the resection path determined by navigation information, the signal stability of the magnetic positioning markers is continuously monitored. If the registration error caused by the displacement of the marker exceeds the tolerance, a re-registration process is triggered; the re-registration process includes at least re-identifying the magnetic positioning marker that has been displaced.

[0038] In some more specific embodiments, the navigation control module specifically performs the registration steps: 1. Multi-target registration: Activate the optical-magnetic navigation system and use a dedicated optical-magnetic probe (auxiliary instrument) to select three core target points in sequence to complete the registration: ① Magnetic markers fixed on the kidney (1-2, all need to be selected); ② Surface auxiliary markers (all fixed surface markers need to be selected); ③ Intraoperative ultrasound probe (auxiliary instrument, with a tracker attached) scans the kidney, aligns the ultrasound section with the preoperative 3D model, and selects 2-3 feature points on the kidney surface (such as the renal poles, avascular depressions) for auxiliary calibration.

[0039] Taking the aforementioned pre-fixation points A and B, located at the upper and lower poles respectively, as examples, a probe equipped with a dual optical and magnetic tracker touches the center of a magnetic marker fixed on the kidney with its tip. The system simultaneously reads: ① the position of the probe tip in the global coordinate system (provided by the optical system); ② the signal characteristics of the magnetic marker. The system matches this physical position with pre-fixation points A and B in the 3D model, establishing a precise correspondence between model point A and real point A, and model point B and real point B. To further eliminate errors, the operator uses an intraoperative ultrasound probe equipped with a tracker to scan the kidney surface, selecting 2-3 obvious anatomical feature points (such as the renal hilum depression, vascular pulsation points), aligning the ultrasound image with the 3D model to confirm the positions of these points. The navigation control module integrates all the above point pairs (at least one core point + surface reference + auxiliary points) to calculate the optimal spatial transformation matrix. At this point, the 3D model is "locked" onto the actual kidney.

[0040] Because the magnetic marker is rigidly fixed to the kidney, when the kidney moves up and down due to breathing or is pulled and displaced by instruments, the magnetic subsystem detects the change in the marker's position in real time. The navigation control module immediately uses this change to update the position of the 3D model on the screen in real time, ensuring that the virtual model always coincides with the real kidney. Even if the kidney is completely obscured by surrounding tissues, the model still accurately displays its position.

[0041] Objective: To establish a spatial coordinate relationship between the preoperative 3D model, the actual intraoperative renal anatomy, and the navigation system. This aims to improve registration accuracy with the aid of auxiliary instruments, ensuring that the navigation system can accurately deduce the real-time location of the kidney and tumor by tracking the coordinate changes of the kidney marker, thus eliminating discrepancies between preoperative imaging and the actual intraoperative anatomy. Core target points include feature points on the body surface and on the kidney. The kidney-related points are core targets and must be selected. The body surface points are auxiliary; at least three points should be selected, with more points resulting in greater accuracy.

[0042] 2. Navigation system debugging and verification After registration, move the laparoscopic lens, ultrasound probe, dissecting forceps, and other auxiliary instruments, and observe the real-time image on the navigation workstation: ① Confirm that the signals of the kidney marker and all auxiliary instrument trackers are stable, without loss or drift; ② Compare the AR fusion effect of the preoperative 3D model and the intraoperative laparoscopic image to ensure the accurate superposition of the tumor, blood vessels, and collecting system; ③ Use dissecting forceps and electric hooks (auxiliary instruments) to simulate the resection path and verify that the distance error between the instruments and the tumor and blood vessels displayed by the navigation system is ≤1mm, which meets the surgical precision requirements.

[0043] Objective: To verify the synergy, accuracy, and stability of the navigation system and assistive devices, eliminate registration errors and signal interference, ensure reliable subsequent navigation guidance, and avoid surgical errors caused by navigation deviations.

[0044] In some embodiments, the system further includes: performing tumor resection operations guided by navigation information. 1. Tumor boundary localization and marking: By using a navigation AR fusion view (the continuous application of combining preoperative imaging with AR), the location of the tumor within the kidney (especially endophytic tumors) can be clearly seen. The navigation marks the tumor boundary and the 5-10mm safety resection line in real time. An ultrasound probe (auxiliary instrument) is used in conjunction with the navigation to double confirm the tumor boundary. An electric hook (auxiliary instrument) is used to mark the kidney surface along the safety resection line. The kidney is fixed with a grasping forceps to prevent kidney displacement during marking and to ensure that the marking line accurately covers the safety margin, avoiding the omission of tumors or excessive removal of normal renal parenchyma.

[0045] Objective: To address the challenge of locating complex tumors (endophytic and central types) that are not directly visible to the naked eye using assistive devices, accurately mark the resection area, provide clear guidance for subsequent resection operations, and ensure complete tumor resection (R0 resection).

[0046] 2. Precise tumor removal: Following the safety resection line marked by the navigation, the renal parenchyma and tumor are removed layer by layer using an ultrasonic scalpel or electrocautery hook (auxiliary instrument). Grasping forceps assist in pulling the removed tissue, and a suction device cleans the surgical field of bleeding and tissue debris in real time to ensure a clear surgical field. During the resection, the navigation system displays the distance between the instrument tip and the residual tumor area, collecting system, and renal vessels in real time. When the instrument approaches a dangerous area (such as the collecting system or major vessels), a warning signal is issued. For endophytic tumors, the navigation guides the surgeon to remove the tumor layer by layer "from superficial to deep," providing real-time feedback on the depth of the resection margin to ensure no tumor residue. During the resection, the renal marker signal is closely observed. If slight displacement occurs, the marker is immediately re-selected with a probe (auxiliary instrument) to complete rapid calibration.

[0047] Objective: To precisely remove tumors under navigation guidance with the aid of auxiliary instruments, control the precision of the resection margin, avoid cutting through the collecting system and damaging major blood vessels, and reduce damage to normal renal parenchyma, so as to balance tumor radicalization and renal function protection. The optical guide plays a role in internal coarse positioning during the installation of the magnetic locator in the kidney.

[0048] Figure 2 This is a schematic diagram of a partial nephrectomy device based on an optical-magnetic navigation system provided in an embodiment of the present invention. The device includes: A memory for storing computer programs; a processor for executing the computer programs to implement the functions of the system described in the first aspect of this application; and hardware devices for the optical positioning subsystem and the magnetic positioning subsystem that are communicatively connected to the processor.

[0049] In some embodiments, the device further includes at least two magnetic positioning markers configured to be rigidly fixed to corresponding anatomical locations on the kidney tissue according to the pre-fixation point plan.

[0050] In some embodiments, the pre-fixation points are selected from the upper pole of the kidney, the lower pole of the kidney, the surface region of the renal artery, the renal pelvis region, and the normal renal parenchyma region with avascular structures surrounding the tumor.

[0051] like Figure 2 As shown, the device 2000 may include: one or more processors 2010 and one or more memories 2020; wherein the memories store computer-readable code that, when run by the one or more processors, can perform the methods described above.

[0052] The processor in this embodiment can be an integrated circuit chip with signal processing capabilities. The processor can be a general-purpose processor, a digital signal processor (DSP), an application-specific integrated circuit (ASIC), an off-the-shelf programmable gate array (FPGA), or other programmable logic devices, discrete gate or transistor logic devices, or discrete hardware components. It can implement or execute the methods, operations, and logic block diagrams disclosed in this embodiment. The general-purpose processor can be a microprocessor or any conventional processor, and can be based on an x86 or ARM architecture.

[0053] In general, the various exemplary embodiments of this disclosure can be implemented in hardware or dedicated circuitry, software, firmware, logic, or any combination thereof. Some aspects can be implemented in hardware, while others can be implemented in firmware or software that can be executed by a controller, microprocessor, or other computing device. When aspects of embodiments of this disclosure are illustrated or described as block diagrams, flowcharts, or using some other graphical representation, it will be understood that the blocks, apparatuses, systems, techniques, or methods described herein can be implemented as non-limiting examples in hardware, software, firmware, dedicated circuitry or logic, general-purpose hardware or controllers or other computing devices, or some combination thereof.

[0054] For example, the method or apparatus according to embodiments of this disclosure can also be used by means of Figure 3 The architecture of the computing device 3000 shown is used for implementation. For example... Figure 3 As shown, the computing device 3000 may include a bus 3010, one or more CPUs 3020, a read-only memory (ROM) 3030, a random access memory (RAM) 3040, a communication port 3050 connected to a network, an input / output component 3060, a hard disk 3070, etc. The storage devices in the computing device 3000, such as the ROM 3030 or the hard disk 3070, may store various data or files used for processing and / or communication of the methods provided in this disclosure, as well as program instructions executed by the CPU. The computing device 3000 may also include a user interface 3080. Of course, Figure 3 The architecture shown is merely exemplary and can be omitted as needed when implementing different devices. Figure 3 One or more components in the computing device shown.

[0055] The exemplary embodiments of this disclosure described in detail above are merely illustrative and not restrictive. Those skilled in the art will understand that various modifications and combinations can be made to these embodiments or their features without departing from the principles and spirit of this disclosure, and such modifications should fall within the scope of this disclosure.

Claims

1. A partial nephrectomy system based on an optical-magnetic navigation system, characterized in that, include: The imaging and planning module is configured to receive enhanced medical images of the kidneys of the subject, reconstruct a three-dimensional model of the kidney including the tumor, renal vessels and urinary tract collecting system based on the images, and plan at least two pre-fixation points for magnetic positioning markers on the surface of the three-dimensional model, the pre-fixation points being determined based on the anatomical features of the kidney tissue; The optical positioning subsystem is configured to establish and maintain a spatial coordinate system based on optical positioning markers on the body surface, and to track the position of visible surgical instruments in the spatial coordinate system. The magnetic positioning subsystem is configured to generate a positioning magnetic field and a signal that tracks the real-time position of a magnetic positioning marker fixed to kidney tissue. The navigation control module is configured as follows: Receive the real-time position signal of the magnetic positioning marker, and the actual fixed position of the magnetic positioning marker corresponds to the pre-fixed point; Based on at least one pair of "pre-fixation point - actual fixation position" correspondences and the positions of the optical positioning markers, spatial registration is performed to establish a mapping relationship between the three-dimensional model and the intraoperative kidney tissue; based on the mapping relationship, surgical navigation information is generated and updated.

2. The partial nephrectomy system based on an optical-magnetic navigation system according to claim 1, characterized in that, The spatial registration process performed in the navigation control module specifically includes: To obtain the location of the auxiliary registration point on the surface of the kidney using an intraoperative ultrasound probe equipped with a locator. The positions of the auxiliary registration points, the actual fixed positions of the magnetic positioning markers, and the positions of the surface optical positioning markers are matched and calculated with the corresponding points in the three-dimensional model to complete the registration.

3. The partial nephrectomy system based on an optical-magnetic navigation system according to claim 1, characterized in that, The pre-fixation points are selected from the upper pole of the kidney, the lower pole of the kidney, the surface area of ​​the renal artery, the renal pelvis area, and the normal renal parenchyma area with no blood vessels around the tumor.

4. The partial nephrectomy system based on an optical-magnetic navigation system according to claim 3, characterized in that, The pre-fixed points of the at least two magnetic positioning markers are respectively selected from the upper and lower poles of the three-dimensional model.

5. The partial nephrectomy system based on an optical-magnetic navigation system according to claim 1, characterized in that, The enhanced renal imaging includes images of the renal arterial phase, venous phase, and excretory phase.

6. The partial nephrectomy system based on an optical-magnetic navigation system according to claim 1, characterized in that, The navigation control module is also configured to: calculate in real time the distance between the tracked visible surgical instrument and the tumor boundary, renal vessels, or urinary tract collection system in the three-dimensional model; and control the system to generate an early warning signal when the distance is less than a preset safety threshold.

7. The partial nephrectomy system based on an optical-magnetic navigation system according to claim 1, characterized in that, The navigation control module is also configured to: During tumor resection along the resection path determined by navigation information, the signal stability of the magnetic positioning markers is continuously monitored. If the registration error caused by the displacement of the marker exceeds the tolerance, a re-registration process is triggered; the re-registration process includes at least re-identifying the magnetic positioning marker that has been displaced.

8. A partial nephrectomy device based on an optical-magnetic navigation system, characterized in that, The device includes: Memory, used to store computer programs. A processor for executing the computer program to perform the functions of the system according to any one of claims 1-7; And the hardware devices of the optical positioning subsystem and the magnetic positioning subsystem that are communicatively connected to the processor.

9. The nephrectomy device based on an optical-magnetic navigation system according to claim 8, characterized in that, The device also includes at least two magnetic positioning markers configured to be rigidly fixed to the corresponding anatomical location of the kidney tissue according to the pre-fixation point plan.

10. The nephrectomy device based on an optical-magnetic navigation system according to claim 8, characterized in that, The pre-fixation points are selected from the upper pole of the kidney, the lower pole of the kidney, the surface area of ​​the renal artery, the renal pelvis area, and the normal renal parenchyma area with no blood vessels around the tumor.

Images