Endoscope-based monitoring apparatus for water jet movement trajectory

Abstract

The present application provides an endoscope-based monitoring apparatus for a water jet movement trajectory, comprising a water jet, an endoscope, a water jet driving unit, an endoscope driving unit, and a control unit. The water jet driving unit and the endoscope driving unit are both electrically connected to the control unit. The water jet is capable of moving along a planned movement trajectory and spraying a water jet stream to perform tissue resection or ablation, the movement trajectory of the water jet being defined by water jet movement position trajectory parameters. The control unit determines a following movement trajectory of the endoscope based on the planned movement trajectory of the water jet. The endoscope is arranged parallel to the linear movement direction of the water jet, and is located at a rear portion of the water jet, with a predetermined distance S maintained between an observation lens of the endoscope and a water jet spray portion. In a following movement mode, the endoscope follows the water jet along the following movement trajectory to perform at least linear movement, while monitoring actual movement position trajectory parameters of the water jet, wherein the following movement trajectory is defined by following movement position trajectory parameters, which are determined by the control unit based on the planned movement position trajectory parameters of the water jet. The present application enables effective, accurate, and real-time monitoring of execution status during water jet surgical procedures.

Description

A monitoring device for water jet motion trajectory based on endoscope Technical Field

[0001] The present application relates to a monitoring device for surgical execution equipment, and in particular to an endoscope-based monitoring device for the motion trajectory of a water jet during actual surgical operation. Background Art

[0002] In recent years, with advances in medical technology, minimally invasive surgeries using image-guided surgical devices, such as water jets, have become increasingly popular. For example, in water jet surgery, ablation or resection trajectories can be pre-planned based on medical images, allowing the water jet to execute the surgical action along the planned ablation or resection trajectory, completing the ablation or resection of tissue.

[0003] However, the medical images used for planning are typically pre-excision images. Even when planning is based on real-time ultrasound images, they only reflect the tissue's state before resection. During surgery, the state of the tissue to be resected and its surrounding tissue may change as the resection proceeds. This change can cause the actual surgical trajectory to differ from the pre-planned trajectory, leading to deviations. Deviations can sometimes be caused by equipment failure, such as when the water jet is loose but the drive components are unaware of this and continue to drive the water jet. More often, they are unrelated to equipment failure or trajectory planning, but rather to the surgical environment or the patient's specific physical condition. Regardless of the cause, deviations are undesirable. On the one hand, deviations mean that the executed trajectory deviates from the planned target trajectory, compromising the precision and controllability of the surgery, which should have been executed according to the planned trajectory. On the other hand, deviations can cause unnecessary harm to the patient. Therefore, it is necessary to monitor the actual surgical execution trajectory in real time. On the one hand, based on the closed-loop feedback mechanism, it can ensure that the operation is carried out according to the planned target trajectory, and timely adjustments can be made when deviations are detected. More importantly, real-time monitoring of the actual surgical execution trajectory can further ensure the safety of the operation, especially during prostate hyperplasia resection surgery. Additional protection of sensitive positions such as the verumontanum is particularly important, which may cause damage even if the operation is performed according to the planned trajectory. Accurate and real-time monitoring of the surgical execution trajectory can ensure the precise control of the planned surgical process to the greatest extent and avoid surgical damage to the greatest extent.

[0004] However, there are many difficulties in real-time monitoring of the actual surgical execution trajectory of the water jet. The main reason is that since the water jet needs to spray high-pressure water jets during the operation to form a water column area, there are a lot of artifacts and noise in the ultrasound image, resulting in real-time ultrasound images that can only be used for rough observation. It cannot be used to accurately calculate the specific parameters related to the actual surgical execution trajectory of the water jet, and therefore it is impossible to achieve real-time monitoring of the actual surgical execution trajectory of the water jet.

[0005] Some researchers have proposed endoscopic monitoring methods. However, because the water jet is in motion during surgery, manual control or image tracking is often required to enable endoscope observation of the water jet. However, manual endoscope control is time-consuming and labor-intensive. Image tracking algorithms are often complex to implement, making it difficult to effectively track the surgical area in real time. Combined with the monitoring and calculation of trajectory parameters, the overall computational complexity is high and the calculation speed is slow, making it even more difficult to calculate the specific parameters related to the water jet's actual surgical trajectory in real time. Furthermore, the water jet ejected during water jet surgery can easily blur the image observed through the endoscope, reducing the clarity of the water jet observed through the endoscope. Furthermore, when using a water jet for prostatectomy, the surrounding tissue can collapse during insertion, obscuring the endoscope's field of view and resulting in an incomplete endoscopic field of view. Summary of the Invention

[0006] In order to solve the above technical problems, the present application provides a monitoring device for a water jet motion trajectory based on an endoscope, comprising a water jet, an endoscope, a water jet driving unit, an endoscope driving unit, and a control unit, characterized in that: the water jet driving unit and the endoscope driving unit are both electrically connected to the control unit; the water jet, driven by the water jet driving unit, can move according to a planned motion trajectory and eject a water jet to perform tissue resection or ablation; the motion trajectory of the water jet is defined by water jet motion position trajectory parameters, and the water jet motion position trajectory parameters include linear motion position trajectory parameters; the endoscope moves under the drive of the endoscope driving unit and has a following motion mode, in which the endoscope can follow the water jet according to the following motion trajectory to perform at least linear motion and monitor the actual motion position trajectory parameters of the water jet; wherein the following motion trajectory is defined by following motion position trajectory parameters, and the following motion position trajectory parameters at least include linear following motion position trajectory parameters; the control unit determines the following motion position trajectory parameters of the endoscope based on the planned motion position trajectory parameters of the water jet.

[0007] Furthermore, the water jet motion position trajectory parameters also include rotational motion position trajectory parameters and / or jet length trajectory parameters.

[0008] Furthermore, the linear motion directions of the endoscope and the water jet are parallel to each other, the endoscope is located behind the water jet, and there is a predetermined distance S between the observation lens of the endoscope and the water jet injection portion.

[0009] Furthermore, the motion trajectory of the water jet is an array combination of water jet motion position trajectory parameters of multiple steps, and the following motion position trajectory of the endoscope is an array combination of following motion position trajectory parameters of the same multiple steps. The control unit determines the following motion position trajectory parameters of the endoscope corresponding to the step size based on the water jet motion position trajectory parameters contained in the array of each step size.

[0010] Furthermore, the endoscope acquires endoscopic images of the water jet head and the water jet in real time in a follow-up motion mode, and the control unit analyzes and determines the jet length trajectory parameters and / or the rotational motion position trajectory parameters in the actual motion position trajectory parameters of the water jet based on the acquired endoscopic images.

[0011] Furthermore, the control unit determines the tracking motion position trajectory parameters according to the tissue collapse visual distance and / or the optimal working distance of the endoscope.

[0012] Furthermore, the control unit performs image segmentation processing on the endoscopic image of the water jet motion acquired by the endoscope in real time, and monitors the jet length trajectory parameters.

[0013] Furthermore, the control unit monitors the rotational motion position trajectory parameters of the water jet by measuring the swing angle and / or the swing frequency of the water column.

[0014] Furthermore, the control unit adopts different water jet rotation motion position trajectory parameter monitoring methods based on the comparison result of the rotation angle range in the preset trajectory of the water jet and the visible angle range of the tissue collapse.

[0015] Furthermore, when the entire water column can be observed through the endoscope, the control unit monitors and evaluates whether the actual rotational motion position trajectory parameters of the water jet are consistent with the planned rotational motion position trajectory parameters by measuring the water column swing angle range in the endoscopic image.

[0016] Furthermore, when the water jet is within the field of view of the endoscope, the control unit calculates the oscillation frequency of the water jet based on the water jet image at the same endoscopic observation angle separated by an even number of steps in the monitoring image of the endoscope; when the water jet is not within the field of view of the endoscope, the control unit calculates the oscillation frequency of the water jet based on the water jet feature point image at the same endoscopic observation angle separated by an even number of steps in the observation image of the endoscope.

[0017] Furthermore, the control unit compares the actual swing frequency of the water column movement within the step length with the swing frequency determined by the rotational motion trajectory parameters of the step length, and then evaluates whether the actual rotational motion position trajectory parameters of the water jet within the step length are consistent with the planned rotational motion position trajectory parameters.

[0018] Furthermore, the endoscope has a lens with adjustable tilt angle, and the following motion trajectory parameters of the endoscope include rotation following motion position trajectory parameters.

[0019] Furthermore, the endoscope also performs safety monitoring on sensitive parts in a follow-up motion mode.

[0020] Furthermore, the control unit determines a safe resection depth based on an image acquired by the endoscope, and judges the risk based on a comparison result between the planned jet length trajectory parameter and the safe resection depth.

[0021] Furthermore, the control unit determines the sensitive part based on the image obtained by the endoscope in the follow-up motion mode, and determines the safe resection depth for the sensitive part based on the shortest distance between the contour boundary of the sensitive part and the water jet cutter head.

[0022] Furthermore, the control unit also determines a safe removal depth based on a preset removal safety distance.

[0023] Furthermore, the control unit performs safety monitoring of sensitive parts based on the rotational motion position trajectory parameters, determines the non-removal area according to the image obtained by the endoscope, and judges the risk based on the comparison result of the planned rotational motion position trajectory parameters and the non-removal area.

[0024] Furthermore, the endoscope also has an autonomous motion mode, in which the movement of the endoscope and the movement of the water jet are independent of each other; in the autonomous motion mode, the endoscope is driven to move and parameters are collected, and the control unit sets or updates the follow-up motion position trajectory parameters based on the collected parameters.

[0025] Furthermore, the endoscope also includes an image acquisition unit, which acquires images and transmits them to the control unit. The control unit analyzes the acquired image data and adjusts the planned motion trajectory of the water jet and the follow-up motion trajectory of the endoscope based on the analysis results.

[0026] According to the above-mentioned scheme proposed in the present application, the technical problems in the background technology can be effectively solved, and the specific parameters related to the actual surgical execution trajectory of the water jet during the actual operation can be effectively, accurately and in real time monitored and calculated. The present application is particularly suitable for automatic water jet systems. When the water jet moves according to the planned surgical execution trajectory to perform tissue ablation or resection operations, the scheme of the present application can monitor the actual motion position trajectory parameters of the water jet in real time, which is conducive to adjusting the planned motion position trajectory parameters based on the real-time monitoring results; and the present application can also monitor the working area of ​​the water jet during the actual operation, especially the area involving sensitive parts, and determine the safety risks of the pre-planned motion trajectory based on the real-time monitoring results. According to the safety risk assessment results, the alarm mechanism can be triggered in advance or the planning scheme can be modified before the water jet performs ablation or resection to reduce damage. The pre-planned motion position trajectory parameters can also be corrected according to the real-time monitoring results to fully ensure the safety of the actual surgical process. BRIEF DESCRIPTION OF THE DRAWINGS

[0027] FIG1 is a schematic structural diagram of a surgical execution device according to an embodiment of the present application.

[0028] FIG2 is a schematic cross-sectional view of a surgical performing device according to an embodiment of the present application.

[0029] FIG. 3 is a diagram schematically showing the field of view of an endoscope.

[0030] FIG. 4 is a diagram schematically showing sensitive areas within a patient's lumen.

[0031] FIG. 5 is a diagram schematically showing a method for measuring the cutting depth of a water jet.

[0032] FIG. 6 is a diagram showing a tiltable endoscope.

[0033] FIG. 7 is a diagram illustrating a surgical procedure of a tissue removal tool according to an embodiment of the present application. DETAILED DESCRIPTION

[0034] The following describes in detail various exemplary embodiments of the present application with reference to the accompanying drawings. The description of the exemplary embodiments is illustrative only and is in no way intended to limit the present application, its application, or its use. The present application can be implemented in many different forms and is not limited to the embodiments described herein. These embodiments are provided to make this application thorough and complete and to fully convey the scope of this application to those skilled in the art. It should be noted that unless otherwise specified, the relative arrangement of components and steps, numerical expressions, and values ​​described in these embodiments should be interpreted as merely exemplary and not as limiting. All terms used in this application (including technical or scientific terms) have the same meaning as understood by those of ordinary skill in the art to which this application belongs, unless otherwise specifically defined. It should also be understood that terms defined in general dictionaries, such as those used in general dictionaries, should be understood to have a meaning consistent with their meaning in the context of the relevant art and should not be interpreted in an idealized or highly formalized sense unless explicitly defined herein. Components, parameters such as specific models of components, relationships between components, and control circuits not described in detail in this section are considered to be techniques, methods, and devices known to those of ordinary skill in the relevant art, but where appropriate, such techniques, methods, and devices should be considered part of the specification.

[0035] The words “include” or “comprising” and similar words used in this application mean that the elements before the word include the elements listed after the word, and do not exclude the possibility of also including other elements.

[0036] Also, in this application, "front" or "distal" or "end" refers to the position of the surgical instrument (water jet or endoscope) closer to the tissue or surgical area, and "back" or "proximal" refers to the position of the surgical instrument (water jet or endoscope) closer to the operator.

[0037] Figure 1 is a schematic diagram of the structure of a surgical execution device according to one embodiment of the present application. Typically, the surgical execution device includes a water jet and a device for monitoring its motion trajectory. As shown in Figure 1, the front end of the surgical execution device includes a water jet and an endoscope, and the rear end of the surgical execution device includes a water jet drive unit, an endoscope drive unit 4, and a control unit. The control unit is electrically connected to the water jet drive unit, which is connected to the water jet drive unit. The control unit is also electrically connected to the endoscope drive unit, which is connected to the endoscope drive unit.

[0038] The water jet includes a sheath and a movable high-pressure resistant pipeline arranged in the sheath. The front end of the high-pressure resistant pipeline can eject a high-pressure water jet to ablate or remove tissue. In this application, the water jet head refers to the front end of the high-pressure resistant pipeline that ejects the water jet (also called the water jet ejection part or nozzle). The part of the high-pressure resistant pipeline other than the blade head is also called the blade body. In some contexts, the water jet and the water jet head are not strictly distinguished. In addition, in this application, "ablation" or "resection" is not strictly distinguished. The two have similar meanings and are also called "removal" in some contexts; "water jet" or "water column" is not strictly distinguished. Both refer to the high-pressure water jet ejected from the water jet head.

[0039] The control unit is electrically connected to the water jet drive unit. Driven by the water jet drive unit, the water jet enters the target tissue area (in the case of prostate hyperplasia resection surgery, it can be through the urethra or the perineum) and performs ablation or resection by spraying high-pressure water jets.

[0040] The water jet moves along a planned path, which can be a path pre-designed by a physician or processor based on image information. The trajectory formed by movement along the planned path is called the planned motion trajectory. The planned motion trajectory can be a motion control position trajectory generated by the image planning module based on the continuous boundary position trajectory pre-planned on the navigation image.

[0041] Driven by the water jet drive unit, the water jet can perform linear motion and / or rotational motion. The linear motion of the water jet refers to the movement of the water jet forward or backward along the straight line direction defined by the water jet sheath channel. The rotational motion of the water jet refers to the rotation of the water jet relative to the axial direction of the water jet blade. While rotating, the blade head sprays a water jet, thereby performing ablation or removal of the target tissue in a scanning manner.

[0042] In addition to linear and / or rotational motion, the water jet also ejects a high-pressure water jet from the water jet head. The length of the water jet indicates the distance of the water jet's point of action. Since the length of the water jet is controllable through pipelines and hydraulic power modules, the water jet length is also an important parameter used to describe the water jet's motion trajectory.

[0043] In order to characterize the above-mentioned motion process of the water jet, in this application, the motion trajectory of the water jet is defined by the motion position trajectory parameters of the water jet, which represent the position of the water jet action point of the water jet in the water jet coordinate system. The motion control module can control the water jet motion motor, pipeline and hydraulic pump of the hydraulic power module to make the water jet move according to the preset motion position trajectory parameters. The preset motion position trajectory parameters can be determined based on the planned motion trajectory.

[0044] Preferably, the linear motion position trajectory parameter characterizing the linear motion of the water jet can be the long axis position of the jet at the action point and / or the long axis velocity of the jet at the action point in the water jet coordinate system; the rotational motion position trajectory parameter characterizing the rotational motion of the water jet can be the cross-sectional angle and / or the cross-sectional rotation velocity of the action point; the jet length trajectory parameter characterizing the length of the water jet ejected by the water jet head (i.e., the distance between the water jet ejection part and the action point) can be the jet length at the action point.

[0045] In this application, the endoscope is provided with a following motion mode. For this purpose, the endoscope is placed near the water jet, the axis of the endoscope and the axis of the water jet are parallel to each other, and the linear motion directions of the endoscope and the water jet are also parallel to each other.

[0046] The endoscope can be positioned near the water jet in a variety of fixed mounting arrangements. For example, the endoscope and the water jet can share a sheath, with the endoscope and the water jet respectively positioned within two parallel channels defined by the sheath. Alternatively, the endoscope and the water jet can each have independent sheaths, but the endoscope sheath and the water jet sheath can be integrally formed, or both can be fixedly mounted relative to the same base. Sharing a sheath or integrating the sheaths of the endoscope and the water jet can further stabilize the relative motion path of the endoscope and the water jet, ensuring consistency between the endoscope's tracking motion trajectory and the water jet's motion trajectory, and facilitating stability in the endoscope's tracking motion.

[0047] The control unit is also electrically connected to the endoscope driver, which drives the endoscope into the target tissue area. The endoscope captures images of the water jet and its surrounding tissue environment, capturing images of the endoscope's field of view in real time and transmitting the captured endoscopic image data to the control unit.

[0048] Driven by the endoscope drive unit, the endoscope can perform linear motion and / or rotational motion. The linear motion is the movement process of the endoscope moving forward or backward along the straight line direction defined by the endoscope sheath channel, and the rotational motion is optional, for example, in order to adjust the endoscope field of view, the endoscope is rotated relative to its axis.

[0049] In the present application, the endoscope has a following motion mode. In the following motion mode, the endoscope can follow the water jet to perform at least linear motion according to the following motion trajectory, and the linear motion of the endoscope is synchronized with the linear motion of the water jet.

[0050] In the following motion mode in some embodiments, the endoscope is set to only follow the water jet for linear motion, but not for rotational motion, so as to facilitate the endoscope to observe the linear and rotational motion of the water jet at a fixed viewing angle.

[0051] In the following motion mode in other embodiments, the endoscope is configured to follow the water jet not only in linear motion but also in rotational motion, to ensure that the rotating water jet and the water column are within the observation field of the endoscope.

[0052] In order to realize the following motion mode of the endoscope, the control unit generates the following motion trajectory of the endoscope based on the planned motion trajectory of the water jet, and sends the generated following motion trajectory of the endoscope to the endoscope driving unit for controlling the endoscope to move according to the following motion trajectory.

[0053] The following motion trajectory of the endoscope is defined by following motion position trajectory parameters, which at least include linear following motion position trajectory parameters. The linear following motion position trajectory parameters are determined based on the linear motion position trajectory parameters of the water jet.

[0054] The endoscope may also have an autonomous motion mode, in which the endoscope independently performs linear motion and / or rotational motion within the endoscope sheath channel, independent of the linear motion and / or rotational motion of the water jet.

[0055] The user can select the endoscope's motion mode through a control unit or similar mechanism to meet the needs of different scenarios. For example, during the preoperative equipment debugging stage, the endoscope can be selected to enter autonomous motion mode, manually control or motor-drive the endoscope to move within its sheath channel, collect relevant parameters, and set or update the follow-up motion position trajectory parameters based on the collected parameters. When the water jet is in place and ready to initiate the elimination or ablation operation of the tissue, the endoscope is selected to enter follow-up motion mode and the motor drives the endoscope to move, which can achieve real-time monitoring of the actual motion position trajectory parameters during the water jet operation.

[0056] Preferably, the image acquisition unit of the endoscope captures images and transmits them to the control unit. After obtaining the image data, the control unit analyzes the image data and adjusts the planned motion trajectory of the water jet and the follow-up motion trajectory of the endoscope based on the analysis results of the image data.

[0057] The control unit can convert the planned motion trajectory or parameters into motion position trajectory parameters. For example, the motion trajectory or parameters planned and set by the doctor in the image coordinate system can be converted into motion control position trajectory or parameters, and further converted into motion position trajectory parameters in the water jet coordinate system; or the received planned motion trajectory or parameters, or motion control position trajectory or parameters can be directly converted into motion position trajectory parameters in the water jet coordinate system.

[0058] The control unit can directly obtain the water jet motion position trajectory parameters, which are determined based on a pre-planned motion trajectory. The control unit sends the water jet motion position trajectory parameters determined based on the pre-planned motion trajectory to the water jet driving unit to drive the water jet to move according to the water jet motion position trajectory parameters.

[0059] The motion position trajectory parameters include: linear motion position trajectory parameters, rotational motion position trajectory parameters, and jet length trajectory parameters.

[0060] The linear motion position trajectory parameter can be the long axis position z of the action point jet and / or the long axis velocity Vz of the action point jet in the water jet coordinate system. The rotational motion position trajectory parameter can be the cross-sectional angle θ of the action point and / or the cross-sectional rotation velocity V in the water jet coordinate system. θ , the jet length position trajectory parameter can be the jet length R of the action point in the water jet coordinate system.

[0061] Furthermore, the linear motion position trajectory parameters may include the linear speed Vz, the linear starting position z_start, the linear ending position z_stop, etc.; the rotational motion position trajectory parameters may include the rotational speed V θ , rotation starting angle θ_start, rotation ending angle θ_stop, etc.; the jet length trajectory parameters may include jet length R, resection depth D, etc.

[0062] The overall motion trajectory of the water jet can be divided into multiple steps, and the motion position trajectory parameters within each step are assigned based on the step. The motion position trajectory parameters of each step can be represented by an array, for example: [{stepNO,z_start,z_stop,Vz,θ_start,θ_stop,V θ ,R}], where stepNO is the step number of the water jet motion, z_start is the linear starting position of the water jet in the step, z_stop is the linear ending position of the water jet in the step, Vz is the linear speed of the water jet in the step, θ_start is the starting angle of rotation of the water jet in the step, θ_stop is the ending angle of rotation of the water jet in the step, V θ is the rotation speed of the water jet within the step length, R is the jet length of the water jet within the step length, alternatively, the resection depth D of the water jet within the step length can also be used to represent the jet length trajectory parameter within the step length. In this application, the resection depth D and the jet length R are regarded as approximately equal parameters.

[0063] By representing the motion position trajectory parameters of the water jet with an array of each step length, the partial or entire motion trajectory of the water jet can be expressed by a combination of the motion position trajectory parameter arrays of each step length.

[0064] The length of each step can be appropriately set based on the surgical scenario and objectives. For example, in prostate hyperplasia resection or ablation surgery, setting the water jet motion trajectory to a step length on the order of mm can generally meet the surgical process control accuracy requirements and achieve precise and controllable resection control. For scenarios with less demanding surgical precision, the length of each step can be set to a larger value.

[0065] In order to use the endoscope to monitor the actual motion trajectory parameters of the water jet during operation, the present application provides the endoscope with a follow motion mode. In follow motion mode, the endoscope moves along the water jet according to the follow motion trajectory. Therefore, the control unit needs to predetermine the endoscope's follow motion trajectory based on the planned motion trajectory of the water jet. Specifically, the endoscope's follow motion trajectory parameters are determined based on the planned motion trajectory parameters of the water jet.

[0066] In the case where the overall motion trajectory of the water jet is divided into multiple steps and the motion position trajectory parameters within each step are assigned based on the step, the following motion trajectory of the endoscope is also divided into the same multiple steps, and the following motion position trajectory parameters within each step of the endoscope are generated based on the motion position trajectory parameters within each step of the water jet. The following motion trajectory of the endoscope is expressed by a combination of the following motion position trajectory parameter arrays of each step of the endoscope.

[0067] Specifically, the motion position trajectory parameters of each step of the water jet are expressed as [{stepNO,z_start,z_stop,Vz,θ_start,θ_stop,V θ ,R}], the follow-up motion position trajectory parameters of each step of the endoscope are expressed as [{CstepNO,Cz_start,Cz_stop,CVz}], wherein, based on the step number stepNO in the planned motion position trajectory parameters of the water jet, the step number CstepNO of the follow-up motion corresponding to the endoscope is determined; based on the straight line starting position z_start of the water jet within the step, the straight line starting position Cz_start of the endoscope within the step is determined; based on the straight line ending position z_stop of the water jet within the step, the straight line ending position Cz_stop of the endoscope within the step is determined; and based on the straight line motion speed Vz of the water jet, the straight line motion speed CVz of the endoscope is determined.

[0068] Preferably, the step length of the endoscope is consistent with the step length of the water jet and the linear motion speed is consistent, and CstepNO = stepNO and CVz = Vz can be set. Furthermore, it is preferred to set the linear motion time within each step length of the endoscope to be consistent with the linear motion time within each step length of the water jet. Therefore, the linear motion speed CVz of the endoscope is calculated by CVz = Vz × (Cz_stop - Cz_start) / (z_stop - z_start).

[0069] Because the water jet ejection portion of the water jet continuously ejects water jets in the working state to form a radial water column (usually a gas-liquid mixture containing cavitation gas masses), if the observation lens of the endoscope is below the water jet ejection portion, it will inevitably be visually interfered with by the radiation of the water column, making it impossible to achieve clear observation. If the observation lens of the endoscope is set at the front end of the water jet ejection portion, it means that the movement area of ​​the endoscope exceeds the movement area of ​​the water jet, resulting in the water jet movement area being limited at the same insertion depth. To achieve clear observation of the water jet by the endoscope, the present application sets the endoscope behind the water jet and sets a predetermined distance S between the observation lens of the endoscope and the water jet ejection portion. In this way, endoscopic observation can avoid the interference caused by the ejected water jet and help provide an improved observation field and observation effect without restriction of the surgical area. Furthermore, after S is determined, the linear starting position Cz_start of each step in the follow-up motion position trajectory parameters of the endoscope can be determined according to the linear starting position z_start of each step in the planned motion position trajectory parameters of the water jet, and the linear ending position Cz_stop of each step in the follow-up motion position trajectory parameters of the endoscope can be determined according to the linear ending position z_stop of each step in the planned motion position trajectory parameters of the water jet. Specifically, when performing a prostate hyperplasia resection operation, the water jet and the endoscope first move synchronously to the farthest position (with this position as the starting point), and then the endoscope is driven back to the rear of the water jet injection part, and the endoscope is set at a position S behind the water jet. Accordingly, the linear starting position Cz_start of the endoscope in the follow-up motion trajectory parameters of the endoscope are set to be z_start+S, and the linear ending position Cz_stop=z_stop+S.

[0070] By staggering the endoscope and the water jet axially a certain distance, the water jet can be ejected without obstruction. The endoscope will not block the water jet, and it is possible for the endoscope to effectively capture the water jet. However, simply setting the endoscope at a predetermined distance behind the water jet is not enough. The determination of S is an important factor in achieving clear observation.

[0071] Figure 3 is a schematic diagram of the visible area within the endoscope's field of view. As shown in the figure, C represents the approximate center of the endoscope, A represents the image of the water jet in the endoscope's field of view, and E represents the water jet, or water column, ejected from the water jet ejection unit. When determining the parameters of the endoscope's tracking motion trajectory, it is necessary to ensure that the endoscope's field of view can clearly observe the water jet A and the water jet E so that the image information of the water jet A and the water jet E can be used for calculation and processing.

[0072] Because different endoscopes have different imaging capabilities, to ensure clear imaging, this application introduces the parameter "endoscope optimal working distance L" when determining the distance between the endoscope lens and the water jet tip. The optimal working distance L represents the distance from the endoscope lens at which an object can be clearly imaged. This distance is typically related to the endoscope's focal length. In this application, the optimal working distance L represents the optimal working distance between the endoscope lens and the water jet tip, within which the endoscope can clearly image the water jet tip A and the water jet E within its field of view. L can be pre-determined experimentally. For example, in autonomous motion mode, the water jet is driven into the target tissue area and then stopped. The endoscope is then driven within the endoscope sheath channel to the vicinity of the water jet tip and reciprocated until the area where the water jet tip A and the water jet E can be clearly observed is recorded. The location of the area where the water jet tip A and the water jet E can be clearly observed is then recorded, and the optimal working distance L is determined based on the recorded location.

[0073] The optimal working distance L of the endoscope can be a numerical range or a set of dynamically changing numerical values ​​related to the water jet position. That is, different optimal working distances L of the endoscope can be determined for different fixed positions P of the water jet, and the array corresponding to the optimal working distance L of the endoscope and the water jet position P can be stored.

[0074] The endoscope's following motion position trajectory parameters can be determined based on the endoscope's optimal working distance L, for example, the endoscope's linear starting position Cz_start=z_start+L and the linear ending position Cz_stop=z_stop+L are set in the endoscope's linear following motion position trajectory parameters.

[0075] When the water jet is inserted into human tissue, tissue collapse will occur around the water jet. This is especially true during prostatectomy where the water jet is inserted through the urethra. The surrounding prostate hyperplasia tissue is squeezed and collapses, surrounding the water jet. As shown in Figure 3, B, D, and F represent the tissues that appear within the endoscopic field of view due to squeezing and deformation of the surrounding tissues caused by the insertion of the water jet.

[0076] Through repeated experiments, the inventors discovered that because the squeezed tissue is soft and deformable, the resulting obstruction of the endoscope's field of view occurs during the movement of the surgical instrument. The degree of obstruction is related to the volume and texture of the tissue, as well as the distance between the endoscope and the water jet cutting head. For example, when the endoscope is close to the water jet cutting head, the water jet cutting head, inserted in front, provides a certain degree of support and expansion for the surrounding tissue, so the endoscope's field of view is almost immune to tissue collapse, or the tissue collapse effect is minimal and does not affect observation. When the distance between the endoscope and the water jet cutting head is greater, the support and expansion effect provided by the water jet cutting head on the surrounding tissue disappears, and the tissue collapse effect around the blade is more pronounced. In severe cases, the entire field of view of the endoscope can be obstructed.

[0077] To address this issue, this application introduces the parameter tissue collapse visual distance T, which represents the distance between the endoscope and the water jet tip and is used to characterize the impact of tissue collapse on the endoscope's field of view. The tissue collapse visual distance T for different tissue locations during water jet insertion in ultrasound images was previously determined experimentally. For example, in autonomous motion mode, the water jet enters the target tissue area and stops. The endoscope is then driven through the endoscope sheath channel to directly below the water jet tip and then gradually moves away from it. Within the tissue collapse visual distance T, a water column E can be observed in the endoscope's field of view. Beyond this distance, tissue contraction, compression, and wrapping obstruct the endoscope's field of view. The distance between the endoscope and the water jet tip corresponding to the point where the endoscope's field of view is unobstructed or begins to be obstructed or is partially obstructed is recorded as the tissue collapse visual distance T. In other words, the tissue collapse visual distance T refers to the distance near the water jet tip where the area is not or is minimally obstructed by tissue compression and deformation.

[0078] The tissue collapse visible distance T can be a numerical range or a set of dynamically changing numerical values ​​related to the water jet position. That is, different tissue collapse visible distances T can be determined for different water jet fixed positions P, and an array corresponding to the tissue collapse visible distance T and the water jet position P can be stored.

[0079] Furthermore, the endoscope's tracking motion position trajectory parameters can be determined based on the tissue collapse visible distance T, and the endoscope's linear starting position Cz_start = z_start + T and linear ending position Cz_stop = z_stop + T in the linear tracking motion position trajectory parameters of the endoscope can be set. In this way, it can be ensured that the endoscope's observation field of view in the tracking motion mode is not affected by the tissue collapse effect.

[0080] More preferably, the present application can determine the endoscope's tracking motion trajectory parameters based on both the tissue collapse viewing distance T and the endoscope's optimal working distance L. For example, Cz_start can be set to z_start + min(L, T); and Cz_stop can be set to z_stop + min(L, T). In this way, the endoscope's observation field of view in the tracking motion mode can be ensured to be unaffected by the tissue collapse effect, while achieving better imaging results.

[0081] Furthermore, the present application may also be configured to adjust the endoscope depth of field delta. The distance between the endoscope lens and the water jet tip may be appropriately adjusted within the allowable range of the endoscope depth of field delta to ensure that the water jet and its ejected water jet fall within the endoscope's field of view as much as possible. The endoscope depth of field delta is the operable range of the endoscope before and after the aforementioned optimal working distance L, i.e., the depth of field of the endoscope when the focus is clearest.

[0082] Through the above configuration, when the water jet is actually operating, the endoscope can activate the follow-up motion mode, driving the endoscope to move along the follow-up motion position trajectory. Because the endoscope's follow-up motion position trajectory parameters are determined based on the water jet's planned motion position trajectory parameters, the linear motion of the endoscope moving according to the follow-up motion position trajectory parameters and the linear motion of the water jet moving according to the planned motion position trajectory parameters can always be synchronized, ensuring that the endoscope can still clearly observe the water jet tip, the water jet it sprays, and the surrounding tissue area, while taking into account the effects of the water jet and the collapse of surrounding tissue. Furthermore, because the endoscope's follow-up motion mode is pre-set and the endoscope's follow-up motion position trajectory parameters are also pre-determined based on the water jet's planned motion position trajectory parameters, the endoscope does not need to perform large amounts of image data calculations such as tracking when executing the follow-up motion. This significantly reduces the amount of computation required by the control unit or processor during the endoscope's movement, allowing the control unit or processor to calculate and analyze the actual motion position trajectory parameters during the water jet operation based on the endoscopic image, achieving the technical effect of near real-time monitoring. The specific monitoring method is detailed below.

[0083] The endoscope in motion-following mode can capture real-time endoscopic images of the waterjet tip and the jetted water column. As previously described, based on the present invention's motion-following trajectory determination method, the waterjet tip and the jetted water column can be clearly identified based on the captured endoscopic images. As shown in Figure 5, the control unit or processor uses an image segmentation algorithm to determine the water column area within each captured endoscopic image and calculates the length of the water column. The resulting water column length is the jet length trajectory parameter R, which is part of the actual motion position trajectory parameters of the waterjet. Because the images are clear and the image segmentation algorithm is highly mature, the calculation result of the jet length trajectory parameter R is obtained almost in real time.

[0084] For example, the water column region E in the endoscopic image can be segmented to obtain the water column region E and its enclosing polygonal region. By measuring the enclosing polygonal region, such as by image detection of the height h and width w of the minimum enclosing rectangle, the actual water jet range w and length h can be determined for monitoring. The length h is the measured jet length trajectory parameter. By comparing the measured length h with the planned jet length trajectory parameter R, it is possible to evaluate whether the measured jet length trajectory parameter of the water jet within the step size is consistent with the planned jet length trajectory parameter.

[0085] Furthermore, the control unit or processor can analyze the endoscopic image acquired in the tracking motion mode to calculate the rotational motion position trajectory parameters within the actual motion position trajectory parameters of the water jet. The present application monitors the rotational motion position trajectory parameters of the water jet by measuring the swing angle and / or the swing frequency of the water jet. Furthermore, different methods for monitoring the rotational motion position trajectory parameters of the water jet can be employed based on a comparison of the rotational angle range within the preset trajectory of the water jet with the visible angle range of tissue collapse.

[0086] The swing angle is measured to evaluate the actual rotational motion position trajectory parameters of the water jet

[0087] When the entire water column can be observed through the endoscope, the rotation angle trajectory parameters of the water jet can be directly obtained by measuring the water column swing angle range. For example, a series of endoscopic image frames can be obtained, and the water column swing angle can be calculated by segmenting the water column image of each frame.

[0088] Specifically, during the movement of a step, the segmented water column images of all frames from the start to the end of the step can be recorded, and the angle between the long axis of the water column in all water column images and the vertical direction can be calculated. With the vertical downward angle from the water jet tip being 0 degrees, the minimum swing angle RotateStartReal and the maximum swing angle RotatestopReal of the long axis of the water column in all water column images during the movement of the step can be obtained. (RotateStartReal, RotatestopReal) is used as the swing angle range, which is the measured rotation angle range of the water column movement within the step. By comparing the measured rotation angle range (RotateStartReal, RotatestopReal) of the water column movement within the step with the planned angle range (θ_start, θ_stop) determined by the rotational motion trajectory parameters of the step, it is possible to evaluate whether the measured rotational motion position trajectory parameters of the water jet within the step are consistent with the planned rotational motion position trajectory parameters.

[0089] However, the above is only an ideal situation. During actual observation, it was found that although the visible distance of tissue collapse was taken into account when determining the parameters of the tracking motion position trajectory, there would still be more or less tissue squeeze and obstruction during actual observation. In this case, the angle of the water jet swing may exceed the field of view of the endoscope, that is, the full angle range of the water jet swing cannot be observed from the field of view of the endoscope alone. As shown in Figure 2, it is a cross-sectional schematic diagram of the water jet of the present application, where W represents the center of the water jet, C represents the center of the endoscope, the solid circle represents the radiation range of the water jet, and the dotted circle represents the field of view of the endoscope. Due to the structural limitations of the water jet and the endoscope, the radiation range of the water jet and the field of view of the endoscope are usually not 360 degrees, but a sector-shaped area less than 360 degrees. As shown in Figure 2, the radiation range of the water jet is the fan-shaped area PWQ, and the field of view of the endoscope is the fan-shaped area PCQ; and referring to Figure 3, due to the obstruction of the water jet's own structure (such as the upper sheath) and the influence of the collapse of the surrounding tissue, it is possible that a part of the radiation range of the water jet does not fall into the field of view of the endoscope, which leads to the problem of incomplete shooting due to obstruction when observing the water jet and its ejected water jet based on the endoscope.

[0090] In this case, if the aforementioned method of calculating the swing angle of the water jet is still used, there will inevitably be a problem of data loss leading to inaccurate monitoring results.

[0091] To solve the above problems, the present application first defines the visible angle of tissue collapse, and selects different rotational motion position trajectory parameter monitoring methods according to different tissue collapse visible angle ranges.

[0092] Specifically, the visible angle of tissue collapse is defined by Tθ_start and Tθ_stop. Tθ_start and Tθ_stop are determined as follows: at the visible distance T, the starting and ending angles of the tangent line between the water jet E, centered at the water jet tip and with the planned jet length R as the radius, and the surrounding collapsed tissue boundary. An image segmentation algorithm can be used to determine regions A, B, C, D, E, and F in Figure 3 on the real-time endoscope image to determine the visible angle of tissue collapse (Tθ_start, Tθ_stop) at the visible distance T.

[0093] This application also defines a parameter called "waterjet_visible," which indicates whether the water jet can be captured by the endoscope. The waterjet's planned angle range (θ_start, θ_stop) is compared with the visible angle of tissue collapse (Tθ_start, Tθ_stop) determined based on endoscopic image segmentation, and the value of the parameter "waterjet_visible" is determined based on the comparison result. For example, taking the vertical downward angle from the water jet head as 0 degrees, when Tθ_start≤θ_start and at the same time Tθ_stop≥θ_stop, it means that the water column within the rotational motion range of the step length can be observed through the endoscope, and waterjet_visible=2 is set; when Tθ_stop≤θ_start, or Tθ_start≥θ_stop, it means that any water column within the rotational motion range of the step length cannot be observed through the endoscope, and waterjet_visible=0 is set; when θ_start<Tθ_stop<θ_stop, or θ_start<Tθ_start<θ_stop, it means that part of the water column within the rotational motion range of the step length can be observed through the endoscope, and waterjet_visible=1 is set.

[0094] The water column oscillation frequency is measured to evaluate the actual rotational motion position trajectory parameters of the water jet

[0095] When waterjet_visible=1, the oscillation frequency of the water column can be measured to evaluate the actual rotational motion position trajectory parameters of the water jet, that is, to evaluate whether the water jet performs operations according to the planned motion trajectory.

[0096] Define the observation angle position CameraObserve_degree. CameraObserve_degree is the angular position of the swing position of the water column observed in the selected endoscopic image. This angular position is used to observe and calculate the actual swing frequency of the water column. CameraObserve_degree is a vector with a direction, which includes both the angular value of the water column swinging to this position and the direction or trend of the change in the angular value of the water column swinging to this position.

[0097] The water jet cuts in a fan-shaped manner at each step, and then cuts in a fan-shaped manner again in the reverse direction after entering the next step. Therefore, when cutting in multiple steps, the water jet moves in a spiral-like manner, and the rotation (swing) within each step has the same effect as the V θ, θ_start, θ_stop related cycles (frequency). The swing frequency of the water column referred to here is calculated as the reciprocal of the sum of the movement times of two steps. When the movement between adjacent steps changes continuously without sudden changes, the frequency of the water jet swinging through the observed angle position can be approximated as 1 / 2 of the reciprocal of the movement time of one of the steps (the time required to move from θ_start to θ_stop). Since the image acquisition frequency of the endoscope is much greater than the swing frequency of the water column. Therefore, by observing the angle position acquisition and calculating its swing frequency, it is possible to determine whether the water jet is performing operations according to the planned rotational motion trajectory.

[0098] First, obtain the rotation trajectory parameters of the planned motion trajectory of the water jet in the current step length, including the water jet's rotation starting angle θ_start within the step length, the water jet's rotation ending angle θ_stop within the step length, and the water jet's rotation speed V within the step length. θ ; Calculate the planned swing frequency θ_f of the water column within this step based on the planned rotational motion trajectory parameters: θ_f = 0.5*V θ / (θ_stop-θ_start).

[0099] Record the segmented water column images of all frames from the start to the end of the step movement. By segmenting the water column image of each frame, obtain the time interval for the water column to reach the adjacent observation angle position (CameraObserve_degree), that is, determine the time interval between two adjacent CameraObserve_degree positions with the same water column angle value and the same direction of change of the water column angle value. The reciprocal of this time interval is the actual swing frequency θ_fReal of the water jet.

[0100] Due to the periodic motion of the water jet, two observation angle positions (CameraObserve_degree) with the same angle value of the water column and the same direction of change of the angle value usually appear at an odd number of steps apart. Theoretically, as long as the two CameraObserve_degrees with the same angle value and the same direction of change of the angle value are separated by an odd number of steps, they can be used to calculate the swing frequency. However, considering the continuity of the resection channel, it is preferred to calculate the swing frequency by using two observation angle positions (CameraObserve_degree) with the same angle value and the same direction of change of the angle value separated by one step. Here, two observation angle positions (CameraObserve_degree) with the same angle value and the same direction of change of the angle value separated by one step are called adjacent observation angle positions. The time interval between adjacent observation angle positions is calculated, and the reciprocal of this time interval is the actual swing frequency θ_fReal of the water jet within that step.

[0101] By comparing the actual swing frequency θ_fReal of the water column movement within the step length with the planned swing frequency θ_f determined by the rotational motion trajectory parameters of the step length, the deviation between the two can be determined, and then the consistency between the measured rotational motion position trajectory parameters of the water jet within the step length and the planned rotational motion position trajectory parameters can be evaluated.

[0102] Calculate the swing frequency of the key points of the blade to evaluate the actual rotational motion position trajectory parameters of the water jet

[0103] For extreme cases, when waterjet_visible = 0, that is, when no water column within the rotational motion range of the step length can be observed through the endoscope, the value determined by the swing frequency measurement method of monitoring the key points of the blade can be used as the water column swing frequency, which is used to evaluate the actual rotational motion position trajectory parameters of the water jet.

[0104] Specifically, as shown in Figure 3, Area A is the water jet area. For the segmented image of Area A, keypoint detection algorithms such as SIFT keypoints are used to identify and mark keypoints. By sampling the endoscopic image, the time interval between the identified keypoint angles reaching adjacent observation angle positions (CameraObserve_degree) with the same observation angle value and angle value change direction is determined. The inverse of this time interval is used as the actual oscillation frequency θ_fReal of the water column. Furthermore, by comparing the measured oscillation frequency θ_fReal of the water column motion within that step length with the planned oscillation frequency θ_f determined by the rotational motion trajectory parameters of that step length, the deviation between the actual oscillation frequency of the water column and the planned oscillation frequency can be determined, thereby evaluating whether the measured rotational motion position trajectory parameters of the water jet within that step length are consistent with the planned rotational motion position trajectory parameters.

[0105] Among the above methods for measuring and evaluating the actual rotational motion trajectory parameters of the water jet, the calculation method based on the swing frequency of the blade key points can also be used in the case of waterjet_visible=1 or 2, and the calculation method based on the water column swing frequency can also be used in the case of waterjet_visible=2. However, in order to achieve better calculation speed and accuracy, based on the comparison results of the rotation angle range and the tissue collapse visible angle range in the preset trajectory of the water jet, that is, for different waterjet_visible assignments, different water jet rotational motion position trajectory parameter monitoring methods are selected. When waterjet_visible=2, the measurement method based on the swing angle is selected. When waterjet_visible=1, the measurement method based on the water column swing frequency is selected. When waterjet_visible=0, the measurement method based on the swing frequency of the blade key points is selected.

[0106] Rotational movement of the endoscope

[0107] In most cases, the endoscope lens is parallel to the axis of the water jet (i.e., facing straight ahead). However, when determining the optimal working distance L of the endoscope, the water column E used for testing is usually directed directly downward or only tested within a certain angle range. In actual operation, the rotation range of the water column may exceed the field of view of the endoscope.

[0108] For example, as shown in the left figure of Figure 6, when the endoscope lens is parallel to the axis of the water jet (i.e., facing straight ahead), the viewing angle of the endoscope is ∠S2-C-S1. When the rotation range of the water column exceeds the field of view of the endoscope during actual operation, the water column cannot be observed through the endoscope lens, that is, waterjet_visible = 0. When the endoscope lens cannot observe the water column, although the aforementioned alternative measurement method can be used, its accuracy may be defective. For this reason, an alternative solution can be adopted, that is, increasing the rotational movement of the endoscope and using a rotatable endoscope lens. As shown in the right figure of Figure 6, an endoscope lens with a certain inclination angle is used. By adjusting the inclination angle of the endoscope lens as the endoscope rotates, the rotated endoscope can meet the endoscope viewing angle requirement within the limited distance determined based on min(L, T).

[0109] For the case where the inclination angle of the endoscope lens is adjustable, the following motion of the endoscope can be set to include rotational motion, that is, the following motion mode of the endoscope is set to not only follow the linear motion of the water jet, but also follow the rotational motion of the water jet. Accordingly, the following motion position trajectory parameters also include Cθ_start, which represents the starting angle of rotation of the endoscope within the step length, Cθ_stop, which represents the ending angle of rotation within the step length, and Cθ_stop, which represents the rotation speed within the step length. θ The purpose of the endoscope's follow-up movement is to adjust the endoscope's field of view to ensure that it can observe the entire picture of the water jet and the jet as much as possible. At this time, it is also necessary to adjust the water jet's θ_start, θ_stop, V θ Determine the endoscope's Cθ_start, Cθ_stop, CV θ .

[0110] Through the above steps, the actual rotational motion position trajectory parameters and jet length trajectory parameters during the water jet operation process can be calculated based on the endoscopic image, and it can be determined whether there is a deviation from the planned rotational motion position trajectory parameters and jet length trajectory parameters. When there is a deviation, an alarm mechanism can be activated or the deviation can be fed back to the control unit, and the planned trajectory of the water jet can be compensated and adjusted according to the feedback result.

[0111] Safety monitoring of sensitive areas

[0112] See Figure 4, which schematically illustrates sensitive areas within a patient's lumen. In the figure, C represents the approximate center of the endoscope, A represents the image of the water jet within the endoscope's field of view, B, D, and F represent tissue deformed by the water jet or other tissue within the lumen, and E represents the water jet. In the context of prostate surgery, F represents sensitive tissue within the lumen, such as the ureteral orifice or the verumontanum. Resection of this sensitive tissue should be avoided during surgery to prevent harm to the patient.

[0113] Generally speaking, when planning the water jet's trajectory based on preoperative or ultrasound images, the avoidance of sensitive areas is already taken into account. However, due to the accuracy of ultrasound images or the movement of the organism, the actual location of sensitive areas during the actual surgery may deviate from the recognition results of preoperative or ultrasound images, resulting in the risk of injury based on the planned plan.

[0114] In this application, the endoscope that follows the motion mode can obtain clear real-time images of the water jet and water column. Based on the real-time images obtained, the safety protection function of sensitive parts is added. The implementation ideas include safety monitoring of sensitive parts based on jet length trajectory parameters, or safety monitoring of sensitive parts based on rotational motion position trajectory parameters.

[0115] Safety monitoring of sensitive parts based on jet length trajectory parameters

[0116] First, a real-time clear image is obtained by following the motion pattern of the endoscope, and the sensitive part F in the endoscope image is identified using the image segmentation algorithm. The shortest distance S1 between the contour boundary of the identified sensitive part F and the water jet cutter head is calculated.

[0117] Next, the safe resection depth for the sensitive part F is determined based on the shortest distance between the contour boundary of the sensitive part F and the water jet cutter head. Preferably, the safe resection depth is also determined based on a pre-set removal safety distance. The removal safety distance is determined in advance through experiments or pre-set based on factors such as experience or surgical requirements. Setting the removal safety distance helps to provide a larger margin to ensure safety under the premise that the water jet does not touch the sensitive part F. For example, when the removal safety distance is set to S2, the resection depth of the water jet should stop at a distance S2 from the contour of the sensitive part F. Further, when the shortest distance between the contour boundary of the sensitive part F and the water jet cutter head is S1, and the removal safety distance is set to S2, the safe resection depth of the sensitive part F is determined to be S1-S2.

[0118] Furthermore, when traversing the planned motion trajectory of the water jet, if it is calculated that the planned jet length trajectory parameter of a certain step length is greater than the aforementioned safe resection depth of the water jet, it means that the water jet is at risk of cutting the sensitive part F in the future. In this case, the surgical execution device 100 issues an alarm and suspends the resection. At this time, the water jet planning can be readjusted to avoid sensitive parts or adjust the safe removal distance S2 of sensitive parts to avoid cutting sensitive parts and causing safety problems and surgical failure. For example, based on the monitoring results, the endoscope step length corresponds to the distance that the jet length needs to be reduced in the water jet planning step length at this position, and then the dynamic adjustment of the water jet planning trajectory is achieved by adjusting the jet length trajectory parameter R in the actual motion position trajectory parameter in the water jet planning step length.

[0119] Safety monitoring of sensitive parts based on rotational motion position trajectory parameters

[0120] According to another embodiment, a non-removal area can be set for sensitive parts. Taking Figure 4 as an example, F is the sensitive part, E to E' are the planned removal areas, and D is the target removal object. The non-removal area C is defined as a fan-shaped area radiating from the water jet A as the center and containing the sensitive part F. The non-removal area C can be expressed by (Sθ_start, Sθ_stop), Sθ_start represents the starting angle of the tangent line of the sensitive part contour with the water jet A as the center, and Sθ_stop represents the ending angle of the tangent line of the sensitive part contour with the water jet A as the center. In this case, when the water jet is directed toward the sensitive part F, no water jet is sprayed, that is, no ablation or resection is performed on the tissue within the non-removal area C, i.e., (Sθ_start, Sθ_stop). For this solution, safe monitoring of sensitive parts can be achieved based on the rotational motion position trajectory parameters, and the specific implementation steps are as follows:

[0121] First, a real-time clear image is obtained by following the motion pattern of the endoscope, and the sensitive part F in the endoscopic image is identified using the image segmentation algorithm, and the actual non-removal area (Sθ_start, Sθ_stop) is calculated.

[0122] Next, compare whether the non-removal area C overlaps with the planned removal area EE', that is, compare whether (Sθ_start, Sθ_stop) overlaps with (θ_start, θ_stop). According to whether there is overlap or the degree of overlap, execute the safety strategy, alarm, suspend resection or adjust the plan.

[0123] Preferably, a safe overlap range U can also be set. The safe overlap range U can be an area size. That is, when the overlapping area of ​​the non-removal area C and the planned removal area EE' is greater than a certain threshold, a risk is considered to exist. In addition, the safe overlap range U can also be the size of the overlap ratio. For example, when the ratio of the overlapping area of ​​the non-removal area C and the planned removal area EE' to the non-removal area C is greater than a certain threshold, a risk is considered to exist.

[0124] When a risk is determined, the water jet planning can be adjusted to avoid sensitive areas F or adjust the safe overlapping range U of sensitive areas F to avoid safety issues and surgical failure caused by cutting sensitive areas F. At the same time, based on the non-removal area C obtained in real time from the endoscopic image, the relationship C∩EE' in each subsequent water jet planning step can be calculated in advance. This serves as real-time feedback on the cutting range of the water jet planning motion trajectory, automatically adjusting the cutting range of the planned water jet motion trajectory in subsequent steps, and realizing dynamic adjustment of the water jet cutting planning trajectory.

[0125] In the aforementioned scheme, an alarm mechanism can be triggered based on the monitoring of the actual motion position trajectory parameters of the water jet and / or based on the monitoring of the actual sensitive parts. In particular, the alarm mechanism in this application is set based on the real-time monitoring of the endoscope in the follow-up motion mode. In actual surgical scenarios, the linear motion trajectory of the water jet cutter head is from front to back. The tissue area (including the resection range, sensitive parts, etc.) observed by the endoscope behind the water jet cutter head includes the area where the water jet cutter head is about to perform cutting. Therefore, it is possible to predict deviations and risks, realize early warning functions, and help provide better planning solutions and safety guarantees.

[0126] Next, one of the processes of performing a resection surgery using the surgical execution device of the present application is described with reference to Figure 7. Those skilled in the art will appreciate that the process described below is only one application of the present application, and the order and specific content of each step can be appropriately set according to the actual scenario.

[0127] Step S1, obtaining the planned motion trajectory of the water jet and calculating the follow-up motion trajectory of the endoscope.

[0128] Step S2: Calculate the initial monitoring position of the endoscope and move the endoscope to the initial monitoring position.

[0129] Step S3: During the operation, based on the monitoring image of the endoscope, the sensitive parts of the biological tissue are detected, and the subsequent resection plan is adjusted based on the sensitive parts.

[0130] Step S4: During the operation, the actual motion position trajectory parameters of the water jet are monitored based on the monitoring image of the endoscope, and the subsequent resection plan is adjusted based on the deviation between the actual motion position trajectory parameters and the planned motion position trajectory parameters.

[0131] Step S5: During the operation, monitor for dangerous scenarios and issue an alarm. Dangerous scenarios include, for example, the loss of both the water jet and the water column within the endoscope's field of view for a period exceeding a specified threshold, or the water jet's oscillation frequency or resection depth exceeding a safety threshold relative to the planned frequency or resection depth.

[0132] Through the above embodiments of the present application, the technical problems in the background technology can be effectively solved, and the execution status of the water jet surgery process can be effectively, accurately and in real time monitored. The present application is particularly suitable for automatic water jet systems. When the water jet moves and works according to the planned motion position trajectory parameters, the solution of the present application can monitor the actual motion position trajectory parameters of the water jet in real time, which is conducive to the real-time adjustment of the motion position trajectory parameters; and the present application can also monitor the actual working scenes of the water jet, especially areas involving sensitive parts in real time, and determine the safety risks of the planned motion trajectory based on the real-time monitoring results, and can trigger the alarm mechanism in time to take emergency measures.

Claims

1. A monitoring device for the movement trajectory of a water knife based on an endoscope, comprising a water knife, an endoscope, a water knife driving part, an endoscope driving part, and a control part, characterized in that: The water knife driving part and the endoscope driving part are both electrically connected to the control part; The water knife can move along a planned movement trajectory under the drive of the water knife driving part and eject a water jet for tissue resection or ablation; the movement trajectory of the water knife is defined by water knife movement position trajectory parameters, and the water knife movement position trajectory parameters include linear movement position trajectory parameters; The endoscope moves under the drive of the endoscope driving part and has a follow-up movement mode. In the follow-up movement mode, the endoscope can follow the water knife for at least linear movement along a follow-up movement trajectory and monitor the actual movement position trajectory parameters of the water knife; wherein, the follow-up movement trajectory is defined by follow-up movement position trajectory parameters, and the follow-up movement position trajectory parameters at least include linear follow-up movement position trajectory parameters; the control part determines the follow-up movement position trajectory parameters of the endoscope based on the planned movement position trajectory parameters of the water knife.

2. The monitoring device for the water jet movement trajectory according to claim 1, wherein, The water knife movement position trajectory parameters further include rotational movement position trajectory parameters and / or jet length trajectory parameters.

3. The monitoring device for the water jet movement trajectory according to claim 1, characterized in that The linear movement direction of the endoscope is parallel to that of the water knife. The endoscope is located behind the water knife, and there is a predetermined distance S between the observation lens of the endoscope and the water jet ejection part.

4. The monitoring device for the water jet movement trajectory according to claim 1, characterized in that, The movement trajectory of the water knife is an array combination of water knife movement position trajectory parameters with multiple step lengths, and the follow-up movement position trajectory of the endoscope is an array combination of follow-up movement position trajectory parameters with the same number of step lengths. The control part determines the follow-up movement position trajectory parameters of the endoscope corresponding to each step length according to the water knife movement position trajectory parameters included in the array of each step length.

5. The monitoring device for the water jet movement trajectory according to claim 2, wherein The endoscope acquires the endoscope image of the water knife head and the water jet in real time in the follow-up movement mode, and the control part analyzes the acquired endoscope image and determines the jet length trajectory parameters and / or rotational movement position trajectory parameters in the actual movement position trajectory parameters of the water knife.

6. The monitoring device for the water jet movement trajectory according to claim 2, characterized in that, The control part determines the follow-up movement position trajectory parameters according to the tissue collapse visible distance and / or the optimal working distance of the endoscope.

7. The monitoring device for the water jet movement trajectory according to claim 2, characterized in that The control part performs image segmentation processing on the endoscope image of the water knife movement acquired by the endoscope in real time to monitor the jet length trajectory parameters.

8. The monitoring device for the water jet movement trajectory according to claim 2, characterized in that, The control part monitors the rotational movement position trajectory parameters of the water knife by measuring the swing angle and / or swing frequency of the water column.

9. The monitoring device for the water jet movement trajectory according to claim 8, characterized in that, The control part adopts different monitoring methods for the rotational movement position trajectory parameters of the water knife based on the comparison result between the rotation angle range in the preset trajectory of the water knife and the tissue collapse visible angle range.

10. The monitoring device for the water jet movement trajectory according to claim 9, characterized in that, When all of the water column can be observed through the endoscope, the control part monitors and evaluates whether the actual rotational movement position trajectory parameters of the water knife are consistent with the planned rotational movement position trajectory parameters by measuring the swing angle range of the water column in the endoscope image.

11. The monitoring device for the water jet movement trajectory according to claim 9, characterized in that, When the water jet is within the field of view of the endoscope, the control unit calculates the swing frequency of the water knife based on the water jet images at the same endoscope observation angle separated by an even number of steps in the monitoring image of the endoscope; when the water jet is not within the field of view of the endoscope, the control unit calculates the swing frequency of the water knife based on the water knife feature point images at the same endoscope observation angle separated by an even number of steps in the observation image of the endoscope.

12. The monitoring device for the water jet movement trajectory according to claim 11, wherein, The control unit evaluates whether the actual rotational movement position trajectory parameter of the water knife within this step is consistent with the planned rotational movement position trajectory parameter by comparing the actual swing frequency of the water column movement within the step with the swing frequency determined by the rotational movement trajectory parameter of this step.

13. The monitoring device for the water jet movement trajectory according to claim 1, characterized in that, The endoscope has a lens with adjustable inclination angle, and the follow - up movement trajectory parameter of the endoscope includes a rotational follow - up movement position trajectory parameter.

14. The monitoring device for the water jet movement trajectory according to claim 1, wherein, The endoscope also performs safety monitoring on sensitive parts in the follow - up movement mode.

15. The monitoring device for the water jet movement trajectory according to claim 14, characterized in that, The control unit determines the safe resection depth based on the image acquired by the endoscope, and judges the risk according to the comparison result between the planned jet length trajectory parameter and the safe resection depth.

16. The monitoring device for the water jet movement trajectory according to claim 15, characterized in that, The control unit determines the sensitive part based on the image acquired by the endoscope in the follow - up movement mode, and determines the safe resection depth for this sensitive part based on the shortest distance between the contour boundary of the sensitive part and the water knife head.

17. The monitoring device for the water jet movement trajectory according to claim 16, wherein The control unit also determines the safe resection depth based on a preset removal safety distance.

18. The monitoring device for the water jet movement trajectory according to claim 14, characterized in that, The control unit conducts safety monitoring on sensitive parts based on the rotational movement position trajectory parameter, determines the non - removal area according to the image acquired by the endoscope, and judges the risk according to the comparison result between the planned rotational movement position trajectory parameter and the non - removal area.

19. The monitoring device for the water jet movement trajectory according to claim 1, wherein The endoscope also has an autonomous movement mode. In the autonomous movement mode, the movement of the endoscope is independent of the movement of the water knife; in the autonomous movement mode, the endoscope is driven to move and parameters are collected, and the control unit sets or updates the follow - up movement position trajectory parameter based on the collected parameters.

20. The monitoring device for the water jet movement trajectory according to claim 1, characterized in that The endoscope also includes an image acquisition unit. The image acquisition unit acquires images and transmits them to the control unit. The control unit analyzes the acquired image data and adjusts the planned movement trajectory of the water knife and the follow - up movement trajectory of the endoscope based on the analysis result.

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