Endolumenal Stone Sizing Using Basket Markers and Imaging
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Solution Overview
Problem
Conventional surgical systems face challenges in accurately measuring the size of kidney stones within a patient's ureter, leading to risks of ureter avulsion during stone extraction, and current methods like fluoroscopy are inadequate for visualization and measurement.
Innovation Solution
An object sizing system that navigates an instrument with an imaging sensor to capture sequential images, uses robotic baskets or structured light to estimate stone size, and employs EM tracking for precise positioning and navigation.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If conventional external viewing techniques like fluoroscopy are used, then visualization is provided, but measurement precision of kidney stones is insufficient
Solution Approach 1:
The patent replaces conventional fluoroscopy (external imaging) with an endolumenal imaging system that uses a camera positioned inside the ureter to directly visualize and measure the kidney stone. This substitution of imaging methodology enables precise measurement of stone dimensions by capturing images from within the lumen where the stone is located.
Solution Approach 2:
The patent introduces an endolumenal safety wire as an intermediary object with known dimensions that serves as a reference scale for measuring kidney stone size. The wire is positioned adjacent to the stone during imaging, allowing the system to calculate stone dimensions by comparing the stone's apparent size to the known size of the wire in the captured images.
2Reliability
If a safety wire is used to guide reattachment, then ureter reattachment is facilitated, but workflow complexity increases
Solution Approach 1:
The patent integrates multiple functions into the endolumenal imaging system: it visualizes the kidney stone for sizing, captures images for measurement, and provides spatial information for navigation. This multi-functional system replaces the separate safety wire procedure, eliminating the need for an additional wire placement step while maintaining the ability to guide ureter reattachment through integrated imaging and positioning capabilities.
Solution Approach 2:
The patent combines the sizing function and the navigation/guidance function into a single endolumenal imaging system. By merging these previously separate functions (sizing via fluoroscopy and guidance via safety wire) into one integrated system that provides both visual measurement and spatial positioning, the workflow is simplified while maintaining reliability.
3Productivity
If the ureteroscope is retracted with a large kidney stone, then stone extraction is achieved, but ureter avulsion risk increases
Solution Approach 1:
The patent performs preliminary sizing of the kidney stone by capturing images with the endolumenal camera before attempting extraction. The system calculates the stone's dimensions and compares them to the ureteroscope's capacity, allowing the surgical team to determine in advance whether the stone can be safely extracted or if fragmentation is required, thereby preventing ureter avulsion.
Solution Approach 2:
The patent provides real-time feedback on kidney stone size by processing images captured from within the ureter and calculating dimensional measurements. This feedback loop allows the surgical team to assess stone dimensions during the procedure and adjust the extraction plan accordingly, ensuring that extraction attempts are only made when the stone size is within safe limits for the ureteroscope.
Data Source
AI summary
An object sizing system sizes an object positioned within an anatomical feature. The object sizing system navigates an elongate body to a location within an anatomical feature and proximate to the object. An imaging sensor coupled to the elongate body captures images of the object. The object sizing system captures the object with a basket. The object sizing system captures an image of the object with the imaging sensor. The object sizing system detects a basket marker in the captured image. The object sizing system determines a distance from the object to the imaging sensor based on the detected basket marker. The object sizing system determines an estimated size of the object based at least in part on the distance.