A method and system for coordinated control of irrigation pressure and laser in scrotal endoscopic surgery.

Abstract

This application relates to a method for coordinated control of perfusion pressure and laser in scrotal endoscopic surgery, comprising the following steps: acquiring pressure data within the tunica vaginalis cavity; comparing the pressure data with a preset target pressure range; adjusting the perfusion flow rate or output pressure based on the comparison result to maintain the pressure within the tunica vaginalis cavity within the target pressure range; monitoring the laser's operating status; and increasing the perfusion flow rate within a preset time period before laser emission when a pre-trigger signal indicating that the laser is about to enter the excitation state is detected. This invention, by monitoring the laser pre-trigger signal, increases the perfusion flow rate in advance before laser emission and delays its recovery after laser emission, ensuring precise synchronization between laser output and perfusion cooling. This solves the problem of independent laser and perfusion without coordination in existing technologies, significantly reducing the risk of thermal damage to surrounding important tissues such as the epididymis, vas deferens, and tunica albuginea during laser cutting.

Description

Technical Field

[0001] This invention relates to the field of minimally invasive surgery and automated control technology of medical devices, specifically to a method and system for the coordinated control of perfusion pressure and laser in scrotoscopic surgery. Background Technology

[0002] Testicular torsion is a common emergency in adolescent males. While traditional open surgery is effective, it has drawbacks such as significant trauma, postoperative pain, and a long recovery period. With the development of minimally invasive surgical techniques, scrotal endoscopy has gradually been promoted and applied in clinical practice due to its advantages of minimal trauma, rapid recovery, and fewer complications, becoming one of the important surgical procedures for treating testicular torsion.

[0003] Currently, in scrotoscopic surgery, the perfusion pressure and flow rate within the tunica vaginalis cavity are mainly adjusted manually by the surgeon based on the endoscopic view. If the perfusion pressure is too low, the tunica vaginalis cavity will not expand sufficiently, resulting in an unclear surgical field and affecting operational accuracy. If the perfusion pressure is too high or the flow rate is too large, the perfusion fluid may leak into the subcutaneous tissue, causing scrotal edema and even affecting postoperative recovery. Furthermore, while holmium lasers generate a large amount of heat when cutting tissue, and the perfusion fluid has a cooling effect, in existing surgical systems, the laser emission and the perfusion pump operate independently, lacking a synergistic mechanism. When the laser is output at high power or for a long time, if the perfusion flow rate does not increase accordingly, local tissue heat cannot be removed in time, potentially damaging the epididymis, vas deferens, or testis. The procedure carries risks to surrounding vital tissues such as the tunica albuginea, and current techniques primarily rely on the surgeon's experience and judgment to mitigate these risks, lacking objective and quantifiable control methods. Furthermore, in existing scrotal endoscopic surgery, surgeons mainly rely on visual observation and experience to assess tissue temperature, lacking real-time and quantifiable temperature monitoring. If tissue temperature exceeds the safety threshold and is not detected and intervened in time, irreversible thermal damage may occur. Currently, there are no reports of combining real-time intraoperative tissue temperature monitoring with automatic laser power control. Therefore, there is an urgent need for an intelligent control method that can deeply integrate and coordinate the control of perfusion pressure, holmium laser output, and intraoperative temperature monitoring to solve these problems and improve surgical safety. Summary of the Invention

[0004] This application provides a method and system for the coordinated control of perfusion pressure and laser in scrotoscopic surgery, in order to solve the problems of blind perfusion control, poor coordination between laser and perfusion operation, and lack of real-time monitoring and active intervention of thermal damage in the prior art, thereby realizing refined and automated closed-loop management of the surgical process.

[0005] In a first aspect, embodiments of this application provide a method for the coordinated control of perfusion pressure and laser during scrotal endoscopic surgery, comprising the following steps: Acquire pressure data within the tunica vaginalis cavity, compare the pressure data with a preset target pressure range, and adjust the perfusion flow rate or output pressure based on the comparison result to maintain the pressure within the tunica vaginalis cavity within the target pressure range; Monitor the working status of the laser. When a pre-trigger signal is detected that the laser is about to enter the excitation state, increase the perfusion flow rate within a preset time period before the laser is emitted, and restore the perfusion flow rate to the value before the increase after a preset delay time after the laser stops. Real-time temperature data of the tissue surface is acquired, and the real-time temperature data is compared with preset multi-level temperature thresholds. Based on the comparison results, corresponding protective actions are executed. The execution priority of the protective actions is higher than the execution priority of increasing the perfusion flow rate, and the execution priority of increasing the perfusion flow rate is higher than the execution priority of adjusting the perfusion flow rate or output pressure to maintain the intrathecal pressure.

[0006] In conjunction with the first aspect, in one embodiment, the increase in perfusion flow rate during a preset time period before laser emission is determined by a preset mapping relationship, and the adjustment of perfusion flow rate or output pressure based on the comparison result is achieved through PID control.

[0007] In conjunction with the first aspect, in one implementation, the preset mapping relationship is determined by the following mathematical expression: ; in, To increase the infusion flow rate, P is the set laser power value, and k is the calibration coefficient.

[0008] In conjunction with the first aspect, in one embodiment, the preset mapping relationship is achieved through a preset calibration table, which records multiple discrete laser power values ​​and their corresponding increased perfusion flow rates.

[0009] In conjunction with the first aspect, in one implementation, it further includes: During laser excitation, if the rate of increase of the pressure data in the sheath cavity exceeds a preset rate threshold, the increase in perfusion flow is limited to a preset percentage of the originally planned increase.

[0010] In conjunction with the first aspect, in one embodiment, acquiring the pressure data within the sheath cavity specifically includes: Pressure data is acquired by a first pressure sensor integrated into the proximal end of the scrotum mirror. Pressure data is acquired via a second pressure sensor integrated at the distal end of the scrotum mirror as a redundant backup. When an abnormality is detected in the first pressure sensor, the system automatically switches to the second pressure sensor to obtain pressure data and enters a degraded operation mode.

[0011] In conjunction with the first aspect, in one embodiment, the criteria for detecting an abnormality in the first pressure sensor include: the difference between the readings of the first pressure sensor and the second pressure sensor exceeds a preset difference threshold and the duration exceeds a preset time, or the signal of the first pressure sensor exceeds the effective range. The degraded operating modes include: reducing the maximum output rate of the injection pump and / or extending the response time of pressure regulation.

[0012] In conjunction with the first aspect, in one embodiment, a pipeline blockage detection step is further included: when the pressure data obtained by the first pressure sensor is higher than the first blockage threshold and the pressure data obtained by the second pressure sensor is lower than the second blockage threshold, the pipeline is determined to be blocked, the injection flow rate is reduced to a preset safety value, and an alarm signal is triggered.

[0013] In conjunction with the first aspect, in one implementation, comparing the real-time temperature data with preset multi-level temperature thresholds and executing corresponding protection actions based on the comparison results specifically includes: When the real-time temperature data is greater than or equal to the first temperature threshold, an early warning signal is triggered; When the real-time temperature data is greater than or equal to the second temperature threshold, the current laser output power is reduced by 50%, or reduced to a preset safe power value. When the real-time temperature data is greater than or equal to the third temperature threshold, the laser output is paused until the real-time temperature data is less than the second temperature threshold.

[0014] Secondly, embodiments of this application provide a system based on a method for coordinated control of perfusion pressure and laser during scrotal endoscopy, comprising: An infusion pump is used to infuse liquid into the sheath cavity; Laser host, which is used to generate and control laser output; The pressure detection module is used to acquire pressure data within the sheath cavity; Temperature detection module, which is used to acquire real-time temperature data of tissue surface; The control unit, which is communicatively connected to the infusion pump, the laser host, the pressure detection module, and the temperature detection module, is configured as follows: The pressure data is compared with a preset target pressure range, and the perfusion flow rate or output pressure is adjusted based on the comparison result to maintain the intrathecal pressure within the target pressure range. Monitor the working status of the laser. When a pre-trigger signal is detected that the laser is about to enter the excitation state, increase the perfusion flow rate within a preset time period before the laser is emitted, and restore the perfusion flow rate to the value before the increase after a preset delay time after the laser stops. The real-time temperature data is compared with preset multi-level temperature thresholds, and corresponding protection actions are executed based on the comparison results. The execution priority of the protective action is higher than that of increasing the perfusion flow rate, and the execution priority of increasing the perfusion flow rate is higher than that of adjusting the perfusion flow rate or output pressure to maintain the intrathecal pressure.

[0015] The beneficial effects of the technical solutions provided in this application include: 1. This invention acquires real-time intravaginal pressure data of the tunica vaginalis and uses a closed-loop control algorithm to automatically adjust the perfusion flow rate or output pressure, ensuring that the intravaginal pressure is stably maintained within a preset target range. This effectively avoids complications such as unclear vision due to excessively low perfusion pressure and scrotal edema caused by excessively high perfusion pressure. Simultaneously, this invention monitors the laser pre-trigger signal, increasing the perfusion flow rate in advance before laser emission and delaying its recovery after laser emission. This ensures precise synchronization between laser output and perfusion cooling, solving the problem of independent laser and perfusion without coordination in existing technologies. This significantly reduces the risk of thermal damage to important surrounding tissues such as the epididymis, vas deferens, and tunica albuginea during laser cutting.

[0016] 2. This invention acquires real-time temperature data of the tissue surface and compares it with preset multi-level temperature thresholds. Based on the different temperature ranges, it executes graded protection actions such as early warning prompts, automatic power reduction, and forced suspension of laser output. Compared with the existing technology that relies solely on the operator's visual observation and experience judgment, this invention provides an objective and quantitative temperature monitoring and graded intervention mechanism. The system automatically intervenes when the operator fails to respond in time, forming a complete safety protection chain from early warning and power reduction to forced shutdown, effectively avoiding thermal damage accidents caused by subjective judgment delays or errors.

[0017] 3. This application uses dual pressure sensors with redundancy for both proximal and distal ends. When the main sensor malfunctions, it automatically switches to the backup sensor and enters a degraded operation mode. It also uses pipeline blockage detection to achieve automatic protection under abnormal conditions, which significantly improves the system's fault tolerance and the continuity of surgery, ensuring that surgery can still be performed safely in extreme situations such as sensor failure or pipeline abnormalities. Attached Figure Description

[0018] To more clearly illustrate the technical solutions in the embodiments of this application, 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 this application. For those skilled in the art, other drawings can be obtained based on these drawings without creative effort.

[0019] Figure 1This is the main control flowchart of the co-control method of infusion pressure and laser of the present invention; Figure 2 This is a flowchart of the fault redundancy and safety handling process of the present invention. Detailed Implementation

[0020] To enable those skilled in the art to better understand the present application, the technical solutions in the embodiments of the present application will be clearly and completely described below with reference to the accompanying drawings. Obviously, the described embodiments are only some embodiments of the present application, and not all embodiments. Based on the embodiments in the present application, all other embodiments obtained by those of ordinary skill in the art without creative effort are within the scope of protection of the present application.

[0021] Example 1: This embodiment provides a coordinated control system for irrigation pressure and laser during scrotoscopic surgery, which mainly includes: a scrotum endoscope, an irrigation pump, a laser host, and a control unit. Specifically: Scrotumoscope: In this embodiment, the scrotumoscope is based on a rigid ureteroscope. A miniature MEMS pressure sensor (model: SMI SM5420) is embedded in the outer wall of the foremost end of the scrotumoscope as the first pressure sensor. Its signal cable is led out through the instrument channel bypass. A second pressure sensor (using the same model MEMS sensor or fiber optic pressure sensor) is set at the distal end of the scrotumoscope, the inner wall of the trocar, or in the irrigation tubing as a redundancy backup and communicates with the control unit. The first pressure sensor is used to acquire real-time pressure data in the sheath cavity, and the second pressure sensor is used to provide backup pressure data when the first pressure sensor is abnormal. A K-type miniature thermocouple is fixed at the front end of the endoscope and next to the field of view window. The temperature measuring point protrudes slightly from the surface of the endoscope to ensure reliable contact with the tissue surface during surgery and to acquire real-time temperature data of the tissue surface. Infusion pump: It adopts a medical intelligent constant pressure infusion pump with an external serial communication interface; Laser host: A medical holmium laser machine with an external control interface is used, which accepts external control commands through the RJ45 interface.

[0022] Control unit: It adopts an embedded industrial computer, which integrates a data acquisition card and an analog / digital output card. It controls the injection pump through an RS232 serial communication interface and controls the laser host through a digital I / O interface.

[0023] The above model selection is only an example. Those skilled in the art can select other models with the same or similar functions according to actual needs, and all of them are within the protection scope of this invention.

[0024] Example 2: Please see Figure 1 and Figure 2 Based on the coordinated control system of perfusion pressure and laser in scrotoscopic surgery provided in Embodiment 1, this embodiment provides a method for coordinated control of perfusion pressure and laser in scrotoscopic surgery, which mainly includes the following steps: S1. Acquire pressure data within the tunica vaginalis cavity, compare the pressure data with a preset target pressure range, and adjust the perfusion flow rate or output pressure based on the comparison result to maintain the pressure within the tunica vaginalis cavity within the target pressure range. Specifically, the control unit acquires the pressure value within the tunica vaginalis cavity in real time through a first pressure sensor integrated at the front end of the scrotum endoscope. The control unit will With respect to the preset target pressure range Compare; In this embodiment, the preset target pressure range The determination of the target pressure range needs to balance effective expansion of the tunica vaginalis cavity with safe tissue perfusion. On the one hand, the pressure inside the tunica vaginalis cavity needs to reach above 8 mmHg to allow for sufficient expansion of the cavity and unfolding of the folds, thus obtaining a clear surgical field. On the other hand, children have a smaller tunica vaginalis cavity volume (usually 5–15 ml) and more porous tissues, resulting in lower tolerance to increased pressure. When the pressure remains above 15 mmHg, the perfusion fluid may leak into the subcutaneous tissue along the interstitial spaces, causing scrotal edema. Considering the above factors, in this embodiment, the target pressure range is preferably... =8mmHg, =12mmHg.

[0025] when < At this time, the control unit sends a command to the infusion pump to increase the infusion flow rate or output pressure; when ≥ At this time, the control unit sends a command to the infusion pump to reduce the infusion flow rate or output pressure. Through the above closed-loop control, the pressure inside the sheath cavity is maintained within the target pressure range. In this embodiment, a PID control algorithm is used to achieve the above-mentioned closed-loop regulation. Since the MEMS pressure sensor has high response characteristics, the system can use a higher proportional gain to achieve a fast response. Simultaneously, to avoid system oscillation caused by pressure disturbances due to laser pulses, appropriate integral and derivative parameters need to be set. After experimental tuning, the preferred PID parameters in this embodiment are: =1.2, =0.3, =0.08. Under the above parameters, the system's step response rise time is less than 0.3 seconds, overshoot is less than 10%, and settling time is less than 0.5 seconds. When a laser pulse (duration 0.1–0.5 seconds) causes pressure disturbance, the pressure fluctuation can be controlled within ±2 mmHg. It is understood that the above parameters (target pressure range, PID parameters) are preferred solutions in this embodiment. For patients of different ages (such as adult patients, whose tunica vaginalis volume is larger and tissue compliance is higher), the upper limit of the pressure range can be appropriately increased to 15-20 mmHg. For different models of infusion pumps (such as pumps with different response speeds), the PID parameters need to be readjusted according to the actual response characteristics. Those skilled in the art can make adaptive adjustments for different surgical scenarios based on the technical concept and the above determination basis of this invention, which are all within the protection scope of this invention.

[0026] S2. Monitor the working status of the laser. When a pre-trigger signal is detected that the laser is about to enter the excitation state, increase the perfusion flow rate within a preset time period before the laser is emitted, and restore the perfusion flow rate to the value before the increase after a preset delay time after the laser stops. S201: Increased infusion flow rate; The control unit monitors the working status of the laser host in real time. When a pre-trigger signal is detected that the laser is about to enter the excitation state, the control unit increases the perfusion flow rate within a preset time period before laser emission to perform predictive flow boosting. In this embodiment, the pre-trigger signal for the excitation state is preferably the pre-trigger signal of the laser host start switch, and the preset time period is preferably 50ms before laser emission. This ensures that before the laser energy begins to act on the tissue, the cooling medium reaches the target area before the heat, forming a continuous liquid film on the tissue surface. When the laser begins to cut, the increased perfusion flow rate can promptly remove the heat generated by the laser, keeping the tissue temperature within a safe range. The preset time period can be adjusted according to the actual performance of the laser host or the surgical requirements. The increased infusion flow rate is determined based on a preset laser power value and a preset mapping relationship. Specifically, the mapping relationship uses a linear formula. ;in, For the increased perfusion flow rate, P is the laser power value, and k is the calibration coefficient; In this embodiment, the calibration coefficient k is determined as follows: During the preoperative preparation stage, using the same perfusion fluid and perfusion tubing as the surgery, different laser powers (e.g., 5W, 10W, 15W, 20W, 25W) are tested under in vitro conditions. The temperature rise curve of the tissue model surface is measured under different additional flow rates. With the constraint that "the tissue temperature is always below 42°C" and the safety boundary that "the pressure increment in the sheath cavity does not exceed 3 mmHg", the minimum safe additional flow rate corresponding to each power point is determined. Then, the k value is obtained through linear fitting. After the above calibration, k is preferably 0.25 in this embodiment. It is an exemplary value of this embodiment. In practical applications, those skilled in the art can redetermine the k value using the same calibration method based on factors such as the specific heat capacity of the perfusion fluid, the flow resistance characteristics of the perfusion tubing, and the differences in tissue heat tolerance among patients of different ages. It still falls within the protection scope of this invention. Through the above mapping relationship, the injection flow rate increases monotonically with the increase of laser power, which avoids the pressure rise caused by excessive injection when the power is low, and also avoids insufficient cooling caused by insufficient injection when the power is high, thus achieving the optimal balance between cooling efficiency and pressure safety.

[0027] As an alternative implementation, the mapping relationship can also be achieved through a preset calibration table. The calibration table records multiple discrete laser power values ​​and their corresponding increased perfusion flow rates. The control unit determines the corresponding additional flow rate based on the currently set laser power value by looking up the table or by linear interpolation.

[0028] S202: Laser limiting; During laser excitation, although the control unit has pre-calculated and increased the perfusion flow rate based on the laser power, in actual operation, the laser's effect on tissue may cause instantaneous changes in local tissue morphology or cavity volume, leading to an unexpected rapid increase in intrathecal pressure. If the additional flow rate is injected as planned when the pressure has already risen rapidly, it may further increase the intrathecal pressure, exceeding the tissue's safe tolerance limit and causing fluid leakage or tissue damage. Therefore, it is necessary to dynamically limit the additional flow rate when the pressure rise rate is too fast, cutting it off to a safe level to avoid pressure shock. At the same time, this limitation should not completely eliminate the additional flow rate; otherwise, the heat generated by the laser will not be effectively dissipated, leading to the risk of thermal damage. Therefore, this method uses a method of limiting it to a preset percentage to maintain basic cooling capacity while avoiding pressure shock, achieving a balance between thermal safety and pressure safety. Specifically: During laser excitation, the control unit continuously monitors the rate of increase of pressure within the sheath cavity. If the rate of increase of pressure within the sheath cavity exceeds a preset rate threshold, the increased perfusion flow rate is limited to a preset percentage of the originally planned increase.

[0029] In this embodiment, the preset rate threshold is preferably 10 mmHg / s, and the preset percentage is preferably 20%. The above-mentioned preset rate threshold and preset percentage (20%) are preferred examples of this embodiment. In practical applications, those skilled in the art can make appropriate adjustments based on the following factors: Adjustment of rate threshold: For pediatric patients, whose tissues are more loose and whose tunica vaginalis compliance is lower, the rate threshold can be appropriately lowered (e.g., set to 8 mmHg / s) to improve the sensitivity of protection; for adult patients, whose tissue tolerance is higher, the rate threshold can be appropriately increased (e.g., set to 12-15 mmHg / s).

[0030] Preset percentage adjustment: When the baseline perfusion flow rate is large, even if it is limited to 20%, the actual increase in absolute flow rate is still sufficient for cooling; when the baseline perfusion flow rate is small, the percentage can be appropriately increased (e.g., 25% to 30%) to ensure the basic cooling effect. Any adaptive adjustment of the above thresholds by those skilled in the art based on actual perfusion parameters and patient conditions is within the scope of protection of this invention.

[0031] Through the aforementioned dynamic limiting mechanism, the system can automatically stabilize when the pressure rises rapidly, limit the flow increment without completely interrupting cooling, avoid pressure shocks from damaging tissues, and further improve the safety and robustness of collaborative control.

[0032] S203: Delayed recovery of traffic; When the laser stops, the control unit does not immediately restore the perfusion flow rate to the value before the increase. Instead, it restores it after a preset delay time (preferably 12 seconds in this embodiment) to fully remove residual heat from the tissue and ensure that the temperature completely drops back to a safe level before restoring the flow rate to the value before the increase.

[0033] S3. Acquire real-time temperature data of the tissue surface, compare the real-time temperature data with preset multi-level temperature thresholds, and execute corresponding protective actions based on the comparison results; among them, the execution priority of the protective action is higher than the execution priority of increasing the perfusion flow rate, and the execution priority of increasing the perfusion flow rate is higher than the execution priority of adjusting the perfusion flow rate or output pressure to maintain the pressure inside the sheath cavity.

[0034] S301: Over-temperature protection; The control unit acquires the actual temperature value of the tissue surface in real time through a miniature temperature sensor integrated into the front end of the scrotum endoscope. The control unit will It compares the temperature with preset multi-level temperature thresholds and executes corresponding protection actions based on the comparison results; In this embodiment, the multi-level temperature threshold is set as follows: First temperature threshold The second temperature threshold is 39℃. The third temperature threshold is 42℃. It is 45℃; ①When When the temperature is ≥ 39℃ and < 42℃, the control unit issues a first-level warning signal (such as a buzzer) to alert the operator to the rise in tissue temperature. During this stage, the laser output and perfusion flow rate are not interfered with, and the operator can decide whether to adjust the operation strategy. ②When When the temperature is ≥ 42℃, the control unit sends a power limiting command to the laser host, automatically reducing the current output power by 50% or to a preset safe power value (preferably 7.5W in this embodiment), and at the same time issuing a second-level warning signal (such as a red flashing alarm and a continuous buzzer). During this stage, the perfusion pump continues to operate at the increased perfusion flow rate to accelerate tissue cooling. When the temperature drops below 42℃, the control unit releases the power reduction command, allowing the operator to resume laser power operation.

[0035] ③When If the laser continues to rise after the power is reduced and reaches the third temperature threshold of 45°C, the control unit sends an emergency stop command to the laser host to immediately suspend the laser output until the temperature drops below 42°C. Then, the control unit automatically releases the emergency stop command and allows the laser to be emitted again.

[0036] By acquiring real-time temperature data of the tissue surface and comparing it with preset multi-level temperature thresholds, the system performs graded protection actions such as early warning prompts, automatic power reduction, and forced suspension of laser output according to different temperature ranges. Compared with the existing technology that relies solely on the operator's visual observation and experience judgment, this invention provides an objective and quantitative temperature monitoring and graded intervention mechanism. The system automatically intervenes when the operator fails to respond in time, forming a complete safety protection chain from early warning and power reduction to forced shutdown, effectively avoiding thermal damage accidents caused by subjective judgment delays or errors.

[0037] In addition, the above-mentioned temperature thresholds (39℃, 42℃, 45℃) and power reduction methods (reducing by 50% or reducing to 7.5W) are preferred solutions in this embodiment. Those skilled in the art can make appropriate adjustments according to different tissue types and safety requirements, all of which fall within the protection scope of this invention.

[0038] S302: Control logic priority; In the control logic within the control unit, the execution priority of protection actions (i.e., warning, power reduction, laser pause, etc. in S301) is higher than the execution priority of increasing perfusion flow (i.e., predictive flow increase action in S201), and the execution priority of increasing perfusion flow is higher than the execution priority of adjusting perfusion flow or output pressure to maintain intrathecal pressure (i.e., pressure closed-loop regulation action in S1). Specifically, when the triggering conditions for multiple actions are met simultaneously, the control unit executes them in the following order: When the tissue temperature reaches or exceeds the second temperature threshold T2 (i.e. triggering the power reduction action in S301 ②), regardless of whether the laser is in the "excitation" state, the control unit will prioritize executing the power reduction command in S301 ② or the laser pause command in S301 ③. After the temperature drops below the second temperature threshold, other control actions will be resumed. When the tissue temperature has not reached the second temperature threshold T2 (i.e., the power reduction or laser pause action in S301 is not triggered), but the laser is in an excited state, the control unit prioritizes the action of increasing the perfusion flow rate in S201. When the tissue temperature has not reached the second temperature threshold T2 and the laser is in standby mode, the control unit executes the pressure closed-loop regulation action in S1.

[0039] This method prioritizes control actions by setting clear execution priorities: protective actions > increasing perfusion flow > closed-loop pressure regulation. This priority order follows the principle of "thermal safety over operational coordination, and operational coordination over baseline pressure stabilization." This ensures that when tissue temperature reaches a dangerous level, even if the laser is in an activated state, the power must be immediately reduced or the system shut down to protect patient safety. Once thermal safety is guaranteed, coordinated cooling of the laser and perfusion is prioritized to ensure surgical efficiency. Only lastly is baseline pressure stabilization considered to ensure a clear surgeon's field of vision. This priority order ensures that in extreme situations, the system can make autonomous decisions based on the principle of "safety first," without surgeon intervention, further improving the safety, reliability, and intelligence of the surgery.

[0040] S303: Dual sensor redundancy and fail-safe strategy; After the system starts, the control unit prioritizes the signal from the first pressure sensor (i.e., the MEMS pressure sensor integrated into the front end of the scrotum endoscope) for rapid and precise closed-loop pressure control. The second pressure sensor (i.e., the backup pressure sensor integrated into the distal end of the scrotum endoscope or the inner wall of the trocar) serves as a redundancy backup, continuously collecting pressure data and transmitting it to the control unit in real time. However, it does not participate in closed-loop control and is only used for comparison and reference in fault diagnosis. Specifically: During the surgery, the control unit continuously compares the readings of the two sensors. The control unit determines that the first pressure sensor is malfunctioning when any of the following conditions are met: ①The difference between the readings of the first pressure sensor and the second pressure sensor exceeds the preset difference threshold and the duration exceeds the preset time; In this embodiment, the preset difference threshold is preferably 5 mmHg, and the preset time is preferably 1 second. This criterion is based on the following considerations: Under normal physiological conditions, the pressure difference between the proximal and distal ends of the scrotum endoscope usually does not exceed 2-3 mmHg. When the readings of the two sensors continuously deviate by more than 5 mmHg, it indicates that the first pressure sensor may have zero-point drift, diaphragm contamination, or abnormal signal amplification circuit. At the same time, setting a duration threshold of 1 second can avoid misjudgment caused by occasional interference such as laser pulses and instantaneous fluctuations of the infusion pump.

[0041] ②The signal from the first pressure sensor exceeds the effective range.

[0042] In this embodiment, the effective measurement range is preferably 0–50 mmHg, meaning that an abnormality is determined when the reading of the first pressure sensor is less than 0 or greater than 50 mmHg. The design range of the first pressure sensor is 0–50 mmHg, and the reading should fluctuate within the range of 8–12 mmHg during normal operation, far below the upper limit of the range. When the reading exceeds this range, it usually indicates that the sensor diaphragm is damaged, the signal cable is open / short-circuited, or the signal conditioning circuit has failed, which is a serious hardware failure and requires immediate switching.

[0043] When the control unit determines that the first pressure sensor is malfunctioning, the system automatically switches to the second pressure sensor as the pressure feedback source within 1 second, simultaneously triggering an audible and visual alarm and entering a degraded operation mode. In degraded operation mode, because the second pressure sensor is located at a remote location with a longer signal transmission path, its response speed is slower than that of the first pressure sensor. To avoid system oscillation, the control unit takes the following measures: Reduce the maximum output rate of the infusion pump, for example, from 10 ml / s to 5 ml / s, to prevent flow overshoot due to response delay; Extend the response time of pressure regulation, for example, by increasing the response time constant of the PID controller from 0.5 seconds to 1 second, to make the regulation process smoother.

[0044] Through the aforementioned degradation measures, the system can still maintain basic pressure control functions after sensor failure, ensuring uninterrupted surgery and giving the surgeon time to deal with the fault.

[0045] In addition, during the operation, the control unit simultaneously monitors the pressure difference between the two sensors to determine the status of the infusion tubing. ③ When the reading of the first pressure sensor is higher than the first blockage threshold and the reading of the second pressure sensor is lower than the second blockage threshold, the control unit determines that the infusion line is blocked; The physical basis of this criterion is that after the pipeline is blocked, the pressure upstream (near end) of the blockage point rises sharply, while the pressure downstream (far end) drops significantly because the injection fluid cannot reach it, forming a significant pressure difference, which is significantly different from the characteristic that the readings of the two sensors are similar (the difference is less than 2-3 mmHg) during normal operation. In this embodiment, the first blockage threshold is preferably 20 mmHg, and the second blockage threshold is preferably 10 mmHg. That is, when the reading of the first pressure sensor is higher than 20 mmHg and the reading of the second pressure sensor is lower than 10 mmHg, the control unit determines that the pipeline is blocked, automatically reduces the infusion pump speed to a safe value (preferably 0.5 ml / s in this embodiment), and triggers an alarm signal to prompt the operator to check the pipeline.

[0046] This embodiment also includes: ④ When the first pressure sensor and the second pressure sensor fail simultaneously (for example, both sensor signals exceed the effective range, the difference between the two sensor readings is continuously abnormal and neither can provide effective feedback), the control unit determines that effective pressure feedback cannot be obtained, immediately issues the highest level alarm (such as "The pressure feedback system has failed completely, please stop the surgery"), and stops the surgery.

[0047] Through the aforementioned dual-sensor redundancy and fail-safe strategies, the system can seamlessly switch to the second pressure sensor within 1 second when the first pressure sensor fails, maintaining uninterrupted pressure control; it can automatically reduce the pump speed and trigger an alarm when the infusion tubing is blocked, preventing abnormal increases in the sheath cavity pressure; and in the extreme case of simultaneous failure of both sensors, it can provide clear termination suggestions, offering clear guidance to the surgeon. This invention, through multi-layered safety strategies, minimizes the risk of single-point failure, significantly improving the reliability of the system and the safety of the surgery.

[0048] Example 3: Complete Procedure of Pediatric Testicular Torsion Resection This embodiment, combined with a specific surgical scenario, fully describes the application process of the collaborative control system and method of the present invention in pediatric testicular torsion resection surgery.

[0049] Preoperative preparation and parameter setting: The surgeon sets the system parameters according to the child's condition. In this embodiment, the target pressure range is set as follows: The initial perfusion flow rate was set at 200 ml / min, and the increased perfusion flow rate... The first temperature threshold is set to 100 ml / min (cooling flow rate is the initial perfusion flow rate + the increased perfusion flow rate, i.e., 300 ml / min). The second temperature threshold is 39℃. The third temperature threshold is 42℃. The system was set to 45℃, with a safe power value of 7.5W. After completing the initial self-test, the system confirmed that the dual pressure sensor signals, temperature sensor signals, and communication connections were all normal.

[0050] Phase One – Establishing the Water Cavity: The surgeon inserts a scrotumoscope into the tunica vaginalis cavity. The control unit acquires the actual pressure value inside the cavity in real time through the first pressure sensor. A PID closed-loop control (Kp=1.2, Ki=0.3, Kd=0.08) is used to automatically adjust the output of the irrigation pump, stabilizing the pressure inside the tunica vaginalis cavity within the range of 8–12 mmHg. The step response rise time is less than 0.3 seconds, and the overshoot is less than 10%. The surgeon does not need to manually adjust the irrigation flow rate, and the field of vision is clear and stable. Second stage – scrotal endoscopic exploration: The surgeon used a scrotoscope to explore and locate the torn, necrotic testicular appendages. The system continuously executed closed-loop pressure regulation in S1, with the infusion pump running at an initial flow rate of 200 ml / min to maintain effective dilation of the tunica vaginalis and ensure a clear field of view. A temperature sensor continuously monitored the tissue surface temperature; the actual temperature value at this time... The system does not issue a warning signal when the temperature is below the first temperature threshold of 39°C.

[0051] Third stage – Laser excision of necrotic appendages: (1) Predictive flow enhancement: After the surgeon confirms the target tissue, he presses the foot switch of the laser host to prepare to fire the laser. After the control unit detects the pre-trigger signal that the laser is about to enter the excitation state, it starts the predictive flow enhancement of S201 50ms before the laser is fired, and sends an enhanced perfusion command to the perfusion pump to increase the perfusion flow rate. Based on the current preset laser power value, using a linear formula Calculation determined, in this embodiment The perfusion rate was 100 ml / min, and the perfusion rate was increased from the initial perfusion rate of 200 ml / min to the sum of the initial perfusion rate and the increased perfusion rate, which is 300 ml / min.

[0052] (2) Laser cutting and overheat warning: The surgeon activates the laser and begins cutting necrotic adnexal tissue. During the cutting process, the temperature sensor detects a gradual increase in the tissue surface temperature. When the actual temperature value... When the temperature reaches the first temperature threshold of 39°C but remains below the second temperature threshold of 42°C, the control unit executes the warning action in S301 ①, issuing a first-level warning signal (such as a buzzer sound) to alert the operator to the rising tissue temperature. At this time, the laser output and perfusion flow rate are unaffected, and the operator can decide whether to adjust the operating strategy independently.

[0053] (3) Automatic power reduction: As the operator continues the cutting operation, the tissue surface temperature rises further to the second temperature threshold of 42°C. The control unit determines that the second temperature threshold has been reached and immediately executes the power reduction action in step ② of S301: a power limiting command is sent to the laser host, forcibly reducing the current output power from 20W to 10W by 50%, while simultaneously issuing a second-level warning signal (such as a red flashing alarm and a continuous buzzer). The perfusion pump continues to operate at the increased perfusion flow rate (300ml / min) as specified in S201 to accelerate tissue cooling. At this time, although the laser power has been reduced, the system still allows laser output to complete the cutting task, while actively cooling by increasing the perfusion flow rate. When the temperature drops below 42°C, the control unit releases the power reduction command, allowing the operator to resume laser power operation.

[0054] (4) Forced laser pause: If the operator does not adjust the operation in time, the tissue surface temperature continues to rise after the power is reduced and reaches the third temperature threshold of 45°C. The control unit immediately executes the laser pause action in S301 ③, sends an emergency stop command to the laser host, the laser output is forcibly cut off, the screen displays a temperature exceeding the threshold prompt, the operator stops cutting, the irrigation pump continues to run at the increased irrigation flow rate (300ml / min) in S201 to accelerate tissue cooling. After waiting for a few seconds, the tissue temperature drops below 42°C, the control unit automatically releases the emergency stop command and allows the laser to be emitted again.

[0055] (5) Delayed flow recovery: After the surgeon completes the cutting of the appendix pedicle, he releases the laser switch and the laser status becomes standby. The control unit executes the delayed flow recovery action of S203. After a 12-second delay, the perfusion flow is restored to the initial perfusion flow of 200ml / min.

[0056] Phase Four – End of Surgery: After the surgeon completes all operations, the scrotum scope is withdrawn. The control unit continues to execute the closed-loop pressure regulation of S1 to maintain the intravaginal pressure within the target pressure range until the trocar is withdrawn. The surgeon can choose to manually stop the system or let the system automatically standby.

[0057] In the description of this application, it should be noted that the terms "upper," "lower," etc., indicating the orientation or positional relationship are based on the orientation or positional relationship shown in the accompanying drawings, and are only for the convenience of describing this application and simplifying the description, and do not indicate or imply that the device or element referred to must have a specific orientation, or be constructed and operated in a specific orientation, and therefore should not be construed as a limitation of this application. Unless otherwise expressly specified and limited, the terms "installed," "connected," and "linked" should be interpreted broadly. For example, they can refer to a fixed connection, a detachable connection, or an integral connection; they can refer to a mechanical connection or an electrical connection; they can refer to a direct connection or an indirect connection through an intermediate medium; they can refer to the internal communication between two elements. For those skilled in the art, the specific meaning of the above terms in this application can be understood according to the specific circumstances.

[0058] It should be noted that in this application, relational terms such as "first" and "second" are used merely to distinguish one entity or operation from another, and do not necessarily require or imply any such actual relationship or order between these entities or operations. Furthermore, the terms "comprising," "including," or any other variations thereof are intended to cover non-exclusive inclusion, such that a process, method, article, or apparatus that comprises a list of elements includes not only those elements but also other elements not expressly listed, or elements inherent to such a process, method, article, or apparatus. Without further limitations, an element defined by the phrase "comprising one..." does not exclude the presence of other identical elements in the process, method, article, or apparatus that includes said element.

[0059] The above description is merely a specific embodiment of this application, enabling those skilled in the art to understand or implement this application. Various modifications to these embodiments will be readily apparent to those skilled in the art, and the general principles defined herein may be implemented in other embodiments without departing from the spirit or scope of this application. Therefore, this application is not to be limited to the embodiments shown herein, but is to be accorded the widest scope consistent with the principles and novel features claimed herein.

Claims

1. A method for coordinated control of perfusion pressure and laser in scrotal endoscopic surgery, characterized in that, Includes the following steps: Acquire pressure data within the tunica vaginalis cavity, compare the pressure data with a preset target pressure range, and adjust the perfusion flow rate or output pressure based on the comparison result to maintain the pressure within the tunica vaginalis cavity within the target pressure range; Monitor the working status of the laser. When a pre-trigger signal is detected that the laser is about to enter the excitation state, increase the perfusion flow rate within a preset time period before the laser is emitted, and restore the perfusion flow rate to the value before the increase after a preset delay time after the laser stops. Real-time temperature data of the tissue surface is acquired, and the real-time temperature data is compared with preset multi-level temperature thresholds. Based on the comparison results, corresponding protective actions are executed. The execution priority of the protective actions is higher than the execution priority of increasing the perfusion flow rate, and the execution priority of increasing the perfusion flow rate is higher than the execution priority of adjusting the perfusion flow rate or output pressure to maintain the intrathecal pressure.

2. The method for coordinated control of perfusion pressure and laser in scrotal endoscopic surgery according to claim 1, characterized in that, The increase in perfusion flow rate during the preset time period before laser emission is determined by a preset mapping relationship, and the adjustment of perfusion flow rate or output pressure based on the comparison result is achieved through PID control.

3. The method for coordinated control of perfusion pressure and laser in scrotal endoscopic surgery according to claim 1, characterized in that, The preset mapping relationship is determined by the following mathematical expression: ； in, To increase the infusion flow rate, P is the set laser power value, and k is the calibration coefficient.

4. The method for coordinated control of perfusion pressure and laser in scrotal endoscopic surgery according to claim 1, characterized in that, The preset mapping relationship is achieved through a preset calibration table, which records multiple discrete laser power values ​​and their corresponding increased perfusion flow rates.

5. The method for coordinated control of perfusion pressure and laser in scrotal endoscopic surgery according to claim 1, characterized in that, Also includes: During laser excitation, if the rate of increase of the pressure data in the sheath cavity exceeds a preset rate threshold, the increase in perfusion flow is limited to a preset percentage of the originally planned increase.

6. The method for coordinated control of perfusion pressure and laser in scrotal endoscopic surgery according to claim 1, characterized in that, The acquisition of pressure data within the sheath cavity specifically includes: Pressure data is acquired by a first pressure sensor integrated into the proximal end of the scrotum mirror. Pressure data is acquired via a second pressure sensor integrated at the distal end of the scrotum mirror as a redundant backup. When an abnormality is detected in the first pressure sensor, the system automatically switches to the second pressure sensor to obtain pressure data and enters a degraded operation mode.

7. The method for coordinated control of perfusion pressure and laser in scrotal endoscopic surgery according to claim 6, characterized in that, The criteria for detecting an abnormality in the first pressure sensor include: the difference between the readings of the first pressure sensor and the second pressure sensor exceeds a preset difference threshold and the duration exceeds a preset time, or the signal of the first pressure sensor exceeds the effective range. The degraded operating modes include: reducing the maximum output rate of the injection pump and / or extending the response time of pressure regulation.

8. The method for coordinated control of perfusion pressure and laser in scrotal endoscopic surgery according to claim 6, characterized in that, It also includes a pipeline blockage detection step: when the pressure data obtained by the first pressure sensor is higher than the first blockage threshold and the pressure data obtained by the second pressure sensor is lower than the second blockage threshold, it is determined that the pipeline is blocked, the injection flow rate is reduced to a preset safety value and an alarm signal is triggered.

9. The method for coordinated control of perfusion pressure and laser in scrotal endoscopic surgery according to claim 1, characterized in that, The step of comparing the real-time temperature data with preset multi-level temperature thresholds and executing corresponding protection actions based on the comparison results specifically includes: When the real-time temperature data is greater than or equal to the first temperature threshold and less than the second temperature threshold, a first-level early warning signal is triggered. When the real-time temperature data is greater than or equal to the second temperature threshold, the current laser output power is reduced by 50%, or reduced to a preset safe power value, and a second-level warning signal is triggered. When the real-time temperature data is greater than or equal to the third temperature threshold, the laser output is paused until the real-time temperature data is less than the second temperature threshold.

10. A system based on the method for coordinated control of perfusion pressure and laser in scrotal endoscopic surgery as described in claim 1, characterized in that, include: An infusion pump is used to infuse liquid into the sheath cavity; Laser host, which is used to generate and control laser output; The pressure detection module is used to acquire pressure data within the sheath cavity; Temperature detection module, which is used to acquire real-time temperature data of tissue surface; The control unit, which is communicatively connected to the infusion pump, the laser host, the pressure detection module, and the temperature detection module, is configured as follows: The pressure data is compared with a preset target pressure range, and the perfusion flow rate or output pressure is adjusted based on the comparison result to maintain the intrathecal pressure within the target pressure range. Monitor the working status of the laser. When a pre-trigger signal is detected that the laser is about to enter the excitation state, increase the perfusion flow rate within a preset time period before the laser is emitted, and restore the perfusion flow rate to the value before the increase after a preset delay time after the laser stops. The real-time temperature data is compared with preset multi-level temperature thresholds, and corresponding protection actions are executed based on the comparison results. The execution priority of the protective action is higher than that of increasing the perfusion flow rate, and the execution priority of increasing the perfusion flow rate is higher than that of adjusting the perfusion flow rate or output pressure to maintain the intrathecal pressure.

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