Surgical system and control method

Abstract

A surgical laser system may include an endoscope. At least one optical emitter located at the distal end of the endoscope may direct emitted light toward a target. The target may reflect at least a portion of the emitted light to form reflected light. At least one camera located at the distal end of the endoscope may capture at least one image of the target illuminated by the emitted light with at least a portion of the reflected light. A controller may determine the distance from the distal end of the endoscope to the target from at least one image. A force sensor may detect when the optical fiber has come into contact with the target. In response to detecting that the optical fiber has come into contact with the target, the controller may cause an actuator to retract the optical fiber by a specific distance in the proximal direction.

Description

Technical Field

[0001] Cross - Reference to Related Applications This application claims the benefit of U.S. Provisional Application No. 63 / 499,536, filed on May 2, 2023, which is hereby incorporated by reference in its entirety.

[0002] This document generally relates to endoscopic systems, and more specifically, to systems and methods for determining and controlling the distance between the tip of a medical device and a target.

Background Art

[0003] An operator, such as a physician, surgeon, or user, can use an endoscope to provide visual access to an internal location of a patient. The operator can insert the endoscope into the patient's body. The endoscope can supply light to a target being examined, such as a target anatomical structure or object. The endoscope can collect light reflected from the object. The reflected light can convey information about the target being examined.

[0004] The endoscope can include a working channel. In some examples, the operator can perform suction through the working channel. In some examples, the operator can pass instruments, such as a brush, biopsy needle, or forceps, through the working channel. In some examples, the operator can perform minimally invasive surgery through the working channel, such as to remove unwanted tissue or foreign objects from the patient's body.

[0005] The endoscope can perform laser treatments, such as ablation, coagulation, vaporization, fragmentation, lithotripsy, etc., using a laser or plasma system. In laser therapy, the operator can use the endoscope to supply surgical laser energy to various target treatment areas, such as soft tissue or hard tissue. In lithotripsy, the operator can use the endoscope to supply surgical laser energy to break up a stone structure in the patient's kidney, gallbladder, ureter, or other stone - forming regions, or to ablate a large stone into smaller fragments.

Summary of the Invention

[0006] [Means for solving the problem]

[0007] In one example, the surgical system may comprise an endoscope, at least one optical emitter positioned at the distal end of the endoscope and configured to illuminate a target site, at least one imaging sensor configured to capture image data associated with the illuminated target site, at least one optical fiber positioned to extend from the distal end of the endoscope and configured to emit fiber light toward the target site, a sensor configured to detect light from the target site, and a controller configured to determine the distance from the distal end of at least one optical fiber to the target site, determine the optical properties associated with the light from the target site, and establish a relationship between the optical properties and the determined distance from the distal end of at least one optical fiber to the target site, at least in part, based on the captured image data.

[0008] For example, a method for operating an endoscope having at least one optical fiber that can be positioned to extend from the distal end of the endoscope may include: illuminating a target site using at least one optical emitter; capturing image data associated with the illuminated target site using at least one imaging sensor; emitting fiber light from at least one optical fiber toward the target site; detecting light from the target site using a sensor; determining the distance from the distal end of at least one optical fiber to the target site using a controller, based at least partially on the captured image data; determining optical properties associated with the light from the target site using a controller; and establishing a relationship between the optical properties and the determined distance from the distal end of at least one optical fiber to the target site using a controller.

[0009] In one example, the surgical system may include an endoscope, an optical fiber that is positionable to extend from the distal end of the endoscope and configured to emit fiber light toward a target, an actuator configured to advance the optical fiber distally and retract it proximally relative to the endoscope, a force sensor configured to detect when the optical fiber makes contact with the target, and a controller configured to cause the actuator to retract the optical fiber by a specific distance proximally in response to the detection that the optical fiber has made contact with the target.

[0010] Various embodiments are shown as examples in the accompanying drawings. Such embodiments are illustrative and are not intended to be exhaustive or exclusive embodiments of the subject matter. [Brief explanation of the drawing]

[0011] [Figure 1] Figure 1 is a schematic side view of an example of a surgical system.

[0012] [Figure 2] Figure 2 is a perspective view of an example of the configuration at the distal end of the endoscope of the surgical system shown in Figure 1.

[0013] [Figure 3] Figure 3 is a perspective view of an example of another configuration at the distal end of the endoscope of the surgical system in Figure 1, for generating the relationship shown in Figure 1.

[0014] [Figure 4] Figure 4 is a perspective view of an example of another configuration at the distal end of the endoscope of the surgical system in Figure 1, for generating the relationship shown in Figure 1.

[0015] [Figure 5] Figure 5 is a schematic side view of an example configuration of the surgical system shown in Figure 1, in which at least one optical fiber may include a single optical fiber.

[0016] [Figure 6] FIG. 6 is a side schematic view of an example of another configuration of the surgical system of FIG. 1, in which at least one optical fiber may include a first optical fiber and a second optical fiber.

[0017] [Figure 7] FIG. 7 is a side schematic view of an example of the configuration of the fiber detection and positioning mechanism of the surgical system of FIG. 1.

[0018] [Figure 8] FIG. 8 is a flowchart of an example of a method for operating an endoscope.

[0019] [Figure 9] FIG. 9 is a flowchart of an example of a method for operating an endoscope.

[0020] [Figure 10] FIG. 10 is a flowchart of an example of a method for operating an endoscope.

[0021] [Figure 11] FIG. 11 is a schematic view of an exemplary computer-based clinical decision support system configured to provide a distance value based on optical characteristics associated with light from a target site.

DETAILED DESCRIPTION OF THE INVENTION

[0022] In laser therapy, the operator may position the distal end of an endoscope close to the target, such as a kidney stone. The endoscope may be equipped with an optical fiber that can deliver therapeutic laser light to the target via the distal end of the optical fiber. During treatment, it may be beneficial to dynamically monitor or control the distance between the distal end of the optical fiber and the target. For example, if the distal end of the optical fiber is positioned too close to the target, it may cause a condition known as flashing, which can degrade the distal end of the optical fiber. Similarly, if the distal end of the optical fiber is positioned too far from the target, a significant portion of the therapeutic laser light may be absorbed before reaching the target, which may reduce the efficiency of the laser therapy treatment or prolong the treatment time.

[0023] It has been found that the amount of reflected light (hereinafter referred to as "reflected light") returning proximal through one optical fiber or another, with optional spectral filtering, can reliably change depending on the distance between the distal end of the optical fiber and the target. As a result, surgical systems, including endoscopes, can use the amount of reflected light to dynamically monitor the distance between the distal end of the optical fiber and the target (hereinafter referred to as "real-time distance").

[0024] Specifically, during laser therapy, the surgical system may dynamically measure the amount of reflected light to dynamically determine the real-time interval, provide user feedback, and / or take action in response to the real-time interval value. For example, the surgical system may provide the practitioner with user feedback representing the real-time interval, such as displaying a numerical value on a display, displaying a graphical representation of the real-time interval on a display, displaying a visual indicator that shows when the real-time interval is within one of several specific ranges (too small, acceptable, too large, etc.), or playing an audible warning. As another example, the surgical system may take action in response to the real-time interval, such as retracting the optical fiber distally if the real-time interval is too low, or automatically positioning the distal end of the optical fiber to have a specific value for the real-time interval.

[0025] The surgical system may include calibration techniques that can determine the relationship between the reflected light and the real-time interval for a particular patient in a specific instance of endoscope insertion. For example, as further described below, the calibration technique may measure the value of the reflected light (e.g., intensity or power) for different values ​​of the real-time interval, use the measurements to form a calibration curve, and store the calibration curve. During laser therapy, the surgical system may measure the value of the reflected light (e.g., intensity or power) and then refer to the calibration curve to determine the real-time interval according to the value of the reflected light.

[0026] The following description concerns the implementation of calibration techniques, which may be performed at the start of laser therapy treatment. After performing the calibration techniques, the practitioner may then use the reflected light to determine the real-time intervals for the remainder of the laser therapy treatment.

[0027] Figure 1 is a schematic side view of an example of surgical system 100. The configuration in Figure 1 is only one example of a surgical system, and other configurations may also be used.

[0028] The surgical system 100 may include an endoscope 102. The endoscope 102 may include an elongated body portion extending between a proximal end and a distal end 106. The exact shape of the elongated body portion may depend on the medical procedure for which the endoscope 102 was originally designed. For simplification, the elongated body portion is shown as cylindrical with a circular cross-section perpendicular to the direction of extension. Other suitable shapes may also be used.

[0029] The endoscope 102 may include various electrical connections extending along its length, such as to power one or more light sources or light emitters at the distal end 106 of the endoscope 102, and / or to transmit data signals from one or more cameras or imaging sensors at the distal end 106 of the endoscope 102. In Figure 1, the electrical connections are shown extending proximal to their respective locations at the proximal end of the elongated endoscope 102, but in practice, the electrical connections may be grouped together so that the electrical connections are made using a single connector at or near the proximal end of the endoscope 102. For example, in practice, the electrical connections may extend along a single passage within the endoscope 102 and may branch out as needed at or near the distal end 106 of the endoscope 102.

[0030] The surgical system 100 may include at least one optical emitter 104 located at the distal end 106 of the endoscope 102. At least one optical emitter 104 may be configured to illuminate a target site 108. Optionally, at least one optical emitter 104 may direct one or more beams 110 of a particular shape towards the target site 108. Figures 2 and 3 below, and the accompanying description, relate to specific shapes and to performing distance measurements using specific shapes.

[0031] The surgical system 100 may include at least one imaging sensor 112. At least one imaging sensor 112 may be configured to capture image data 116 associated with an irradiated target site 108. In some examples, at least one imaging sensor 112 may capture image data 116 while at least one optical emitter 104 irradiates the target site 108 with one or more beams of a particular shape. In some examples, at least one imaging sensor 112 may include a camera configured to form a video image of the target site 108. In some examples, at least one imaging sensor 112 may form at least one image from light 114 emitted by at least one optical emitter 104 and reflected by the target site 108.

[0032] In some examples, the camera used in the calibration technique may be the same camera used subsequently during laser therapy treatment to provide the practitioner with a live image of the target site 108 during the treatment procedure, and may form a real-time video image of the target site 108. To provide illumination for the real-time video image during the treatment procedure, the surgical system 100 may also include one or more white light sources 136, such as one or more white light-emitting diodes (LEDs) located at the distal end 106 of the endoscope 102. In some examples, one or more white light sources 136 may be used during the treatment procedure but not during the calibration before the treatment procedure.

[0033] The surgical system 100 may include at least one optical fiber 118. At least one optical fiber 118 may be positionable to extend from the distal end 106 of the endoscope 102. At least one optical fiber 118 may be configured to emit fiber light 122 toward a target site 108. In some examples, the fiber light 122 may be used during a therapeutic procedure, such as being directed toward a kidney stone to perform lithotripsy and / or pulverization of the kidney stone.

[0034] The surgical system 100 may include a laser light source 138 configured to generate laser light 140, direct the laser light 140 to the proximal portion of the optical fiber 118, and direct the laser light 140 distally along the length of the optical fiber 118, causing it to emerge from the distal end of the optical fiber 118 to form fiber light 122. In some examples, the laser light source 138 may include a thulium fiber laser capable of generating light at wavelengths of 1908 nm and / or 1940 nm. In some examples, the laser light source 138 may include a thulium:YAG (yttrium aluminum garnet) laser capable of generating light at a wavelength of 2010 nm. In some examples, the laser light source 138 may include a holmium:YAG laser capable of generating light at a wavelength of 2120 nm. In some examples, the laser light source 138 may include an erbium:YAG laser capable of generating light at a wavelength of 2940 nm. In the case of these (and other) laser sources, the laser light 140 has wavelengths or groups of wavelengths in the electromagnetic spectrum in which water (a major component of tissue) has relatively high absorption. During the procedure, the tissue may absorb the laser light, be locally heated to relatively high temperatures, and be separated by localized thermal strain within the tissue.

[0035] The surgical system 100 may include a sensor 126. The sensor 126 may be configured to detect light 124 from a target site 108. In some examples, the distal end 120 of at least one optical fiber 118 may emit fiber light 122 toward the target site 108, and at least a portion of the light 124 reflected from the target site 108 may be coupled to at least one optical fiber 118 to form a reflected light. In some examples, the sensor 126 may include a spectrometer located separately from the endoscope 102 and configured to measure the optical power / intensity (I) of the reflected light. In some examples, the sensor 126 may be located in or near the proximal portion of at least one optical fiber 118. In some examples, the sensor 126 may include a single (e.g., non-pixelated) detector region, so that the sensor 126 is a non-imaging sensor. The sensor 126 may generate a sensor signal 142 in response to the received optical power / intensity (I) of the reflected light.

[0036] The surgical system 100 may include a controller 128. The controller 128 may receive image data 116 from at least one imaging sensor 112. The controller 128 may receive sensor signals 142 from sensor 126. The controller 128 may generate a laser control signal 144 to control a laser light source 138. The controller 128 may generate at least one optical emitter control signal 146 to control at least one optical emitter 104 and / or a white light source 136.

[0037] The controller 128 may be configured to determine the distance (Z) from the distal end 120 of at least one optical fiber 118 to the target site 108, based at least partially on the captured image data 116.

[0038] The controller 128 may be further configured to determine the optical properties associated with the light 124 from the target site 108. In some examples, the optical properties may include the optical power / intensity (I) of the reflected light. In some examples, the optics may include the optical power / intensity (I) of one or more spectral regions of the reflected light.

[0039] The controller 128 may be further configured to establish a relationship 130 between the optical properties of the returned light (e.g., output or intensity) and a determined distance (Z) from the distal end 120 of at least one optical fiber 118 to the target site 108. In some examples, the relationship 130 may include a calibration curve that includes measurements of the optical power / intensity (I) of light 124 from the target site 108 corresponding to the distance (Z) from the distal end 120 of at least one optical fiber 118 to the target site 108, for a plurality of distances (Z) from the distal end 120 of at least one optical fiber 118 to the target site 108. The relationship 130, such as a calibration curve relating distance (Z) to optical power / intensity (I), can be the final product of the calibration technique described herein. In some examples, the controller 128 may store the relationship 130 in a storage device 132, such as a lookup table. Once stored, relation 130 can then be accessed by controller 128 or other suitable processor for purposes such as generating real-time distance (Z) values ​​in response to measured real-time optical power / intensity (I).

[0040] In some examples, the controller 128 may be further configured to dynamically determine a real-time distance between the distal end 120 of at least one optical fiber 118 and the target site 108 in response to a real-time measured value of the optical power / intensity of the light 124 from the target site 108, at least in part based on a relationship 130 such as a calibration curve.

[0041] In some examples, the controller 128 may be further configured to suggest the movement (e.g., forward or backward) and / or the degree of movement (e.g., 2 mm) of the optical fiber to improve treatment efficiency. For example, the controller 128 may measure the optical power / intensity (I), determine from the measured optical power / intensity (I) where the optical fiber should be positioned relative to the target site 108, and instruct the actuator to move the optical fiber to a position corresponding to the peak of the calibration curve. In another example, the controller 128 may measure the optical power / intensity (I), determine from the measured optical power / intensity (I) where the optical fiber should be positioned relative to the target site 108, and instruct the actuator to move the optical fiber by a specific amount (e.g., 1 mm) toward a position corresponding to the peak of the calibration curve. Furthermore, the controller 128 may be further configured to use the calibration curve to automatically position the distal end 120 of at least one optical fiber 118 to set the real-time distance between the distal end 120 of at least one optical fiber 118 and the target site 108 to a specific value. For example, the surgical system 100 may include a fiber detection and positioning mechanism 700 that can change the position of at least one optical fiber 118 in the distal and proximal directions and can detect when the distal end of at least one optical fiber 118 has come into contact with the target site 108. Figure 7 below provides further details of the fiber detection and positioning mechanism 700.

[0042] In some examples, the controller 128 may be further configured to provide user feedback representing the real-time distance between the distal end of at least one optical fiber and the target site. For example, the surgical system 100 may include at least one alarm 134 that can provide an alarm to the operator in response to the real-time distance (Z) meeting certain criteria or a set of certain criteria. For example, if the real-time distance (Z) falls below a certain threshold, it means that the distal end of at least one optical fiber 118 may be too close to the target site 108, and at least one alarm 134 may generate an alarm to warn the operator. In another example, if the real-time distance (Z) exceeds a certain threshold, it means that the distal end of at least one optical fiber 118 may be too far from the target site 108, and at least one alarm 134 may generate an alarm to warn the operator. In yet another example, if the real-time distance (Z) falls outside a certain acceptable distance range, at least one alarm 134 may generate an alarm to warn the operator. In some examples, at least one alarm 134 may include a speaker capable of producing a sound, such as a beep, to warn the practitioner. In some examples, the speaker may produce a first sound, such as a low-pitched beep, when the real-time distance (Z) is greater than the maximum value of a particular distance range, and a second sound, such as a high-pitched beep, when the real-time distance (Z) is less than the minimum value of a particular distance range. In some examples, at least one alarm 134 may include one or more lights to provide an alarm, such as one or more light-emitting diodes, one or more light-emitting diodes of different colors, etc. Other suitable alarms may also be used.

[0043] Figure 2 is a perspective view of an example configuration 200 at the distal end 106 of the endoscope 102 of the surgical system 100 of Figure 1, for generating relation 130 of Figure 1. Configuration 200 in Figure 2 is only one example of a suitable configuration, and other suitable configurations may be used.

[0044] In the configuration 200 of Figure 2, at least one optical emitter 104 may include two optical emitters 104A and 104B located at the distal end 106 of the endoscope 102. In some examples, each optical emitter 104 may emit its respective beam 204, such as a collimated beam. In some examples, the beam 204 may have a cross-sectional intensity profile with a peak that decreases as the distance from the peak increases. In other examples, the beam 204 may have a cross-sectional intensity profile that is uniform or nearly uniform across the beam range. Other suitable beam profiles may also be used. In some examples, the optical emitters 104A and 104B emit their respective beams 204A and 204B having the same wavelength. In other examples, the optical emitters 104A and 104B emit their respective beams 204A and 204B having different wavelengths. In some examples, the optical emitters 104A and 104B emit their respective beams 204A and 204B having different spectral profiles. In some examples, using different spectral profiles can enable more complex multidimensional interference patterns.

[0045] In some examples, two light emitters 104A and 104B may illuminate the target site 108 with their respective beams 204A and 204B, which are at an angle to each other. In some examples, the respective beams 204A and 204B may intersect at a predetermined distance (D) away from the distal end 106 of the endoscope 102, such as at position 220.

[0046] In some examples, at least one imaging sensor 112 may include a single camera. In some examples, the controller 128 (Figure 1) may partially determine the distance (Z) by determining the spacing (X) between beams 204A and 204B from the captured image data 116.

[0047] For example, at least one imaging sensor 112 may capture an image of the target area 108 and send that image to the controller as captured image data 116. In one embodiment, if the captured image shows a single point corresponding to the intersection of two beams 204A, 204B, it indicates that the image plane of the sensor 112 is a predetermined distance (D) from the distal end 106. In various embodiments, the captured image shows two points corresponding to each of the two beams, and the controller 128 may calculate the distance between the image plane and the distal end 106 based on the shape. For example, the controller 128 may measure the spacing (X) between beams 204A, 204B in the image. The controller 128 may use the measured spacing (X), a specific lateral spacing between the optical emitters 104A, 104B, and a specific angle between beams 204A, 204B to determine the distance (Y) between the distal end 106 of the endoscope 102 and the target area 108. The controller may determine the distance (Z) between the distal end 120 of at least one optical fiber 118 and the target site 108 by subtracting the distance between the distal end 106 of the endoscope 102 and the distal end 120 of at least one optical fiber 118 from the distance (Y). This is just one example of a technique for determining distance (Z) from captured image data 116, and other techniques may also be used.

[0048] In various embodiments, while at least one imaging sensor 112 captures an image of the target area (and in one embodiment, a controller 128 is configured to calculate the distance (Z) between the distal end 120 of at least one optical fiber 118 and the target area 108), a sensor 126 (e.g., a spectrometer) may simultaneously or substantially simultaneously measure the optical power / intensity (I) of the reflected light from the target area 108. An exemplary method for measuring the optical power / intensity (I) of the reflected light from the target area 108 can be found in U.S. Patent Application Publication 2021 / 0038306, the contents of which are incorporated herein by reference. The determined distance (Z) and the measured optical power / intensity (I) of the reflected light from the target area 108 can then be used to generate a calibration curve 130 showing the relationship between the distance (Z) and the optical power / intensity (I) of the reflected light.

[0049] The endoscope 102 may include a suction channel 210, which may extend longitudinally along the endoscope 102 from the proximal portion to the distal end 106 of the endoscope 102. The suction channel 210 may be connected to a suction dispenser, which may remove debris and portions of the target site 108 through the suction channel 210 during laser therapy treatment. An optical fiber 118 may be inserted into the suction channel 210 to supply laser light to the target site 108 for treatment. Alternatively, the optical fiber 118 may be inserted into the endoscope 102 through a second channel different from the suction channel 210.

[0050] Figure 3 is a perspective view of an example of another configuration 300 at the distal end 106 of the endoscope 102 of the surgical system 100 of Figure 1, for generating relation 130 of Figure 1. Configuration 300 in Figure 3 is just one example of a suitable configuration, and other suitable configurations may be used.

[0051] In the configuration 300 of Figure 3, at least one optical emitter 104 may include a single optical emitter 104' located at the distal end 106 of the endoscope 102. In some examples, the single optical emitter 104' may illuminate the target site 108 with a beam 304 that diverges away from the single optical emitter 104A at a controlled, specific divergence angle (e.g., using optically designed components).

[0052] A specific divergence angle may be formed between opposing edges 306 of the diverging beam 304. In Figure 3, the edges 306 of the diverging beam 304 are represented by dashed lines. As the diverging beam 304 propagates (longitudinally) away from the optical emitter 104', the lateral distance between the edges 306 (e.g., perpendicular to the longitudinal direction) increases. In some examples, the edges 306 may be "soft" edges to the diverging beam 304, such as the full width at half maximum of the peak intensity or other appropriate proportions. In other examples, the edges 306 may be "hard" edges, such as being limited by a physical aperture. For example, the edges of the diverging beam 304 may form a circle or any shape on an image captured by at least one imaging sensor 112. Other appropriate beam profiles may also be used.

[0053] In some examples, the controller 128 may be configured to partially determine the distance (Z) by determining the cross-sectional size of the beam 304 from the captured image data 116. For example, a camera 112A may capture an image of the target site 108 and send that image to the controller as captured image data 116. The controller 128 may measure the spacing (X) between the edges 306 of the diverging beam 304 in the image (e.g., the diameter of the circle on the captured image). The controller 128 may use the measured spacing (X) and a specific divergence angle of the beam 304 to determine the distance (Y) between the distal end 106 of the endoscope 102 and the target site 108. The controller may subtract the distance between the distal end 120 of at least one optical fiber 118 and the target site 108 from the distance (Y). This is merely one example of a technique for determining distance (Z) from captured image data 116, and other techniques may be used. For example, any optical component that can be used to generate any shape of a divergent beam on the captured image may be implemented to measure distance (Z) using the method described above.

[0054] Furthermore, while the camera 112A captures an image of the target area (and in one embodiment, the controller is configured to calculate the distance (Z) between the distal end 120 of at least one optical fiber 118 and the target area 108), the sensor 126 (e.g., a spectrometer) may simultaneously or substantially simultaneously measure the optical power / intensity (I) of the reflected light from the target area 108. Based on the determined distance (Z) and the measured optical power / intensity (I) of the reflected light from the target area 108, a calibration curve 130 can be generated showing the relationship between the distance (Z) and the optical power / intensity (I) of the reflected light.

[0055] Figure 4 is a perspective view of an example of another configuration 400 at the distal end 106 of the endoscope 102 of the surgical system 100 of Figure 1 for generating relation 130 of Figure 1. Configuration 400 in Figure 4 is just one example of a suitable configuration, and other suitable configurations may be used.

[0056] In some examples, at least one imaging sensor 112 may include a first camera 112A and a second camera 112B positioned at the distal end 106 of the endoscope 102. In some examples, a three-dimensional image can be generated by using two cameras. In some examples, an N+1-dimensional image can be generated by using N cameras. In some examples, the first camera 112A and the second camera 112B are separated laterally.

[0057] In some examples, the captured image data 116 may include a first image captured by a first camera 112A and a second image captured by a second camera 112B. In some examples, the first and second images are captured simultaneously or nearly simultaneously such that the tissue or material in and around the target site 108 does not move significantly during the time the first and second images are captured. One or more white light sources 136 may be operated to generate a white light illumination that illuminates the target site 108 while the first and second images are being captured.

[0058] In some examples, the controller 128 may determine the distance from the first and second images by triangulation. For example, the lateral distance between an element in the first image and the corresponding element in the second image may be proportional to the vertical distance between the element and the first and second cameras 112A and 112B. This is just one example of a technique for determining the distance (Z) from the captured image data 116, and other techniques may also be used.

[0059] Similar to the alternative method described in Figures 2 and 3, while the first and second cameras 112A, 112B capture images (and in one embodiment, the controller is configured to calculate the distance (Z) between the distal end 120 of at least one optical fiber 118 and the target site 108), the sensor 126 (e.g., a spectrometer) may simultaneously or substantially simultaneously measure the optical power / intensity (I) of the reflected light from the target site 108. Based on the determined distance (Z) and the measured optical power / intensity (I) of the reflected light from the target site 108, a calibration curve 130 showing the relationship between the distance (Z) and the optical power / intensity (I) of the reflected light may be generated.

[0060] Figure 5 is a schematic side view of an example configuration 500 of the surgical system 100 of Figure 1, in which at least one optical fiber 118 may include a single optical fiber. The configuration in Figure 5 is just one example of a surgical system, and other configurations may be used.

[0061] In a single-fiber configuration, the laser light source 138 generates laser light 140, directs the laser light 140 to the proximal portion of the optical fiber 118, and directs the laser light 140 distally along the length of the optical fiber 118, causing it to emerge from the distal end 120 of the optical fiber 118 and form fiber light 122. The fiber light 122 may be reflected from the target site 108 to form part of the light 124. Additionally or alternatively, light irradiated onto the target site from one or more white light LEDs may be reflected from the target site to form at least part of the light 124. At least part of the light 124 may be coupled to the distal end 120 of the optical fiber 118 and propagate proximal along the optical fiber 118 as return light 508.

[0062] In some examples, the surgical system 100 may further include a beam splitter 502 configured to separate the optical path of the fiber optic light 122 from the optical path of the reflected light 508. For example, laser light 140 may be incident on the optical fiber 118 as incident light 504. At least a portion of the incident light 504 may pass through the beam splitter 502 to form light 506 that propagates distally. Light 506 that propagates distally may exit the distal end 120 of the optical fiber 118 to form fiber optic light 122. At least a portion of the reflected light 508 may be reflected from the beam splitter 502 to form light 510 that propagates outward. At least a portion of the light 510 that propagates outward may strike the sensor 126. In some examples, the positions of the laser light source 138 and the sensor 128 may be swapped. In some examples, the beam splitter 502 may include at least partially reflective elements that are at an angle to the optical path crossing the beam splitter 502. In some examples, the beam splitter 502 may be implemented as a fiber splitter.

[0063] Figure 6 is a schematic side view of an example of another configuration 600 of the surgical system 100 of Figure 1, in which configuration 600 may include at least one optical fiber 118 comprising a first optical fiber 118A and a second optical fiber 118B. In some examples, the first optical fiber 118A and the second optical fiber 118B extend substantially parallel to each other along the length of the endoscope 102. In some examples, the first optical fiber 118A and the second optical fiber 118B have their respective distal ends on the same plane. In some examples, the first optical fiber 118A and the second optical fiber 118B are on the same plane and have their respective distal ends substantially perpendicular to the longitudinal axis of at least one optical fiber 118. The configuration in Figure 6 is just one example of a surgical system, and other configurations may be used.

[0064] In some examples, the first optical fiber 118A can direct the fiber light 122 distally towards the target site 108 along the first optical fiber 118A. In some examples, the second optical fiber 118B can direct the reflected light proximal towards a sensor 126, such as a spectrometer, along the second optical fiber.

[0065] For example, laser light 140 may be incident on the first optical fiber 118A as incident light 604. The incident light 604 may exit the distal end 120 of the first optical fiber 118A and form fiber light 122. At least a portion of the fiber light 122 may be reflected from the target site 108 to form light 124. Additionally or alternatively, light irradiated onto the target site from one or more white light LEDs may be reflected from the target site to form at least a portion of light 124. At least a portion of light 124 may be incident on the distal end of the second optical fiber 118B and propagate proximally along the second optical fiber 118B as proximal light 606. At least a portion of the proximal light 606 may strike the sensor 126.

[0066] In some examples, the positions of the laser light source 138 and the sensor 128 can be swapped. In some examples, the beam splitter 502 may include at least partially reflective elements that are at an angle to the optical path crossing the beam splitter 502. In some examples, the beam splitter 502 may be implemented in free space so that light incident on the beam splitter and reflected from the beam splitter propagates in free space. In other examples, the beam splitter 502 may be implemented as a fiber splitter so that light incident on the beam splitter and reflected from the beam splitter propagates through an optical fiber.

[0067] Figure 7 is a schematic side view of an example configuration of the fiber detection and positioning mechanism 700 of the surgical system 100 shown in Figure 1. The configuration in Figure 7 is merely one example of a suitable fiber detection and positioning mechanism, and other suitable configurations may be used.

[0068] For example, the surgical system 100 may include an endoscope 102 (Figure 1). The surgical system 100 may further include an optical fiber 118 that is positionable to extend from the distal end 106 (Figure 1) of the endoscope 102 and configured to emit fiber light 122 toward a target such as a target site 108. The surgical system 100 may further include an actuator configured to advance the optical fiber 118 distally and retract the optical fiber 118 proximal to the endoscope 102. The surgical system 100 may further include a force sensor configured to detect when the optical fiber 118 has made contact with a target. The surgical system 100 may further include a controller 128 configured to cause the actuator to retract the optical fiber 118 proximal by a specific distance in response to detection that the optical fiber 118 has made contact with a target.

[0069] In various embodiments, when a force sensor detects that the tip of the optical fiber 118 has made contact with the target, the controller sets the position of the fiber tip to position "0," i.e., the distance between the fiber tip and the target is 0. From this point, the optical fiber 118 can be retracted proximally in a controlled manner using an actuator. For example, the actuator may be configured to precisely control the movement of the optical fiber 118, and as a result, the distance (Z) between the tips of the optical fiber 118 during its retraction can be determined. Furthermore, while the actuator is configured to advance or retract the optical fiber 118 (and in one embodiment, the controller is configured to calculate the distance (Z) between the distal end 120 of at least one optical fiber 118 and the target area 108 based on the recorded position "0" and the movement of the optical fiber 118), the sensor 126 (e.g., a spectrometer) may simultaneously or substantially simultaneously measure the optical power / intensity (I) of the reflected light from the target. Based on the determined distance (Z) and the measured optical power / intensity (I) of the reflected light from the target, a calibration curve 130 can be generated that shows the relationship between the distance (Z) and the optical power / intensity (I) of the reflected light.

[0070] In some examples, the actuator may include a wheel 702. The wheel 702 may have a center 704 fixed in a predetermined position relative to the endoscope 102. The wheel 702 may have a circumferential surface 706 that contacts the optical fiber 118. The wheel 702 may be rotatable from a rotary actuator 708 positioned close to the center of the wheel 702.

[0071] In some examples, the force sensor may include a torque sensor positioned between the rotary actuator and the circumferential surface 706. In some examples, the torque sensor may be implemented as a strain sensor 710 positioned along a generally radial bend 712 extending between the rotary actuator 708 and the circumferential surface 706. In typical use, the generally radial bend 712 may optionally be straight or nearly straight along the radial direction. When the distal end 120 of the optical fiber 118 contacts a target such as the target portion 108, the generally radial bend 712 may deform tangentially (e.g., to form a deformed bend 714), and the strain sensor 710 may detect a non-zero strain value. The controller 128 may optionally convert the strain value to a torque value by multiplying it by the radius of the circumferential surface 706. The fiber detection and positioning mechanism 700 may also include a guide wheel 716 positioned such that the optical fiber 118 extends between the guide wheel 716 and the circumferential surface 706. During use, the guide wheel 716 can apply a resistive force to the wheel 702 via the optical fiber 118, ensuring that the wheel 702 remains in contact with the optical fiber 118 without slipping. The guide wheel 716 may have a selectively adjustable position to accommodate different diameters of the optical fiber 118 or multiple optical fibers 118.

[0072] Figure 8 is a flowchart of an example of a method 800 for operating an endoscope, such as endoscope 102 (Figure 1). The endoscope may include at least one optical fiber, such as at least one optical fiber 118, which is positionable to extend from the distal end of the endoscope.

[0073] In operation 802, the endoscope may irradiate a target site, such as a target site 108, with at least one optical emitter, such as at least one optical emitter 104.

[0074] In operation 804, the endoscope may capture image data associated with the irradiated target area using at least one imaging sensor, such as at least one imaging sensor 112.

[0075] In operation 806, the endoscope may emit fiber optic light from at least one optical fiber toward the target site. Additionally or alternatively, the endoscope may emit light toward the target site from an LED.

[0076] In operation 808, the endoscope may detect reflected light from the target site using sensors such as sensor 126.

[0077] In operation 810, the endoscope may determine the distance from the distal end of at least one optical fiber to the target site based at least partially on the captured image data, using a controller such as the controller 128.

[0078] In operation 812, the endoscope may use a controller to determine optical properties (e.g., intensity or output) associated with light from the target site.

[0079] In operation 814, the endoscope may establish a relationship such as relationship 130 between the optical properties and a determined distance from the distal end of at least one optical fiber to the target site using the controller.

[0080] In some examples, at least one optical emitter may include two optical emitters located at the distal end of the endoscope and configured to emit beams at an angle to each other. In some examples, determining the distance may involve determining the spacing between the beams from the captured image data.

[0081] In some examples, at least one optical emitter may include a single optical emitter located at the distal end of the endoscope and configured to emit a beam that diverges away from a single optical emitter at a specific divergence angle. In some examples, determining the distance may include determining the cross-sectional size of the beam from captured image data.

[0082] In some examples, at least one imaging sensor may include a first camera and a second camera located at the distal end of the endoscope. In some examples, the captured image data may include a first image captured by the first camera and a second image captured by the second camera. In some examples, determining the distance may involve using triangulation from the first and second images.

[0083] Figure 9 is a flowchart of an example of a method 900 for operating an endoscope, such as endoscope 102 (Figure 1). The endoscope may include at least one optical fiber, such as at least one optical fiber 118, which can be positioned to extend from the distal end of the endoscope. In particular, method 900 may be suitable for performing endoscope calibration, such as at the start of a medical procedure. For example, method 900 may be performed once to establish a relationship, such as relationship 130 (Figure 1). The relationship may include a calibration curve. After method 900 is performed, the practitioner may proceed with the medical procedure. During the medical procedure, the calibration curve may function as a lookup table and may provide distance (Z) values ​​as needed.

[0084] In operation 902, the distance (Z) can be determined by performing method 800, for example.

[0085] In operation 904, the optical characteristics can be determined by performing method 800, for example.

[0086] In operation 906, a controller such as controller 128 may store data points representing the determined distance and optical characteristics. A data point may correspond to a single data point on a calibration curve.

[0087] In operation 908, the controller may determine whether additional data points can be used to form a complete calibration curve. For example, the controller may use several specific distances, such as distances equally spaced over a certain range of distances, to form the calibration curve. As another example, the controller may use optical characteristic values ​​from operation 904 to determine whether the calibration curve has reached a peak and may acquire additional data as needed to ensure that the peak value was included in the calibration curve. If additional data points are needed, the controller may instruct the actuator to vary the distance in operation 910. If additional data points are not needed, the controller may proceed to operation 912, where the relationship has been established. In operation 912, a calibration curve is generated showing the relationship between the distance (Z) and the reflected light power / intensity (I), based on the determined distance (Z) and the measured optical power / intensity (I) of the reflected light from the target.

[0088] In some examples, method 900 may optionally include interpolating between measured data points, fitting a curve to the measured data points, and / or smoothing the measured data points.

[0089] Figure 10 is a flowchart of an example of a method 1000 for operating an endoscope, such as endoscope 102 (Figure 1). The endoscope may include at least one optical fiber, such as at least one optical fiber 118, which can be positioned to extend from the distal end of the endoscope. In particular, method 1000 may be suitable for execution during medical procedures after the endoscope has been calibrated, such as by performing method 900.

[0090] In operation 1002, the real-time value of the optical power / intensity (I) can be measured by the sensor 126 (Figure 1), etc.

[0091] In operation 1004, established relationships such as calibration curves can be used to determine the real-time value of distance (Z) from the measured real-time value of optical power / intensity (I).

[0092] In operation 1006, the operation may be performed in response to a determined real-time value of distance (Z). For example, the operation may include automatically positioning the distal end of at least one optical fiber using a calibration curve to set the real-time interval between the distal end of at least one optical fiber and the target site to a specific value. As another example, the operation may include providing user feedback representing the real-time interval between the distal end of at least one optical fiber and the target site. Other suitable operations may also be used.

[0093] Figure 11 is a schematic diagram of an exemplary computer-based clinical decision support system (CDSS) 1100 configured to provide a distance (Z) value based on optical properties associated with light from a target site. For example, the optical properties may include the light power / intensity (I) of the reflected light. In various embodiments, the CDSS 1100 includes an input interface 1102 to which patient-specific optical properties are provided as input features to an artificial intelligence (AI) model 1104; a processor such as a controller 128 that performs an inference operation in which the optical properties are applied to the AI ​​model to generate a distance (Z) value; and a user interface (UI) to which the distance (Z) value is communicated to a user, such as a clinician.

[0094] In some embodiments, the input interface 1102 may be a direct data link between the CDSS 1100 and one or more medical devices, such as a surgical system 100 or endoscope 102, that generate at least some of the input features. For example, the input interface 1102 may transmit optical properties directly to the CDSS during therapeutic and / or diagnostic medical procedures. Additionally or alternatively, the input interface 1102 may be a conventional user interface that facilitates interaction between the user and the CDSS 1100. For example, the input interface 1102 may facilitate a user interface in which the user may manually input optical properties. Additionally or alternatively, the input interface 1102 may provide the CDSS 1100 with access to an electronic patient record from which one or more input features may be extracted. In any of these cases, the input interface 1102 is configured to collect optical properties relevant to a particular patient at or before the time the CDSS 1100 is used to assess a medical condition, such as kidney stones, that is addressed by the surgical system 100 or endoscope 102.

[0095] Based on one or more of the above input features, a processor such as controller 128 uses the AI ​​model to perform an inference operation to generate a distance (Z) value. For example, the input interface 1102 may transmit optical properties to the input layer of the AI ​​model, which propagates these input features to the output layer via the AI ​​model. The AI ​​model can provide a computer system with the ability to perform tasks without being explicitly programmed by performing inference based on patterns found in the analysis of the data. The AI ​​model explores the study and construction of algorithms (e.g., machine learning algorithms) that may learn from existing data and make predictions about new data. Such algorithms operate by constructing an AI model from exemplary training data to make data-driven predictions or decisions, which are expressed as outputs or evaluations.

[0096] Machine learning (ML) has two common modes: supervised ML and unsupervised ML. Supervised ML learns relationships between inputs and outputs using prior knowledge (e.g., correlating inputs to outputs or results). The goal of supervised ML is to learn a function that best approximates the relationship between training inputs and outputs, given some training data, so that the ML model can implement the same relationship when given inputs to produce corresponding outputs. Unsupervised ML is the training of ML algorithms using unclassified and unlabeled information, allowing the algorithm to act on that information without instructions. Unsupervised ML is useful for exploratory analysis because it can automatically identify structures in the data.

[0097] Common tasks in supervised machine learning are classification and regression problems. Classification problems, also known as categorization problems, aim to classify items into one of several categorical values ​​(e.g., is this object an apple or an orange?). Regression algorithms aim to quantify several items (e.g., by assigning a score to some input value). Some examples of commonly used supervised machine learning algorithms include logistic regression (LR), naive Bayes, random forest (RF), neural networks (NN), deep neural networks (DNN), matrix factorization, and support vector machines (SVM).

[0098] Some common tasks for unsupervised machine learning include clustering, representation learning, and density estimation. Some examples of commonly used unsupervised machine learning algorithms include K-means clustering, principal component analysis, and autoencoders.

[0099] Another type of machine learning is federative learning (also known as collaborative learning), which trains algorithms across multiple distributed devices that hold local data without exchanging data. This approach contrasts with traditional centralized machine learning techniques where all local datasets are uploaded to a single server, and with more classical distributed methods that often assume local data samples are uniformly distributed. Federative learning enables multiple entities to build a common, robust machine learning model without sharing data, thereby addressing critical issues such as data privacy, data security, data access rights, and access to heterogeneous data.

[0100] In some examples, the AI ​​model may be trained continuously or periodically before an inference operation is performed by a processor such as the controller 128. Then, during the inference operation, patient-specific input features provided to the AI ​​model may be propagated from the input layer through one or more hidden layers to the output layer, which ultimately corresponds to the distance (Z) value.

[0101] In some examples, the AI ​​model may include a database that may contain patient-related data. The database may provide patient records to CDSS1100. In some examples, the AI ​​model may receive optical properties from sensors such as sensor 126 or at least one imaging sensor 112.

[0102] During and / or following the inference operation, the distance (Z) value may be communicated to the user via the user interface (UI) and / or cause an actuator or alarm connected to the processor to automatically perform a desired action. For example, the processor may instruct an actuator to move an optical fiber relative to the endoscope, or the processor may instruct an alarm to warn the operator.

[0103] In some examples, the CDSS1100 may be optionally used to determine the operation performed in response to the value of distance (Z) and / or the value of an optical property such as optical power / intensity (I).

[0104] In the detailed description above, the methods and apparatus of this disclosure are described with reference to specific embodiments thereof. However, it will be apparent that various modifications and changes may be made without departing from the broader spirit and scope of this disclosure. Accordingly, this specification and the drawings should be considered illustrative rather than restrictive.

[0105] To further illustrate the apparatus and related methods disclosed herein, a non-limiting list of examples is provided below. Each of the following non-limiting examples can stand alone or be combined with any one or more of the other examples in any permutation or combination.

[0106] In Example 1, the surgical system may comprise an endoscope, at least one optical emitter positioned at the distal end of the endoscope and configured to illuminate a target site, at least one imaging sensor configured to capture image data associated with the illuminated target site, at least one optical fiber positioned to extend from the distal end of the endoscope and configured to emit fiber light toward the target site, a sensor configured to detect light from the target site, and a controller configured to determine the distance from the distal end of at least one optical fiber to the target site, determine the optical properties associated with the light from the target site, and establish a relationship between the optical properties and the determined distance from the distal end of at least one optical fiber to the target site, at least in part based on the captured image data.

[0107] In Example 2, the surgical system of Example 1 may optionally be configured such that at least one optical emitter includes two optical emitters located at the distal end of the endoscope, the two optical emitters are configured to illuminate a target site with beams that are at an angle to each other, and the controller is configured to partially determine the distance by determining the spacing between the beams from captured image data.

[0108] In Example 3, any one of the surgical systems from Examples 1-2 may be optionally configured such that each beam intersects at a predetermined distance from the distal end of the endoscope.

[0109] In Example 4, any one of the surgical systems in Examples 1-3 may be optionally configured such that at least one imaging sensor comprises a single camera.

[0110] In Example 5, any one of the surgical systems in Examples 1-4 may be optionally configured such that at least one optical emitter includes a single optical emitter located at the distal end of the endoscope, the single optical emitter is configured to illuminate a target site with a beam that diverges away from the single optical emitter at a specific divergence angle, and the controller is configured to partially determine the distance by determining the cross-sectional size of the beam from captured image data.

[0111] In Example 6, any one of the surgical systems in Examples 1-5 may be optionally configured such that at least one imaging sensor comprises a single camera.

[0112] In Example 7, any one of the surgical systems in Examples 1 to 6 may be optionally configured such that at least one imaging sensor comprises a first camera and a second camera located at the distal end of an endoscope, the captured image data includes a first image captured by the first camera and a second image captured by the second camera, and the controller is configured to determine the distance from the first image and the second image by triangulation.

[0113] In Example 8, any one of the surgical systems in Examples 1 to 7 may be optionally configured such that the distal end of at least one optical fiber emits fiber light toward a target site and couples at least a portion of the light from the target site to at least one optical fiber to form reflected light, the optical properties include the optical power or intensity of the reflected light, and the sensor comprises a spectrometer located separately from the endoscope and configured to measure the optical power or intensity of the reflected light.

[0114] In Example 9, any one of the surgical systems in Examples 1-8 may be optionally configured such that at least one optical fiber includes a single optical fiber, and the surgical system further comprises a beam splitter configured to separate the optical path of the fiber light from the optical path of the return light.

[0115] In Example 10, any one of the surgical systems in Examples 1 to 9 may be optionally configured such that at least one optical fiber includes a first optical fiber and a second optical fiber, the first optical fiber being configured to direct fiber light distally toward a target site along the first optical fiber, and the second optical fiber being configured to direct the reflected light proximal toward a spectrometer along the second optical fiber.

[0116] In Example 11, any one of the surgical systems from Examples 1 to 10 may be optionally configured such that the relationship includes a calibration curve that includes measurements of the optical power or intensity of light from the target site corresponding to the distance from the distal end of at least one optical fiber to the target site, for a plurality of distances from the distal end of at least one optical fiber to the target site.

[0117] In Example 12, any one of the surgical systems from Examples 1 to 11 may be optionally configured such that the controller is further configured to dynamically determine a real-time distance between the distal end of at least one optical fiber and the target site in response to real-time measurements of the optical power or intensity of light from the target site, at least in part on a calibration curve.

[0118] In Example 13, any one of the surgical systems from Examples 1 to 12 may be optionally configured such that the controller is further configured to automatically position the distal end of at least one optical fiber to set the real-time distance between the distal end of at least one optical fiber and the target site to a specific value using a calibration curve.

[0119] In Example 14, any one of the surgical systems from Examples 1 to 13 may be optionally configured such that the controller is further configured to provide user feedback representing the real-time interval between the distal end of at least one optical fiber and the target site.

[0120] Example 15 describes a method for operating an endoscope having at least one optical fiber that can be positioned to extend from the distal end of the endoscope, which may include: illuminating a target site using at least one optical emitter; capturing image data associated with the illuminated target site using at least one imaging sensor; emitting fiber light from at least one optical fiber toward the target site; detecting light from the target site using a sensor; determining the distance from the distal end of at least one optical fiber to the target site using a controller, based at least partially on the captured image data; determining optical properties associated with the light from the target site using a controller; and establishing a relationship between the optical properties and the determined distance from the distal end of at least one optical fiber to the target site using a controller.

[0121] In Example 16, the method of Example 15 may optionally be configured such that at least one optical emitter includes two optical emitters positioned at the distal end of the endoscope and configured to emit beams at an angle to each other, and the distance is determined from captured image data to determine the spacing between the beams.

[0122] In Example 17, any one of the methods in Examples 15–16 may optionally be configured such that at least one optical emitter is located at the distal end of the endoscope and is configured to emit a beam that diverges away from a single optical emitter at a specific divergence angle, and determining the distance includes determining the cross-sectional size of the beam from captured image data.

[0123] In Example 18, any one of the methods in Examples 15-17 may optionally be configured such that at least one imaging sensor comprises a first camera and a second camera located at the distal end of the endoscope, the captured image data includes a first image captured by the first camera and a second image captured by the second camera, and determining the distance includes using triangulation from the first and second images.

[0124] In Example 19, the surgical system may include an endoscope, an optical fiber that is positionable to extend from the distal end of the endoscope and configured to emit fiber light toward a target, an actuator configured to advance the optical fiber distally and retract it proximal to the endoscope, a force sensor configured to detect when the optical fiber has made contact with the target, and a controller configured to cause the actuator to retract the optical fiber by a specific distance in response to the detection that the optical fiber has made contact with the target.

[0125] In Example 20, the surgical system of Example 19 may be optionally configured such that the actuator comprises a wheel, the wheel having a center fixed in a predetermined position relative to the endoscope, the wheel having a circumferential surface that contacts an optical fiber, the wheel being rotatable from a rotary actuator positioned close to the center of the wheel, and the force sensor comprises a torque sensor positioned between the rotary actuator and the circumferential surface.

Claims

1. Endoscope and, The endoscope comprises at least one optical emitter positioned at its distal end and configured to irradiate a target site, At least one imaging sensor configured to capture image data associated with the irradiated target area, At least one optical fiber, which is positionable to extend from the distal end of the endoscope and configured to emit fiber light toward the target site, A sensor configured to detect light from the target site, Based at least partially on the captured image data, the distance from the distal end of the at least one optical fiber to the target region is determined. Determine the optical properties associated with the light from the target site, A controller configured to establish a relationship between the optical properties and the determined distance from the distal end of the at least one optical fiber to the target site, A surgical system equipped with [a specific feature / feature].

2. The at least one optical emitter includes two optical emitters located at the distal end of the endoscope, The two light emitters are configured to irradiate the target area with beams that are at an angle to each other. The surgical system according to claim 1, wherein the controller is configured to partially determine the distance by determining the interval between the beams from the captured image data.

3. The surgical system according to claim 2, wherein each of the beams is configured to intersect at a predetermined distance from the distal end of the endoscope.

4. The surgical system according to claim 2, wherein the at least one imaging sensor comprises a single camera.

5. The at least one optical emitter includes a single optical emitter located at the distal end of the endoscope, The single optical emitter is configured to illuminate the target area with a beam that diverges away from the single optical emitter at a specific divergence angle, The surgical system according to claim 1, wherein the controller is configured to partially determine the distance by determining the cross-sectional size of the beam from the captured image data.

6. The surgical system according to claim 5, wherein the at least one imaging sensor comprises a single camera.

7. The at least one imaging sensor comprises a first camera and a second camera located at the distal end of the endoscope, The captured image data includes a first image captured by the first camera and a second image captured by the second camera. The surgical system according to claim 1, wherein the controller is configured to determine the distance by triangulation from the first image and the second image.

8. The distal end of the at least one optical fiber is configured to emit the fiber light toward the target site and to couple at least a portion of the light from the target site to the at least one optical fiber to form reflected light. The optical properties include the optical power or intensity of the reflected light. The surgical system according to claim 1, wherein the sensor comprises a spectrometer, which is positioned separately from the endoscope and configured to measure the optical power or intensity of the reflected light.

9. The aforementioned at least one optical fiber includes a single optical fiber, The surgical system according to claim 8, further comprising a beam splitter configured to separate the optical path of the fiber optic light from the optical path of the return light.

10. The at least one optical fiber includes a first optical fiber and a second optical fiber, The first optical fiber is configured to direct the fiber light distally toward the target site along the first optical fiber, The surgical system according to claim 8, wherein the second optical fiber is configured to direct the reflected light along the second optical fiber in a proximal direction toward the spectrometer.

11. The surgical system according to claim 1, wherein the relationship includes a calibration curve that includes measurements of the optical power or intensity of the light from the target site corresponding to the distance from the distal end of the at least one optical fiber to the target site for a plurality of distances from the distal end of the at least one optical fiber to the target site.

12. The surgical system according to claim 11, wherein the controller is further configured to dynamically determine a real-time distance between the distal end of the at least one optical fiber and the target site in response to a real-time measurement of the optical power or intensity of the light from the target site, at least in part on the calibration curve.

13. The surgical system according to claim 12, wherein the controller is further configured to automatically position the distal end of the at least one optical fiber to set the real-time interval between the distal end of the at least one optical fiber and the target site to a specific value using the calibration curve.

14. The surgical system according to claim 12, wherein the controller is further configured to provide user feedback representing the real-time interval between the distal end of the at least one optical fiber and the target site.

15. A method for operating an endoscope, wherein the endoscope comprises at least one optical fiber that can be positioned to extend from the distal end of the endoscope, Using at least one optical emitter to irradiate the target area, Using at least one imaging sensor, capture image data associated with the irradiated target area, Emitting fiber light from at least one optical fiber toward the target site, Using a sensor, light from the target area is detected, Using a controller, the distance from the distal end of at least one optical fiber to the target site is determined based at least partially on the captured image data, Using the controller, the optical properties associated with the light from the target site are determined, Using the controller, establish the relationship between the optical characteristics and the determined distance from the distal end of the at least one optical fiber to the target site, Methods that include...

16. The at least one optical emitter includes two optical emitters positioned at the distal end of the endoscope and configured to emit beams that are at an angle to each other, The method according to claim 15, wherein determining the distance includes determining the interval between beams from the captured image data.

17. The at least one optical emitter includes a single optical emitter located at the distal end of the endoscope and configured to emit a beam that diverges away from the single optical emitter at a specific divergence angle, The method according to claim 15, wherein determining the distance includes determining the cross-sectional size of the beam from the captured image data.

18. The at least one imaging sensor comprises a first camera and a second camera located at the distal end of the endoscope, The captured image data includes a first image captured by the first camera and a second image captured by the second camera. The method according to claim 15, wherein determining the distance includes using triangulation from the first image and the second image.

19. Endoscope and, An optical fiber, which can be positioned to extend from the distal end of the endoscope and is configured to emit fiber light toward a target, An actuator configured to advance the optical fiber distally and retract the optical fiber proximal to the endoscope, A force sensor configured to detect when the optical fiber comes into contact with the target, A controller configured to retract the optical fiber by a specific distance in the proximal direction in response to detecting that the optical fiber has come into contact with the target, A surgical system equipped with [a specific feature / feature].

20. The actuator comprises a wheel, the wheel having a center fixed to a predetermined position relative to the endoscope, the wheel having a circumferential surface in contact with the optical fiber, and the wheel being rotatable from a rotary actuator positioned close to the center of the wheel. The surgical system according to claim 19, wherein the force sensor comprises a torque sensor disposed between the rotary actuator and the circumferential surface.

Images