Fluorescent Peptide Conjugates for Ureter Visualization
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Solution Overview
Problem
Ureteral injuries during surgical procedures are common due to the difficulty in visualizing thin-walled ureters amidst surrounding tissues, leading to delayed diagnoses and significant healthcare costs, with existing visualization methods being either invasive, disruptive to surgical workflow, or having limited sensitivity and duration of action.
Innovation Solution
Administration of fluorescent peptide conjugates comprising a peptide and a fluorescent moiety for sensitive and prolonged visualization of ureters, allowing concurrent nerve visualization, which can be detected through fluorescence, thereby reducing the risk of ureteral injuries during surgeries.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If conventional surgical visualization methods are used, then surgical workflow is maintained, but ureter visualization sensitivity and duration are limited
Solution Approach 1:
The fluorescent conjugate is administered to the patient before the surgical procedure begins, allowing the compound to accumulate in the ureters in advance. This preliminary administration ensures that when surgery starts, the ureters are already highly visible with maximum sensitivity, and the visualization persists throughout the entire surgical duration without requiring repeated interventions.
Solution Approach 2:
The patent utilizes fluorescent compounds with specific photophysical properties that emit light in the near-infrared spectrum (650-900 nm), which penetrates tissue more effectively than visible light. By changing the wavelength parameter of the imaging modality to match the fluorescent emission spectrum, the system achieves both high sensitivity detection and prolonged visualization duration as the fluorescent signal persists as long as the conjugate remains in the ureters.
2Measurement precision
If stents or illuminated catheters are inserted into ureters, then ureter visualization is improved, but surgical workflow is disrupted and specialist consultation is required
Solution Approach 1:
The patent extracts the visualization function from invasive devices (stents and catheters) and transfers it to a pharmacological agent (fluorescent conjugate) that can be administered systemically. This eliminates the need for urologist consultation and device insertion, allowing the general surgeon to maintain full control of the surgical workflow while achieving superior ureter visualization through fluorescence imaging.
Solution Approach 2:
The fluorescent conjugate acts as an intermediary substance that temporarily binds to ureteral tissue and emits fluorescent signal when excited by appropriate light. This intermediary approach provides visualization without requiring permanent or semi-permanent invasive devices, thereby maintaining surgical workflow continuity while enabling real-time ureter identification throughout the procedure.
3Productivity
If ureteral injury occurs, then surgery can proceed, but patient morbidity increases and healthcare costs exceed $30,000 per injury
Solution Approach 1:
The fluorescent imaging system provides continuous real-time feedback during surgery by displaying the fluorescent signal from ureters on monitors. This feedback loop allows the surgical team to immediately detect any changes in ureteral fluorescence that might indicate injury, such as sudden signal loss or abnormal fluorescence patterns, enabling immediate corrective action before permanent damage occurs. The system transforms the previously hidden ureter into a visible, monitorable structure throughout the entire surgical process.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
The method provides effective and prolonged visualization of ureters, enabling real-time detection during surgical procedures, reducing the risk of ureteral injuries and associated costs by allowing for precise surgical navigation.
Implementation Method 1
detecting fluorescence of the fluorescent moiety in the ureter following administration
Data Source
AI summary
Methods for visualizing a ureter, including fluorescent visualization of a ureter, as well as other target tissues, during a surgical procedure, comprising administering to a subject a fluorescent conjugate comprising a peptide and a fluorescent moiety.