Surgical System

Abstract

In surgical systems, the endoscope can extend distally toward the target site. A sensing optical fiber extending distally to the endoscope may include a fiber Bragg grating positioned at the distal end of the sensing optical fiber. A sensing controller can guide the sensing light distally along the sensing optical fiber so that at least a portion of the sensing light is reflected as reflected light from the fiber Bragg grating. The sensing controller can perform optical frequency domain reflectance measurements on the reflected light to determine parameter values, such as pressure or temperature, at the fiber Bragg grating. A processing circuit can analyze the parameter values ​​to determine if specified conditions are met, such as excessively high pressure or temperature at the target site, and respond by generating a warning data signal or performing an appropriate task.

Description

Technical Field

[0001] Cross - Reference to Related Applications This application claims the benefit of U.S. Provisional Patent Application No. 63 / 465,172, filed on May 9, 2023, and U.S. Provisional Patent Application No. 63 / 558,352, filed on February 27, 2024, both of which are hereby incorporated by reference in their 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, practitioner, 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 deliver light to an object being examined, such as an anatomical structure or object of the target. The endoscope can collect the light reflected from the object. The reflected light can carry information about the object being examined.

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

[0005] Endoscopes can perform laser treatments such as ablation, coagulation, vaporization, fragmentation, and lithotripsy using laser or plasma systems. In laser treatment, the operator can use the endoscope to deliver surgical laser energy to various target treatment areas, such as soft or hard tissue. In lithotripsy, the operator can use the endoscope to deliver surgical laser energy to destroy the stone structure in the patient's kidney, gallbladder, ureter, or other stone-forming area, or to break up large stones into smaller fragments. [Overview of the Initiative] [Problems that the invention aims to solve]

[0006] [Means for solving the problem]

[0007] In one example, a surgical system may include an endoscope configured to extend distally toward the target site; a sensing optical fiber extending to the distal end of the endoscope and including a fiber Bragg grating positioned at the distal end of the sensing optical fiber; a sensing controller configured to guide the sensing light distally along the sensing optical fiber such that at least a portion of the sensing light is reflected from the fiber Bragg grating as reflected light, perform a frequency-domain reflectance measurement on the reflected light, and determine parameter values ​​in the fiber Bragg grating from the frequency-domain reflectance measurement; and a processing circuit configured to analyze the parameter values, determine from the analysis of the parameter values ​​that the parameters at the target site meet specified conditions, and generate a warning data signal in response to the determination that the parameters at the target site meet the specified conditions.

[0008] In one example, the surgical system may include an endoscope configured to extend distally toward the target site and provide insufflation medium to the target site; a sensing optical fiber extending to the distal end of the endoscope and including a fiber Bragg grating positioned at the distal end of the sensing optical fiber; a sensing controller configured to guide the sensing light distally along the sensing optical fiber such that at least a portion of the sensing light is reflected from the fiber Bragg grating as reflected light, perform a frequency-domain reflectance measurement on the reflected light, and determine the pressure value at the fiber Bragg grating from the frequency-domain reflectance measurement; and a processing circuit configured to compare the pressure value with a threshold pressure, determine from the comparison that the pressure value exceeds the threshold pressure, and in response to the determination that the pressure value exceeds the threshold pressure, cause the endoscope to perform at least one of the following: warn the user to reduce the pressure of the insufflation medium, or automatically reduce the pressure of the insufflation medium.

[0009] In one example, the surgical system may include an endoscope, which includes a cooling element that extends distally toward the target site and is configured to provide therapeutic laser light to the target site, provide a flushing agent to the target site, and controllably cool the target site; a sensing optical fiber that extends to the distal end of the endoscope and includes a fiber Bragg grating positioned at the distal end of the sensing optical fiber; a sensing controller configured to guide the sensing light distally along the sensing optical fiber such that at least a portion of the sensing light is reflected from the fiber Bragg grating as reflected light, perform a frequency-domain reflectance measurement on the reflected light, and determine a temperature value at the fiber Bragg grating from the frequency-domain reflectance measurement; and a processing circuit configured to compare the temperature value with a threshold temperature, determine from the comparison that the temperature value exceeds the threshold temperature, and in response to the determination that the temperature value exceeds the threshold temperature, cause the endoscope to perform at least one of the following actions: automatically reduce the output of the therapeutic laser light, automatically increase the flow rate of the flushing agent, or automatically activate the cooling element, thereby warning the user that the temperature of the target site may be too high.

[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 shows a schematic side view of an example of a surgical system.

[0012] [Figure 2] Figure 2 shows a flowchart illustrating an example of a method for operating an endoscope.

[0013] [Figure 3] Figure 3 shows a flowchart illustrating an example of a method for operating an endoscope.

[0014] [Figure 4] Figure 4 shows a flowchart illustrating an example of a method for operating an endoscope.

[0015] [Figure 5] Figure 5 shows a schematic diagram of an example of a computer-based clinical decision support system configured to provide distance values ​​based on optical properties related to light from the target site. [Modes for carrying out the invention]

[0016] In a surgical system, the endoscope can extend distally toward the target site. A sensing optical fiber extending distally to the endoscope may include a fiber Bragg grating positioned distal to the sensing optical fiber. The sensing controller can guide the sensing light distally along the sensing optical fiber so that at least a portion of the sensing light is reflected as reflected light from the fiber Bragg grating. The sensing controller can perform a frequency-domain reflectance measurement on the reflected light to determine parameter values ​​such as pressure or temperature at the fiber Bragg grating. The processing circuit can analyze the parameter values ​​and determine if a specified condition is met, such as the pressure or temperature at the target site being too high. In response, the processing circuit can generate a warning data signal and / or perform other tasks such as automatically adjusting or reducing the pressure of the insufflation medium, automatically adjusting or reducing the flow rate of the flushing agent, or automatically activating a cooling or heating element.

[0017] For the purposes of this specification, the term “automatically” may mean that a particular operation can be initiated by a processing circuit. For example, the term “automatically” may mean that a particular operation can be performed without receiving instructions from the user to initiate that operation. The term “automatically” may also include prompting the user for confirmation and obtaining confirmation from the user to continue the particular operation. For example, the processing circuit may automatically calculate or determine new proposed parameter values ​​and may prompt the user to accept the proposed parameter values ​​or to confirm that the proposed parameter values ​​are acceptable.

[0018] Figure 1 shows a schematic side view of an example of a surgical system 100. The configuration in Figure 1 is just one example of a surgical system, and other configurations can also be used.

[0019] The surgical system 100 may include an endoscope 102. The endoscope 102 may include an elongated body portion extending between a proximal end 104 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 simplicity, 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. During use in a procedure, the endoscope 102 may extend distally toward a target site 110, such as a kidney stone. The endoscope 102 may include one or more light sources or emitters 108 at the distal end 106 of the endoscope 102 to illuminate the target site 110. Examples of suitable emitters 108 include light-emitting diodes such as white light-emitting diodes, arc lamps such as xenon arc lamps, etc. The endoscope 102 may include one or more cameras or imaging sensors 112 at the distal end 106 of the endoscope 102 to capture images, such as real-time video images, of the illuminated target site 110. The endoscope 102 may include one or more heating elements 114, such as an electric resistance heater, which can controllably heat the target site 110 or one or more other suitable areas on the endoscope 102. The endoscope 102 may include one or more cooling elements 116, such as a thermoelectric cooler, which can controllably cool the target site 110 or one or more other suitable areas on the endoscope 102. The endoscope 102 may provide a pneumoperitoneum medium, such as helium or carbon dioxide, to the target site 110 via a pneumoperitoneum medium port 120 to temporarily inflate the target site 110 during the procedure. The endoscope 102 may provide a flushing agent, such as saline solution, to the target site 110 via a flushing agent port 122 to help cool or remove particles, such as kidney stone fragments, which may be generated during the procedure.

[0020] The endoscope 102 may include various electrical connections extending along its length, such as powering one or more light emitters 108, transmitting data signals from one or more imaging sensors 112, powering one or more heating elements 114, powering one or more cooling elements 116, and so on. Although the electrical connections in Figure 1 are shown extending proximal to their respective positions on the proximal end 104 of the endoscope 102, in practice the electrical connections can be grouped together so that they can be connected at or near the proximal end 104 of the endoscope 102. For example, in practice the electrical connections can extend along a single channel within the endoscope 102 and fan out as needed at or near the distal end 106 of the endoscope 102.

[0021] The endoscope 102 can provide therapeutic laser light to the target site 110. The surgical system 100 can include at least one therapeutic optical fiber 118 for delivering the therapeutic laser light. The at least one therapeutic optical fiber 118 can be placed to extend from the distal end 106 of the endoscope 102. The therapeutic optical fiber 118 can be configured to guide the therapeutic fiber light to the target site 110 and perform dusting and / or fragmentation of kidney stones, for example, as induced to the kidney stones. The surgical system 100 can include a therapeutic laser light source 128 that generates the therapeutic laser light, guides the therapeutic laser light to the proximal portion of the therapeutic optical fiber 118, and guides the therapeutic laser light distally along the length of the therapeutic optical fiber 118 so as to emerge from the distal end of the therapeutic optical fiber 118 to form the therapeutic fiber light. The therapeutic laser light source 128 can include a thulium fiber laser capable of generating light having a wavelength of 1908 nm and / or 1940 nm. The therapeutic laser light source 128 can include a thulium:YAG (yttrium aluminum garnet) laser capable of generating light having a wavelength of 2010 nm. The therapeutic laser light source 128 can include a holmium:YAG laser capable of generating light having a wavelength of 2120 nm. The therapeutic laser light source 128 can include an erbium:YAG laser capable of generating light having a wavelength of 2940 nm. In the case of these (and other) therapeutic laser light sources, the therapeutic laser light can have a wavelength in a part of the electromagnetic spectrum where water (a major component of tissue) has a relatively high absorption. During the treatment, the tissue can absorb the therapeutic laser light, heat up to a relatively high temperature locally, and can separate as a result of local thermal distortion within the tissue.

[0022] The surgical system 100 can include a sensing optical fiber 124 that can extend to the distal portion of the endoscope 102. The sensing optical fiber 124 can include a fiber Bragg grating 126 disposed at the distal site of the sensing optical fiber.

[0023] The sensing optical fiber 124 can include a plurality of fiber Bragg gratings 126 along the length of the sensing optical fiber 124. For example, the sensing optical fiber 124 can include a first fiber Bragg grating 126A and a second fiber Bragg grating 126B located proximal to the first fiber Bragg grating 126A. By using a plurality of fiber Bragg gratings 126 along the sensing optical fiber 124, the surgical system can determine one or more physical states at the location of the fiber Bragg grating 126. For example, the sensing optical fiber 124 can have a first fiber Bragg grating 126A at or near the distal end 106 of the endoscope 102 to determine the physical state at or near the target site 110, and can be routed within the endoscope 102 to have a second fiber Bragg grating 126B to determine the physical state of a component of the endoscope 102, such as a handle, or near it. Other locations can also be used.

[0024] Alternatively or additionally, by using a plurality of fiber Bragg gratings 126 along the sensing optical fiber 124, the surgical system 100 can compare physical states at two different locations. For example, the surgical system 100 can use pressure or fluid pressure measurements taken at two different locations along a fluid channel to determine whether the fluid channel is blocked.

[0025] The surgical system 100 may include a sensing controller 130 coupled to a sensing optical fiber 124. The sensing controller 130 can guide the sensing light distally along the sensing optical fiber 124 so that at least a portion of the sensing light is reflected as reflected light from the fiber Bragg grating 126. The sensing controller 130 can perform optical frequency domain reflectance measurements on the reflected light. From the optical frequency domain reflectance measurements, the sensing controller 130 can determine parameter values ​​at the fiber Bragg grating 126. Appropriate parameter values ​​may include pressure values, temperature values, etc. To sense a sensing optical fiber 124 containing multiple fiber Bragg gratings 126, the sensing controller 130 can determine parameter values ​​at some or all of the locations of the fiber Bragg gratings 126, and this can be determined essentially simultaneously via optical frequency domain reflectance measurements. The sensing controller 130 can determine temperature and / or (fluid) pressure values ​​at the location of the fiber Bragg grating 126, or at one or more fiber Bragg gratings 126 arranged along the sensing fiber optic cable 124, using Optical Frequency Domain Reflectometry (OFDR) in conjunction with the sensing optical fiber 124. The sensing controller 130 may include a variable frequency laser beam coupled to an optical interferometer. The sensing controller 130 can split light from the variable frequency laser beam between the reference arm and the measuring arm of the interferometer. In the optical path of the measuring arm, the sensing controller 130 can further split the light so that it propagates distally along the length of the sensing optical fiber 124, including the fiber Bragg grating 126, and returns proximal along the sensing optical fiber 124. The light in the measuring arm may interfere with the light in the reference arm to form an interference pattern. The sensing controller 130 may include a photodetector capable of detecting the interference pattern. Using other suitable configurations, it is also possible to determine the temperature and / or pressure in one or more fiber Bragg gratings 126 positioned along the sensing optical fiber 124.

[0026] For example, a polarization-maintaining fiber may have a cross-section that includes a core at its center and two holes on either side of the core. The holes can define two hollow (or gas-filled) passages extending along the length of the fiber on either side of the core. The holes may optionally have a circular cross-section. The holes induce birefringence in the fiber such that a cross-sectional axis extending through the center of the holes can define the slow axis, and a cross-sectional axis extending between the holes (e.g., if there are holes on both sides of the axis) can define the fast axis. The core may optionally have an elongated cross-section along the fast axis. In a polarization-maintaining fiber, light emitted into a fiber with linear polarization aligned to the fast axis can exit from a fiber with linear polarization aligned to the fast axis. Similarly, light emitted into a fiber with linear polarization aligned to the slow axis can exit from a fiber with linear polarization aligned to the slow axis.

[0027] In addition to providing birefringence to the fiber, the holes can provide relatively high sensitivity to pressure along the fast axis and relatively low sensitivity to pressure along the slow axis. For example, a change in pressure may cause a shift in the wavelength reflected by the fiber Bragg grating 126, with a relatively small wavelength shift along the slow axis and a relatively large wavelength shift along the fast axis.

[0028] In contrast to pressure, sensitivity to temperature may be the same along both the slow and fast axes. For example, a change in temperature may shift the wavelength reflected by the fiber Bragg grating 126 by the same wavelength shift in both the slow and fast axes.

[0029] Polarization-maintaining fibers (with holes through them) exhibit directional differences in pressure sensitivity but not in temperature sensitivity. Therefore, polarization-maintaining fibers (with holes through them) allow the surgical system 100 to isolate the effect of temperature from pressure, thus enabling more accurate values ​​of both temperature and pressure. Specifically, the sensing controller 130 can guide a first sensing light linearly polarized along the slow axis of the sensing optical fiber 124 distally along the sensing optical fiber 124, and a second sensing light linearly polarized along the fast axis of the sensing optical fiber 124 distally along the sensing optical fiber 124. The sensing controller 130 can perform two measurements of pressure, one for the first sensing light and the other for the second sensing light. To accurately determine the pressure value at the fiber Bragg grating 126, the sensing controller 130 can optionally use one or both of the pressure measurements and optionally one or both of the temperature measurements to use the difference between the two pressure measurements. In other words, by detecting changes in the wavelength difference between the reflected fast-axis and slow-axis signals, the surgical system 100 can detect and measure pressure changes in the fiber Bragg grating, independently of temperature fluctuations and strain in the fiber Bragg grating. The surgical system 100 can perform pressure and temperature measurements using the OFDR technique described herein, and optionally, a set of fast-axis measurements and another set of slow-axis measurements can be obtained to more accurately determine the pressure and / or temperature.

[0030] The surgical system 100 may include a processing circuit 132 coupled to a sensing controller 130. The processing circuit 132 may also be referred to as a controller. The processing circuit 132 may be implemented purely in software. The processing circuit 132 may be implemented purely in hardware. In some examples, the processing circuit 132 may be implemented as a combination of software and hardware. The processing circuit 132 may be implemented on a single processor. The processing circuit 132 may be implemented on multiple processors. The multiple processors may be housed in a common housing, such as a housing 134. In some examples, at least two of the multiple processors may be separated in different housings. The housing 134 can house one or more of the processing circuit 132, the sensing controller 130, or the therapeutic laser light source 128. The processing circuit 132 may include one or more processors and a memory containing instructions that can be executed by one or more processors to cause one or more processors to perform an operation. Examples of such operation are detailed below.

[0031] The processing circuit 132 can analyze parameter values. From the analysis of parameter values, the processing circuit 132 can determine whether the parameters in the target part 110 meet specified conditions. Appropriate parameters may include pressure, temperature, and other physical conditions. Appropriate specified conditions may include the pressure being too high or too low, the pressure gradient (e.g., obtained from two or more locations along the sensing optical fiber 124) being too high or too low, the rate of change of pressure (e.g., obtained from repeated time-dependent measurements of time-varying pressure) being too high or too low, the temperature being too high or too low, the temperature gradient (e.g., obtained from two or more locations along the sensing optical fiber 124) being too high or too low, and the rate of change of temperature (e.g., obtained from repeated time-dependent measurements of time-varying temperature) being too high or too low. Determining whether a parameter value is too high may include determining that the parameter value is greater than a specified threshold. Determining whether a parameter value is too low (or too high) may include determining that the parameter value is less (or greater) than a specified threshold. Other criteria may also be used.

[0032] The processing circuit 132 can take one or more actions in response to a determination that the parameters at the target area 110 (or another location along the sensing optical fiber 124) meet the specified conditions.

[0033] Appropriate actions may include generating a warning data signal 136 to alert the user, device, or process. The warning data signal 136 may warn the user that the pressure at the target site 110 may be too high. The warning data signal 136 may warn the user that the pressure at the target site 110 may be changing too rapidly. The warning data signal 136 may warn the user that the insufflation medium channel may be blocked. The warning data signal 136 may warn the user to adjust the pressure of the insufflation medium. The warning data signal 136 may warn the user that the temperature at the target site 110 may be too high. The warning data signal 136 may warn the user that the temperature at the target site 110 may be changing too rapidly. The warning data signal 136 may warn the user that the temperature at the target site 110 may be changing too rapidly. The warning data signal 136 may warn the user that components of the endoscope 102 may be getting too hot and may instruct the user to take one or more actions to avoid damage to the components. Other appropriate warning data signals may also be used. Warnings may be provided visually, such as through one or more indicator lights 138 or signs on the endoscope 102 or on a graphical user display 140 coupled to the endoscope 102 or processing circuit 132. Alternatively or additionally, warnings may be provided audibly, such as through a speaker inside or on the endoscope 102, or on a graphical user display 140 coupled to the endoscope 102 or processing circuit 132.

[0034] Other appropriate operations may include automatically adjusting the pressure of the insufflation medium, automatically decreasing the flow rate of the flushing agent, automatically increasing the flow rate of the flushing agent, automatically decreasing the power of the therapeutic laser light, automatically activating one or more cooling elements 116, and automatically activating one or more heating elements 114.

[0035] The parameters and their values, the specified conditions, and more specific examples of appropriate behavior are described below.

[0036] In the first example, where the parameter is pressure and the parameter value is a pressure value, the processing circuit 132 can, in response to a determination that the pressure at the target site 110 meets a specified condition, cause the endoscope 102 to provide a warning to the user, device, or process and adjust the pressure of the insufflation medium. The processing circuit 132 can, in response to a determination that the pressure at the target site 110 meets a specified condition, cause the endoscope 102 to automatically adjust the pressure of the insufflation medium.

[0037] In the second example, where the parameter is pressure and the parameter value is the pressure value, the processing circuit 132 can analyze the pressure value by comparing it with a threshold pressure. The specified condition may be that the pressure value exceeds the threshold pressure. The warning data signal 136 can warn the user, device, or process that the pressure at the target part 110 may be too high.

[0038] In the third example, where the parameter is pressure and the parameter value is the pressure value, the processing circuit 132 can automatically reduce the flow rate of the flushing agent in response to a determination that the pressure value exceeds the threshold pressure.

[0039] In the fourth example, where the parameter is pressure and the parameter value is the pressure value, the processing circuit 132 can analyze the pressure value by comparing the rate of change of the pressure value with a specified standard or condition, such as a threshold pressure gradient value. The specified condition may be that the rate of change of the pressure value exceeds the threshold pressure gradient value. The warning data signal 136 can warn the user, device, or process that the pressure change at the target part 110 may be too rapid.

[0040] In the fifth example, the sensing optical fiber 124 may include a plurality of fiber Bragg gratings 126. For example, the parameter can be pressure. The fiber Bragg grating 126 can be a first fiber Bragg grating 126A. The sensing optical fiber 124 may include a second fiber Bragg grating 126B located proximal to the first fiber Bragg grating 126A. The sensing controller 130 can determine a first pressure value at the first fiber Bragg grating 126A and a second pressure value at the second fiber Bragg grating 126B from optical frequency domain reflectance measurements. The processing circuit 132 can analyze the first and second pressure values ​​by comparing the difference between the first and second pressure values ​​with a specified criterion such as a threshold pressure difference. From the analysis of the first and second pressure values, the processing circuit 132 can determine that the pressure at the target site 110 exceeds the threshold pressure difference. The warning data signal 136 can alert the user, apparatus, or process that the insufflation medium channel may be blocked.

[0041] In the sixth example, where the parameter is temperature and the parameter value is a temperature value, the processing circuit 132 can analyze the temperature value by comparing it to a specified condition, such as a threshold temperature. The specified condition may be that the temperature value exceeds the threshold temperature. The warning data signal 136 can warn the user, device, or process that the temperature of the target part 110 may be too high.

[0042] In the seventh example, where the parameter is temperature and the parameter value is a temperature value, the processing circuit 132 can automatically reduce the output of the therapeutic laser light in response to a determination that the temperature value satisfies a specified condition, for example, that it exceeds a threshold temperature.

[0043] In the eighth example, where the parameter is temperature and the parameter value is a temperature value, the processing circuit 132 can automatically increase the flow rate of the flushing agent in response to a determination that the temperature value satisfies a specified condition, for example, that it exceeds a threshold temperature.

[0044] In the ninth example, where the parameter is temperature and the parameter value is a temperature value, the processing circuit 132 can automatically activate the cooling element 116 in response to a determination that the temperature value satisfies a specified condition, for example, that it exceeds a threshold temperature.

[0045] In the tenth example, where the parameter is temperature and the parameter value is a temperature value, the processing circuit 132 can analyze the temperature value by comparing it to a specified criterion, such as a threshold temperature. The specified condition may be that the temperature value is below the threshold temperature. In response to the determination that the temperature value is below the threshold temperature, the processing circuit 132 can automatically activate the heating element 114.

[0046] In the eleventh example, where the parameter is temperature and the parameter value is a temperature value, the processing circuit 132 can analyze the temperature value by comparing the rate of change of the temperature value with a specified criterion, such as a threshold temperature gradient value. The specified condition may be that the rate of change of the temperature value exceeds the threshold temperature gradient value. The warning data signal 136 can warn the user, device, or process that the temperature change of the target part 110 may be too rapid.

[0047] In the twelfth example, the sensing optical fiber 124 may include a plurality of fiber Bragg gratings 126. For example, the fiber Bragg grating may be a first fiber Bragg grating 126A. The sensing optical fiber 124 may include a second fiber Bragg grating 126B located proximal to the first fiber Bragg grating 126A. The sensing controller 130 can determine a first temperature value in the first fiber Bragg grating and a second temperature value in the second fiber Bragg grating from optical frequency domain reflectance measurements. The processing circuit 132 can analyze the first and second temperature values. From the analysis of the second temperature value, the processing circuit 132 can determine that the temperature of the components of the endoscope 102 meets specified conditions. For example, the temperature of a component may exceed a specified threshold temperature for that component. As a specific example, the warning data signal 136 may warn the user, equipment, or process that the temperature of a component may be too high and instruct them to take one or more actions to avoid damaging the component.

[0048] The twelve specific examples of parameters, parameter values, specified conditions, and appropriate actions are merely examples. Other appropriate combinations of parameters, parameter values, specified conditions, and appropriate actions can also be used.

[0049] Figure 2 shows a flowchart of an example of a method 200 for operating a surgical system, such as surgical system 100 (Figure 1). In the surgical system, an endoscope, such as endoscope 102, can extend distally toward a target site, such as a target site 110. A sensing fiber, such as sensing fiber optic 124, can extend distally to the endoscope and may include a fiber Bragg grating, such as fiber Bragg grating 126, positioned distal to the sensing fiber optic. Method 200 can be performed by surgical system 100 or by another suitable surgical system. For example, method 200 can be performed by a unipolar or bipolar radiofrequency device, an ultrasonic lithotripsy device, an ultrasound device for tissue modification, a combined energy device, a cryogenic plasma device, a diagnostic device such as a needle sampler in which the device uses pneumoperitoneum to create an improved view of the target site, or a diagnostic device that captures a sample using cryogenic or radiofrequency energy. Method 200 is just one method for operating a surgical system, and other suitable methods can also be used.

[0050] In operation 202, a sensing controller such as the sensing controller 130 can guide the sensing light distally along the sensing optical fiber such that at least a portion of the sensing light is reflected as reflected light from the fiber Bragg grating.

[0051] In operation 204, the sensing controller can perform optical frequency domain reflectance measurement (OFDR) on the reflected light.

[0052] In operation 206, the sensing controller can determine the parameter values ​​in the fiber Bragg grating from the optical frequency domain reflectance measurement.

[0053] In operation 208, processing circuits such as processing circuit 132 can analyze parameter values.

[0054] In operation 210, the processing circuit can determine from the analysis of parameter values ​​that the parameters in the target area satisfy the specified conditions.

[0055] In operation 212, the processing circuit can generate a warning data signal, such as a warning data signal 136, in response to a determination that the parameters in the target area satisfy the specified conditions.

[0056] Figure 3 shows a flowchart of an example of a method 300 for operating a surgical system, such as surgical system 100 (Figure 1). In the surgical system, an endoscope, such as endoscope 102, extends distally toward a target site, such as target site 110, and can provide pneumoperitoneum to the target site. A sensing optical fiber, such as sensing optical fiber 124, can extend distally to the endoscope and may include a fiber Bragg grating, such as fiber Bragg grating 126, positioned distal to the sensing optical fiber. Method 300 can be performed by surgical system 100 or by another suitable surgical system. Method 300 is just one method for operating a surgical system, and other suitable methods may also be used.

[0057] In operation 302, a sensing controller such as the sensing controller 130 can guide the sensing light distally along the sensing optical fiber such that at least a portion of the sensing light is reflected as reflected light from the fiber Bragg grating.

[0058] In operation 304, the sensing controller can perform optical frequency domain reflectance measurement (OFDR) on the reflected light.

[0059] In operation 306, the sensing controller can determine the pressure value in the fiber Bragg grating from the optical frequency domain reflectance measurement.

[0060] In operation 308, processing circuits such as processing circuit 132 can compare the pressure value with a specified standard such as a threshold pressure.

[0061] In operation 310, the processing circuit can determine from the comparison that the pressure value exceeds the threshold pressure.

[0062] In operation 312, the processing circuit can cause the endoscope to perform at least one of operation 314 or 316 in response to a determination that the pressure value exceeds the threshold pressure.

[0063] In operation 314, the endoscope may provide a warning to the user, the device, or the process to reduce the pressure of the insufflation medium.

[0064] In operation 316, the endoscope can automatically reduce the pressure of the pneumoperitoneum medium.

[0065] The endoscope can further supply flushing agent to the target area. The processing circuit can automatically reduce the flow rate of the flushing agent in response to a determination that the pressure value exceeds a threshold pressure.

[0066] Figure 4 shows a flowchart of an example of a method 400 for operating a surgical system, such as surgical system 100 (Figure 1). In the surgical system, an endoscope, such as endoscope 102, can extend distally toward a target site, such as a target site 110. The endoscope can deliver therapeutic laser light to the target site. The endoscope can deliver a flushing agent to the target site. The endoscope may include a cooling element that can controlly cool the target site. A sensing optical fiber, such as sensing optical fiber 124, can extend distally to the endoscope and may include a fiber Bragg grating, such as fiber Bragg grating 126, positioned distal to the sensing optical fiber. Method 400 can be performed by surgical system 100 or by another suitable surgical system. Method 400 is just one method for operating a surgical system, and other suitable methods may also be used.

[0067] In operation 402, a sensing controller such as the sensing controller 130 can guide the sensing light distally along the sensing optical fiber such that at least a portion of the sensing light is reflected as reflected light from the fiber Bragg grating.

[0068] In operation 404, the sensing controller can perform optical frequency domain reflectance measurement (OFDR) on the reflected light.

[0069] In operation 406, the sensing controller can determine the temperature value in the fiber Bragg grating from the optical frequency domain reflectance measurement.

[0070] In operation 408, processing circuits such as processing circuit 132 can compare the temperature value with a specified standard such as a threshold temperature.

[0071] In operation 410, the processing circuit can determine from the comparison that the temperature value exceeds the threshold temperature.

[0072] In operation 412, the processing circuit can, in response to the determination that the temperature value exceeds the threshold temperature, cause the endoscope to perform at least one of operations 414, 416, 418, or 420.

[0073] In operation 414, the endoscope may provide a warning to the user, device, or process that the temperature of the target area may be too high.

[0074] In operation 416, the endoscope can automatically reduce the output of the therapeutic laser light.

[0075] In operation 418, the endoscope can automatically increase the flow rate of the flushing agent.

[0076] In operation 420, the endoscope can automatically activate the cooling element.

[0077] Figure 5 shows a schematic diagram of an example of a Computer-Based Clinical Decision Support System (CDSS) 500 configured to determine whether parameter values, such as pressure or temperature values, meet specified conditions. In various embodiments, the CDSS 500 includes an input interface 502 to which patient-specific parameter values ​​are provided as input features to an Artificial Intelligence (AI) model 504; a processor that performs inference operations to which the parameter values ​​are applied to the AI ​​model to determine whether the parameter values ​​meet specified conditions; and a user interface (UI) or output interface 508 to which the determination is communicated to a user, such as a clinician.

[0078] In some embodiments, the input interface 502 may be a direct data link between the CDSS 500 and one or more medical devices, such as a surgical system 100 or an endoscope 102, that generate at least some of the input features. For example, the input interface 502 may transmit parameter values ​​directly to the CDSS during therapeutic and / or diagnostic medical procedures. Additionally or alternatively, the input interface 502 may be a classic user interface that facilitates interaction between the user and the CDSS 500. For example, the input interface 502 may be user-friendly so that the user inputs parameter values ​​manually. Additionally or alternatively, the input interface 502 may provide the CDSS 500 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 502 is configured to collect parameter values ​​in relation to a particular patient at or before the time the CDSS 500 is used to assess a medical condition, such as kidney stones, that is addressed by the surgical system 100 or the endoscope 102.

[0079] Based on one or more of the above input features, a processor such as processing circuit 132 uses the AI ​​model to perform inference operations and generate a decision. For example, the input interface 502 can deliver parameter values ​​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 inferences based on patterns found in the analysis of data. The AI ​​model explores the study and construction of algorithms (e.g., machine learning algorithms) that can 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 assessments.

[0080] Machine learning (ML) has two modes: supervised ML and unsupervised ML. Supervised ML learns the relationship 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 a given input to produce a corresponding output. Unsupervised ML is the training of ML algorithms using unclassified and unlabeled information, allowing the algorithm to act on that information without guidance. Unsupervised ML is useful for exploratory analysis because it can automatically identify structures within the data.

[0081] Common tasks in supervised machine learning are classification and regression problems. Classification problems, also known as categorical 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).

[0082] Some common tasks for unsupervised machine learning include clustering, representation learning, and density estimation. Some examples of commonly used unsupervised machine learning algorithms are K-means clustering, principal component analysis, and autoencoders.

[0083] Another type of machine learning is federative learning (also known as collaborative learning), which trains algorithms across multiple decentralized 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, as well as more classical decentralized methods that often assume local data samples are uniformly distributed. Federative learning enables multiple parties to build a common, robust machine learning model without sharing data, and thus allows for addressing important issues such as data privacy, data security, data access rights, and access to heterogeneous data.

[0084] The AI ​​model may be trained continuously or periodically before the inference operation is performed by a processor such as the processing circuit 132. 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 that ultimately corresponds to the decision.

[0085] The AI ​​model can include a database that can contain patient-specific data. The database can provide patient records to CDSS500. The AI ​​model can receive parameter values ​​from sensors.

[0086] During and / or following the inference operation, the distance (Z) value may be communicated to the user via the User Interface (UI), and / or the processor may automatically cause an actuator or alarm connected to it to 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.

[0087] CDSS500 can optionally be used to determine the actions taken in response to parameter values.

[0088] 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.

[0089] To further illustrate the apparatus and related methods disclosed herein, a list of non-limiting examples is provided below. Each of the following non-limiting examples may exist alone or in permutations or combinations with one or more of the other examples.

[0090] In Example 1, the surgical system may include an endoscope configured to extend distally toward the target site, a sensing optical fiber extending to the distal end of the endoscope and including a fiber Bragg grating positioned at the distal end of the sensing optical fiber, a sensing controller configured to guide the sensing light distally along the sensing optical fiber such that at least a portion of the sensing light is reflected from the fiber Bragg grating as reflected light, perform a frequency-domain reflectance measurement on the reflected light, and determine parameter values ​​in the fiber Bragg grating from the frequency-domain reflectance measurement, and a processing circuit configured to analyze the parameter values, determine from the analysis of the parameter values ​​that the parameters at the target site satisfy specified conditions, and generate a warning data signal in response to the determination that the parameters at the target site satisfy the specified conditions.

[0091] In Example 2, the surgical system of Example 1 can be arbitrarily configured such that the parameter is pressure and the parameter value is the pressure value.

[0092] In Example 3, the surgical system described in either Example 1 or 2 may be optionally configured such that the endoscope is further configured to provide a pneumoperitoneum medium to the target site, and the processing circuit is further configured to cause the endoscope to perform at least one of the following in response to a determination that the pressure at the target site meets specified conditions: warn the user to adjust the pressure of the pneumoperitoneum medium, or automatically adjust the pressure of the pneumoperitoneum medium.

[0093] In Example 4, the surgical system described in any one of Examples 1 to 3 is configured such that the processing circuit analyzes the pressure value by comparing the pressure value with a threshold pressure, and the specified condition is that the pressure value exceeds the threshold pressure, which can be optionally configured.

[0094] In Example 5, the surgical system described in any one of Examples 1 to 4 may be optionally configured such that the warning data signal is configured to warn the user that the pressure at the target site may be too high.

[0095] In Example 6, the surgical system described in any one of Examples 1 to 5 may be optionally configured such that the endoscope is further configured to provide a flushing agent to the target site, and the processing circuit is further configured to automatically reduce the flow rate of the flushing agent in response to a determination that the pressure value exceeds a threshold pressure.

[0096] In Example 7, the surgical system described in any one of Examples 1 to 6 may be optionally configured such that the processing circuit is configured to analyze the pressure value by comparing the rate of change of the pressure value with a threshold pressure gradient value, the specified condition being that the rate of change of the pressure value exceeds the threshold pressure gradient value, and the warning data signal is configured to warn the user that the pressure change at the target site may be too rapid.

[0097] In Example 8, the surgical system described in any one of Examples 1 to 7 may be optionally configured such that the parameter is pressure, the fiber Bragg grating is a first fiber Bragg grating, the sensing optical fiber includes a second fiber Bragg grating located proximal to the first fiber Bragg grating, the sensing controller is further configured to determine a first pressure value at the first fiber Bragg grating and a second pressure value at the second fiber Bragg grating from optical frequency domain reflectance measurements, the processing circuit is further configured to analyze the first and second pressure values ​​by comparing the difference between the first and second pressure values ​​with a threshold pressure difference, the analysis of the first and second pressure values ​​determines that the pressure at the target site exceeds the threshold pressure difference, and a warning data signal is configured to warn the user that the insufflation medium channel may be blocked.

[0098] In Example 9, the surgical system described in any one of Examples 1 to 8 may be configured such that the parameter is temperature and the parameter value is a temperature value.

[0099] In Example 10, the surgical system described in any one of Examples 1 to 9 is configured such that the processing circuit analyzes the temperature value by comparing the temperature value with a threshold temperature, and the specified condition is that the temperature value exceeds the threshold temperature.

[0100] In Example 11, the surgical system described in any one of Examples 1 to 10 may be optionally configured such that the warning data signal is configured to warn the user that the temperature of the target site may be too high.

[0101] In Example 12, the surgical system described in any one of Examples 1 to 11 may be optionally configured such that the endoscope is further configured to provide therapeutic laser light to the target site, and the processing circuit is further configured to automatically reduce the output of the therapeutic laser light in response to a determination that the temperature value exceeds a threshold temperature.

[0102] In Example 13, the surgical system described in any one of Examples 1 to 12 may be optionally configured such that the endoscope is further configured to provide a flushing agent to the target site, and the processing circuit is further configured to automatically increase the flow rate of the flushing agent in response to a determination that the temperature value exceeds a threshold temperature.

[0103] In Example 14, the surgical system described in any one of Examples 1 to 13 may be optionally configured such that the endoscope includes a cooling element configured to controllably cool the target site, and the processing circuit is further configured to automatically activate the cooling element in response to a determination that the temperature value exceeds a threshold temperature.

[0104] In Example 15, the surgical system described in any one of Examples 1 to 14 may be optionally configured such that the processing circuit is configured to analyze a temperature value by comparing the temperature value with a threshold temperature, the specified condition being that the temperature value is below the threshold temperature, the endoscope includes a heating element configured to controllly heat the target site, and the processing circuit is further configured to automatically activate the heating element in response to the determination that the temperature value is below the threshold temperature.

[0105] In Example 16, the surgical system described in any one of Examples 1 to 15 may be optionally configured such that the processing circuit is configured to analyze the temperature value by comparing the rate of change of the temperature value with a threshold temperature gradient value, the specified condition being that the rate of change of the temperature value exceeds the threshold temperature gradient value, and the warning data signal is configured to warn the user that the temperature of the target site may be changing too quickly.

[0106] In Example 17, the surgical system described in any one of Examples 1 to 16 may be optionally configured such that the fiber Bragg grating is a first fiber Bragg grating, the sensing optical fiber includes a second fiber Bragg grating located proximal to the first fiber Bragg grating, the sensing controller is further configured to determine a first temperature value at the first fiber Bragg grating and a second temperature value at the second fiber Bragg grating from optical frequency domain reflectance measurements, and the processing circuit is further configured to analyze the first and second temperature values ​​and determine from the analysis of the second temperature value that the temperature of the endoscope components satisfies specified conditions.

[0107] In Example 18, the surgical system may include: an endoscope that extends distally toward the target site and is configured to provide an insufflation medium to the target site; a sensing optical fiber that extends to the distal part of the endoscope and includes a fiber Bragg grating positioned at the distal part of the sensing optical fiber; a sensing controller configured to guide the sensing light distally along the sensing optical fiber such that at least a portion of the sensing light is reflected from the fiber Bragg grating as reflected light, perform an optical frequency domain reflectance measurement on the reflected light, and determine the pressure value at the fiber Bragg grating from the optical frequency domain reflectance measurement; and a processing circuit configured to compare the pressure value with a threshold pressure, determine from the comparison that the pressure value exceeds the threshold pressure, and in response to the determination that the pressure value exceeds the threshold pressure, cause the endoscope to perform at least one of the following: provide a warning to the user to reduce the pressure of the insufflation medium, or automatically reduce the pressure of the insufflation medium.

[0108] In Example 19, the surgical system of Example 18 may be optionally configured such that the endoscope is further configured to provide a flushing agent to the target site, and the processing circuit is further configured to automatically reduce the flow rate of the flushing agent in response to a determination that the pressure value exceeds a threshold pressure.

[0109] In Example 20, the surgical system may include an endoscope including a cooling element configured to extend distally toward the target site, provide therapeutic laser light to the target site, provide a flushing agent to the target site, and controllably cool the target site; a sensing optical fiber including a fiber Bragg grating positioned distally to the distal end of the sensing optical fiber; a sensing controller configured to guide the sensing light distally along the sensing optical fiber such that at least a portion of the sensing light is reflected from the fiber Bragg grating as reflected light, perform a frequency-domain reflectance measurement on the reflected light, and determine the temperature value at the fiber Bragg grating from the frequency-domain reflectance measurement; and a processing circuit configured to compare the temperature value with a threshold temperature, determine from the comparison that the temperature value exceeds the threshold temperature, and in response to the determination that the temperature value exceeds the threshold temperature, cause the endoscope to perform at least one of the following: warn the user that the temperature of the target site may be too high, automatically reduce the output of the therapeutic laser light, automatically increase the flow rate of the flushing agent, or automatically activate the cooling element.

Claims

1. It is a surgical system, An endoscope configured to extend distally toward the target site, The sensing optical fiber extends to the distal portion of the endoscope and includes a fiber Bragg grating positioned at the distal portion of the sensing optical fiber, The sensing light is guided distally along the sensing optical fiber such that at least a portion of the sensing light is reflected as reflected light from the fiber Bragg grating. A reflectance measurement in the optical frequency domain is performed on the reflected light. A sensing controller configured to determine parameter values ​​in the fiber Bragg grating from the optical frequency range reflectance measurement, Analyze the aforementioned parameter values, From the analysis of the parameter values, it is determined that the parameters at the target site satisfy the specified conditions. A processing circuit configured to generate a warning data signal in response to the determination that the parameters in the target area satisfy the specified conditions, A surgical system equipped with the following features.

2. The aforementioned parameter is pressure, The aforementioned parameter value is a pressure value. The surgical system according to claim 1.

3. The endoscope is further configured to provide the pneumoperitoneum medium to the target site, The processing circuit, in response to the determination that the pressure at the target site satisfies the specified conditions, controls the endoscope, To provide the user with a warning to adjust the pressure of the insufflation medium, or Automatically adjusting the pressure of the insufflation medium, It is further configured to perform at least one of the following: The surgical system according to claim 2.

4. The processing circuit is configured to analyze the pressure value by comparing it with a threshold pressure. The specified condition is that the pressure value exceeds the threshold pressure. The surgical system according to claim 2.

5. The warning data signal is configured to warn the user that the pressure at the target area may be too high. The surgical system according to claim 4.

6. The endoscope is further configured to provide a flushing agent to the target site, The processing circuit is further configured to automatically reduce the flow rate of the flushing agent in response to the determination that the pressure value exceeds the threshold pressure. The surgical system according to claim 4.

7. The processing circuit is configured to analyze the pressure value by comparing the rate of change of the pressure value with a threshold pressure gradient value. The specified condition is that the rate of change of the pressure value exceeds the threshold pressure gradient value. The aforementioned warning data signal is configured to warn the user that the pressure change at the target area may be too rapid. The surgical system according to claim 2.

8. A surgical system according to claim 1, The aforementioned parameter is pressure, The fiber Bragg grating is a first fiber Bragg grating, The sensing optical fiber includes a second fiber Bragg grating located near the first fiber Bragg grating. The sensing controller is further configured to determine a first pressure value in the first fiber Bragg grating and a second pressure value in the second fiber Bragg grating from the optical frequency domain reflectance measurement. The aforementioned processing circuit is The first pressure value and the second pressure value are analyzed by comparing the difference between the first pressure value and the second pressure value with a threshold pressure difference. The system is further configured to determine, based on the analysis of the first and second pressure values, that the pressure at the target site exceeds a threshold pressure difference. The aforementioned warning data signal is configured to alert the user that the insufflation medium channel may be blocked in a surgical system.

9. The aforementioned parameter is temperature, The aforementioned parameter value is a temperature value. The surgical system according to claim 1.

10. The processing circuit is configured to analyze the temperature value by comparing it with a threshold temperature. The specified condition is that the temperature value exceeds the threshold temperature. The surgical system according to claim 9.

11. The aforementioned warning data signal is configured to warn the user that the temperature of the target area may be too high. The surgical system according to claim 10.

12. The endoscope is further configured to provide therapeutic laser light to the target area, The processing circuit is further configured to automatically reduce the output of the therapeutic laser light in response to the determination that the temperature value exceeds the threshold temperature. The surgical system according to claim 10.

13. The endoscope is further configured to provide a flushing agent to the target site, The processing circuit is further configured to automatically increase the flow rate of the flushing agent in response to the determination that the temperature value exceeds the threshold temperature. The surgical system according to claim 10.

14. The endoscope includes a cooling element configured to controllably cool the target area, The processing circuit is further configured to automatically activate the cooling element in response to the determination that the temperature value exceeds the threshold temperature. The surgical system according to claim 10.

15. A surgical system according to claim 9, The processing circuit is configured to analyze the temperature value by comparing it with a threshold temperature. The specified condition is that the temperature value falls below the threshold temperature. The endoscope includes a heating element configured to controllably heat the target area, A surgical system wherein the processing circuit is further configured to automatically activate the heating element in response to the determination that the temperature value is below the threshold temperature.

16. A surgical system according to claim 9, The processing circuit is configured to analyze the temperature value by comparing the rate of change of the temperature value with a threshold temperature gradient value. The specified condition is that the rate of change of the temperature value exceeds the threshold temperature gradient value. A surgical system in which the warning data signal is configured to warn the user that the temperature change of the target area may be too rapid.

17. A surgical system according to claim 1, The fiber Bragg grating is a first fiber Bragg grating, The sensing optical fiber includes a second fiber Bragg grating located near the first fiber Bragg grating. The sensing controller is further configured to determine a first temperature value in the first fiber Bragg grating and a second temperature value in the second fiber Bragg grating from the optical frequency domain reflectance measurement. The aforementioned processing circuit is The first temperature value and the second temperature value are analyzed, A surgical system further configured to determine, based on the analysis of the second temperature value, that the temperature of the components of the endoscope satisfies specified conditions.

18. It is a surgical system, An endoscope that extends distally toward the target site and is configured to provide a pneumoperitoneum medium to the target site, A sensing optical fiber extending to the distal portion of the endoscope and including a fiber Bragg grating positioned at the distal portion of the sensing optical fiber, The sensing light is guided distally along the sensing optical fiber such that at least a portion of the sensing light is reflected as reflected light from the fiber Bragg grating. A reflectance measurement in the optical frequency domain is performed on the reflected light. A sensing controller configured to determine the pressure value in the fiber Bragg grating from the optical frequency range reflectance measurement, The aforementioned pressure value is compared with the threshold pressure, From the above comparison, it is determined that the pressure value exceeds the threshold pressure. A surgical system comprising: a processing circuit configured to cause the endoscope to perform at least one of the following in response to the determination that the pressure value exceeds the threshold pressure: to warn the user to reduce the pressure of the insufflation medium, or to automatically reduce the pressure of the insufflation medium.

19. The endoscope is further configured to provide a flushing agent to the target site, The processing circuit is further configured to automatically reduce the flow rate of the flushing agent in response to the determination that the pressure value exceeds the threshold pressure. The surgical system according to claim 18.

20. It is a surgical system, An endoscope comprising a cooling element configured to extend distally toward a target site, provide therapeutic laser light to the target site, provide a flushing agent to the target site, and controllably cool the target site, A sensing optical fiber extending to the distal portion of the endoscope and including a fiber Bragg grating positioned at the distal portion of the sensing optical fiber, The sensing light is guided distally along the sensing optical fiber such that at least a portion of the sensing light is reflected as reflected light from the fiber Bragg grating. A reflectance measurement in the optical frequency domain is performed on the reflected light. A sensing controller configured to determine the temperature value in the fiber Bragg grating from the optical frequency range reflectance measurement, The aforementioned temperature value is compared with the threshold temperature, From the above comparison, it is determined that the temperature value exceeds the threshold temperature. In response to the determination that the temperature value exceeds the threshold temperature, To provide the user with a warning that the temperature of the target area may be too high. Automatically reducing the output of the therapeutic laser light, Automatically increasing the flow rate of the flushing agent, or A surgical system comprising: a processing circuit configured to cause the endoscope to perform at least one of the actions of automatically activating the cooling element.

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