CN114424974B - Positioning method and system for laparoscopic operation hole based on pneumoperitoneum simulation - Google Patents
Positioning method and system for laparoscopic operation hole based on pneumoperitoneum simulation Download PDFInfo
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- 208000005646 Pneumoperitoneum Diseases 0.000 title claims abstract description 127
- 238000004088 simulation Methods 0.000 title claims abstract description 68
- 238000000034 method Methods 0.000 title claims abstract description 44
- 210000000683 abdominal cavity Anatomy 0.000 claims abstract description 50
- 210000004185 liver Anatomy 0.000 claims abstract description 30
- 206010028980 Neoplasm Diseases 0.000 claims abstract description 28
- 210000003815 abdominal wall Anatomy 0.000 claims abstract description 26
- 230000000007 visual effect Effects 0.000 claims description 16
- 238000005520 cutting process Methods 0.000 claims description 13
- 238000003780 insertion Methods 0.000 claims description 10
- 230000037431 insertion Effects 0.000 claims description 10
- 238000012545 processing Methods 0.000 claims description 7
- 210000004303 peritoneum Anatomy 0.000 claims description 2
- 230000003187 abdominal effect Effects 0.000 abstract description 9
- 238000007599 discharging Methods 0.000 abstract description 3
- 230000009466 transformation Effects 0.000 abstract description 3
- 230000008569 process Effects 0.000 description 12
- 238000002357 laparoscopic surgery Methods 0.000 description 4
- 230000003902 lesion Effects 0.000 description 4
- 238000012795 verification Methods 0.000 description 3
- CURLTUGMZLYLDI-UHFFFAOYSA-N Carbon dioxide Chemical compound O=C=O CURLTUGMZLYLDI-UHFFFAOYSA-N 0.000 description 2
- 210000001015 abdomen Anatomy 0.000 description 2
- 238000002591 computed tomography Methods 0.000 description 2
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- 238000012549 training Methods 0.000 description 2
- 230000009286 beneficial effect Effects 0.000 description 1
- 238000004364 calculation method Methods 0.000 description 1
- 229910002092 carbon dioxide Inorganic materials 0.000 description 1
- 239000001569 carbon dioxide Substances 0.000 description 1
- 210000003109 clavicle Anatomy 0.000 description 1
- 238000010276 construction Methods 0.000 description 1
- 238000010586 diagram Methods 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 238000010438 heat treatment Methods 0.000 description 1
- 230000006872 improvement Effects 0.000 description 1
- 239000002699 waste material Substances 0.000 description 1
- 210000002417 xiphoid bone Anatomy 0.000 description 1
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- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
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Abstract
The invention discloses a method and a system for positioning a laparoscopic operation hole based on pneumoperitoneum simulation, wherein the method comprises the following steps: building an abdominal cavity three-dimensional model in an uninflated state, and displaying the liver, a liver pipeline, a tumor and an abdominal wall in the abdominal cavity three-dimensional model; simulating the human pneumoperitoneum based on the abdominal cavity three-dimensional model to obtain a human pneumoperitoneum simulation model; determining an endoscope hole, a main operation hole and an auxiliary operation hole and positions thereof on a pneumoperitoneum based on a human pneumoperitoneum simulation model; and (3) discharging the abdominal pressure to enable the pneumoperitoneum to return to an uninflated state, so as to obtain the positions of the corresponding endoscope hole, the main operation hole and the auxiliary operation hole on the uninflated outer abdominal wall. The positioning system is used for realizing the positioning method. The invention not only analyzes the abdominal environment in advance, but also positions the position of the operation hole on the uninflated outer abdominal wall through the inverse transformation of simulated inflation, thereby improving the fixed point level of the operation hole, and effectively helping doctors to determine the operation hole easier for operation under the condition of no inflation before operation.
Description
Technical Field
The invention relates to the technical field of medical simulation models, in particular to a method and a system for positioning a laparoscopic operation hole based on pneumoperitoneum simulation.
Background
The traditional liver laparoscopic surgery is to inject medical gas such as carbon dioxide into an endoscope hole to enlarge the inflation of an abdominal cavity, form a basic environment for the laparoscopic surgery, extend the laparoscope into the endoscope hole to observe the abdominal cavity environment, search the operation position through CT scanning before operation and external probing, combine the operation experience of a doctor to determine the position of an operation hole, and finally open the operation hole by a scalpel, so that the doctor can view the abdominal cavity environment through the abdominal cavity picture returned by the endoscope and perform the operation.
The traditional method for searching the position of the operation hole mainly depends on the experience of doctors, lacks data support and actual verification, and even has positioning errors and other conditions for doctors with low experience; in addition, because the prior art is limited, the inflation and perforation are generally carried out in the operation, and the waste of operation time is caused, so the quick searching of the operation hole is a difficult problem to be solved at present.
Disclosure of Invention
Based on the method and the system, three-dimensional reconstruction is firstly carried out on an inflated abdominal cavity to obtain a human body pneumoperitoneum simulation model, the operation holes are selected according to a principle of operation Kong Xuanqu based on the human body pneumoperitoneum simulation model, simulation and simulation checking and movement interference checking are carried out, positions of the endoscope holes, the main operation holes and the auxiliary operation holes on the pneumoperitoneum are determined, the pneumoperitoneum is returned to an uninflated state, positions of the corresponding endoscope holes, the main operation holes and the auxiliary operation holes on an uninflated outer abdominal wall are located, and operation holes which are easier to operate can be determined under the condition that a doctor does not inflate before operation.
Description of the terminology:
pneumoperitoneum, i.e. inflatable abdominal cavity, refers to an inflated abdominal cavity formed by deformation of the abdominal wall under the influence of pressure of manually inflated air.
The operation area refers to an area for performing tumor cutting operation according to an operation cutting line.
The field of view refers to the visual range of an endoscope.
The technical scheme adopted by the invention is as follows:
the method for positioning the laparoscopic operation hole based on pneumoperitoneum simulation comprises the following steps:
step S1, building an abdominal cavity three-dimensional model in an uninflated state, and displaying a liver, a liver pipeline, a tumor and an abdominal wall in the abdominal cavity three-dimensional model;
step S2, simulating a human pneumoperitoneum based on the abdominal cavity three-dimensional model to obtain a human pneumoperitoneum simulation model;
s3, determining an endoscope hole, a main operation hole, an auxiliary operation hole and positions thereof on a pneumoperitoneum based on a human pneumoperitoneum simulation model;
and S4, discharging the abdominal pressure, and returning the pneumoperitoneum to an uninflated state to obtain the positions of the corresponding endoscope hole, the main operation hole and the auxiliary operation hole on the uninflated outer abdominal wall.
In the method for positioning the laparoscopic operation hole based on pneumoperitoneum simulation disclosed in the application, in the step S1, a specific process of building a three-dimensional model of the abdominal cavity in an uninflated state is as follows:
and acquiring abdominal cavity CT data or abdominal cavity MRI data, and processing to build an abdominal cavity three-dimensional model in an uninflated state.
In the method for positioning the operation hole of the laparoscope based on pneumoperitoneum simulation disclosed by the application, in the step S2, the human pneumoperitoneum is simulated based on the three-dimensional model of the abdominal cavity, and the specific process for obtaining the simulation model of the human pneumoperitoneum is as follows:
based on the abdominal cavity three-dimensional model, the human pneumoperitoneum simulation model is obtained by changing the elastic modulus or the air pressure and simulating the human pneumoperitoneum under different elastic modulus or air pressure.
In the positioning method for the laparoscopic operation hole based on pneumoperitoneum simulation disclosed in the application, in the step S3, the endoscope hole and the position thereof on the pneumoperitoneum are determined, and the specific process is as follows:
s31, selecting a plurality of operation holes A according to the principle of an endoscope Kong Xuanqu based on a human pneumoperitoneum simulation model;
s32, simulating the extension and rotation of the endoscope in the operation hole A, adjusting the center of the visual field of the endoscope, and observing the operation field;
s33, calculating the coincidence rate of the working field and the center of the visual field, and selecting an operation hole A with the largest coincidence rate as an endoscope hole, wherein the position of the operation hole A is the position of the endoscope hole on the pneumoperitoneum.
In the positioning method for the laparoscopic operation hole based on pneumoperitoneum simulation disclosed in the application, in the step S3, the main operation hole and the position thereof on the pneumoperitoneum are determined, and the specific process is as follows:
s34, selecting a plurality of operation holes B according to a principle of main operation Kong Xuanqu based on a human pneumoperitoneum simulation model;
s35, simulating the main scalpel to cut a tumor in the operation hole B according to the operation area;
s36, calculating and selecting an operation hole B closest to the tumor and with the minimum liver cutting volume as a main operation hole, wherein the position of the operation hole B is the position of the main operation hole on the pneumoperitoneum.
In the positioning method for the laparoscopic operation hole based on pneumoperitoneum simulation disclosed in the application, in the step S3, the auxiliary operation hole and the position thereof on the pneumoperitoneum are determined, and the specific process is as follows:
s37, determining the positions of the main operation holes based on a human pneumoperitoneum simulation model, and selecting a plurality of operation holes C according to a principle of auxiliary operation Kong Xuanqu;
s38, simulating the insertion of a main scalpel into the main operation hole, and simulating the insertion of an auxiliary scalpel into the operation hole C;
s39, analyzing the movement ranges of the main surgical knife and the auxiliary surgical knife, calculating the interference degree of the main surgical knife and the auxiliary surgical knife, and selecting an operation hole C with the minimum interference degree as an auxiliary operation hole, wherein the position of the operation hole C is the position of the auxiliary operation hole on the pneumoperitoneum.
Based on the same inventive concept, the invention also discloses a positioning system for the laparoscopic operation hole based on pneumoperitoneum simulation, which is used for realizing the positioning method, in particular,
positioning system to peritoneum emulation is to laparoscopic operation hole based on, includes:
the three-dimensional pneumoperitoneum reconstruction module is used for constructing an abdominal cavity three-dimensional model in an unaerated state and a human pneumoperitoneum simulation model;
the operation hole measuring and verifying module is used for determining the endoscope hole, the main operation hole, the auxiliary operation hole and the positions of the endoscope hole, the main operation hole and the auxiliary operation hole on the pneumoperitoneum on the human body pneumoperitoneum simulation model;
and the operation hole positioning module is used for returning the pneumoperitoneum to an uninflated state to obtain the positions of the corresponding endoscope hole, the main operation hole and the auxiliary operation hole on the uninflated outer abdominal wall.
In the positioning system for a laparoscopic operation hole based on pneumoperitoneum simulation disclosed by the application, the three-dimensional pneumoperitoneum reconstruction module comprises:
the reconstruction sub-module is used for reconstructing a three-dimensional abdominal cavity model in an uninflated state according to abdominal cavity CT data or abdominal cavity MRI data, and displaying the liver, the liver pipeline, the tumor and the abdominal wall in the three-dimensional abdominal cavity model;
and constructing a sub-module for changing the elastic modulus or the air pressure and simulating the human pneumoperitoneum under different elastic modulus or air pressure to obtain the human pneumoperitoneum simulation model.
In the pneumoperitoneum simulation-based positioning system for a laparoscopic operation hole disclosed by the application, the operation hole measuring and calculating and verifying module comprises:
the endoscope hole sub-module is used for selecting an operation hole A according to the principle of an endoscope Kong Xuanqu, simulating the extension and rotation of the endoscope in the operation hole A, adjusting the center of a visual field of the endoscope, observing the operation field, calculating the coincidence rate of the operation field and the center of the visual field, and selecting the operation hole A with the largest coincidence rate as an endoscope hole, wherein the position of the operation hole A is the position of the endoscope hole on a pneumoperitoneum;
the main operation hole sub-module is used for selecting an operation hole B according to a main operation Kong Xuanqu principle, simulating a main scalpel to cut a tumor in the operation hole B according to an operation domain, calculating and selecting the operation hole B closest to the tumor and having the smallest liver cutting volume as a main operation hole, wherein the position of the operation hole B is the position of the main operation hole on a pneumoperitoneum;
the auxiliary operation hole sub-module is used for selecting an operation hole C according to an auxiliary operation Kong Xuanqu principle, simulating the insertion of an auxiliary surgical knife into the operation hole C, simulating the insertion of a main surgical knife into a determined main operation hole, analyzing the movement range of the main surgical knife and the auxiliary surgical knife, calculating the interference degree of the main surgical knife and the auxiliary surgical knife, and selecting the operation hole C with the minimum interference degree as the auxiliary operation hole, wherein the position of the operation hole C is the position of the auxiliary operation hole on a pneumoperitoneum.
In the positioning system for the laparoscopic operation hole based on pneumoperitoneum simulation disclosed by the application, the positioning system further comprises a data recording and processing module, and the data recording and processing module is used for recording the tumor position and each operation hole position in a database.
Compared with the prior art, the invention has the beneficial effects that:
the method comprises the steps of carrying out three-dimensional reconstruction on an inflated abdominal cavity to obtain a human body pneumoperitoneum simulation model, calculating and selecting an operation hole based on a human body pneumoperitoneum simulation model according to an operation hole selection principle, carrying out simulation and simulation checking and motion interference checking, determining positions of an endoscope hole, a main operation hole and an auxiliary operation hole on the pneumoperitoneum, returning the pneumoperitoneum to an uninflated state, and positioning positions of the corresponding endoscope hole, the main operation hole and the auxiliary operation hole on an uninflated outer abdominal wall. The invention not only analyzes the abdominal environment in advance, but also positions the position of the operation hole on the uninflated outer abdominal wall through the inverse transformation of simulated inflation, thereby improving the fixed point level of the operation hole, and effectively helping doctors to determine the operation hole easier for operation under the condition of no inflation before operation.
Drawings
In order to more clearly illustrate the embodiments of the present application or the technical solutions in the prior art, the drawings that are required in the embodiments or the description of the prior art will be briefly described below, it being obvious that the drawings in the following description are only some embodiments of the present application, and that other drawings may be obtained according to these drawings without inventive effort for a person skilled in the art.
FIG. 1 is a schematic diagram of a positioning system for a laparoscopic port based on pneumoperitoneum simulation of the present invention;
FIG. 2 is a simulation model of a human pneumoperitoneum prior to inflation;
FIG. 3 is a simulated model of an inflated human pneumoperitoneum;
FIG. 4 is a schematic view of the endoscope in visual range configuration;
FIG. 5 is a schematic view of the structure of the endoscope field of view;
FIG. 6 is a schematic view of the structure of the tangent line of the cutting line and the center line of the field of view.
Detailed Description
In order to make the above objects, features and advantages of the present application more comprehensible, embodiments accompanied with figures are described in detail below. It is to be understood that the specific embodiments described herein are for purposes of illustration only and are not limiting. It should be further noted that, for convenience of description, only some, but not all of the structures related to the present application are shown in the drawings. All other embodiments, which can be made by one of ordinary skill in the art without undue burden from the present disclosure, are within the scope of the present disclosure.
The terms "comprising" and "having" and any variations thereof herein are intended to cover a non-exclusive inclusion. For example, a process, method, system, article, or apparatus that comprises a list of steps or elements is not limited to only those listed steps or elements but may include other steps or elements not listed or inherent to such process, method, article, or apparatus.
Reference in the specification to "an embodiment" means that a particular feature, structure, or characteristic described in connection with the embodiment may be included in at least one embodiment of the application. The appearances of such phrases in various places in the specification are not necessarily all referring to the same embodiment, nor are separate or alternative embodiments mutually exclusive of other embodiments. Those of skill in the art will explicitly and implicitly appreciate that the embodiments described herein may be combined with other embodiments.
The embodiment of the application provides a positioning method for a laparoscopic operation hole based on pneumoperitoneum simulation, which mainly aims at determining the position of the operation hole on a pneumoperitoneum by constructing a human pneumoperitoneum simulation model, returning the pneumoperitoneum to an uninflated state, positioning the position of the operation hole on an uninflated outer abdominal wall, and effectively helping a doctor to determine the operation hole easier to operate under the condition of no inflation before operation.
The method for positioning the laparoscopic operation hole based on pneumoperitoneum simulation, disclosed by the application, comprises the following steps:
and S1, building a three-dimensional abdominal cavity model in an uninflated state, and displaying the liver, the liver pipeline, the tumor and the abdominal wall in the three-dimensional abdominal cavity model. And 3, performing three-dimensional reconstruction of the abdominal cavity before operation, and positioning the liver, liver pipelines and tumors.
And S2, simulating the human pneumoperitoneum based on the abdominal cavity three-dimensional model to obtain a human pneumoperitoneum simulation model. The abdominal cavity is inflated before and after the inflation as shown in fig. 2 and fig. 3.
And S3, determining an endoscope hole, a main operation hole, an auxiliary operation hole and positions thereof on the pneumoperitoneum based on the human pneumoperitoneum simulation model. In general, the triangle distribution principle of the operation Kong Bingcheng is that the endoscope holes, the main operation holes and the auxiliary operation holes are distributed as far as possible into a plane isosceles triangle, and other auxiliary holes are flexibly distributed around the core triangle according to the operation requirement. Therefore, only the selection of the endoscope aperture, the main operation aperture, and the sub operation aperture needs to be considered.
And S4, discharging the abdominal pressure, and returning the pneumoperitoneum to an uninflated state to obtain the positions of the corresponding endoscope hole, the main operation hole and the auxiliary operation hole on the uninflated outer abdominal wall. Through selecting, measuring and calculating and determining the operation hole on the human pneumoperitoneum simulation model, and then removing the abdominal pressure, the pneumoperitoneum returns to the uninflated state, so that the position of the operation hole on the uninflated outer abdominal wall is obtained, and a doctor can be effectively helped to determine the operation hole which is easier to operate under the condition of no inflation before operation.
In one embodiment, for step S1, the specific process of building the three-dimensional model of the abdominal cavity in the uninflated state is: and acquiring abdominal cavity CT data or abdominal cavity MRI data, and processing to build an abdominal cavity three-dimensional model in an uninflated state.
In one embodiment, for step S2, the specific process of obtaining the human pneumoperitoneum simulation model based on the abdominal cavity three-dimensional model is as follows: based on the abdominal cavity three-dimensional model, the human pneumoperitoneum simulation model is obtained by changing the elastic modulus or the air pressure and simulating the human pneumoperitoneum under different elastic modulus or air pressure. Specifically, in the process of determining the operation hole of the laparoscope, due to the existence of the laparoscope, the movement of the liver is not changed too much before and after the abdominal cavity is inflated, so that in the process of reconstructing the three-dimensional pneumoperitoneum, the initial value of the elastic modulus of each tissue of the abdominal wall is firstly set, and the stress condition of the abdominal wall is analyzed according to the air pressure of the inflated air, so that the inflation process of the abdominal cavity is primarily simulated; and then adjusting the elastic modulus value of each tissue of the abdominal wall to obtain the human pneumoperitoneum simulation model.
In one embodiment, for step S3, the endoscope aperture and its position on the pneumoperitoneum are determined by:
s31, selecting a plurality of operation holes A according to the principle of an endoscope Kong Xuanqu based on a human pneumoperitoneum simulation model;
s32, simulating the extension and rotation of the endoscope in the operation hole A, adjusting the center of the visual field of the endoscope, and observing the operation field;
s33, calculating the coincidence rate of the working field and the center of the visual field, and selecting an operation hole A with the largest coincidence rate as an endoscope hole, wherein the position of the operation hole A is the position of the endoscope hole on the pneumoperitoneum.
Specifically, the selection principle of the endoscope hole is as follows: the selection of the endoscope aperture is performed on the outer abdominal wall surface in a direction in which the navel is biased toward the working area. Liver laparoscopic surgery typically uses a 30 ° scope, as shown in fig. 4, with the visual field being a cone space. By adjusting the field of view by rotation and retraction of the endoscope, a larger field of view may be presented, as shown in fig. 5. In order to perform the tumor cutting operation better, it is required to ensure that the video thrown back by the endoscope can see the operation area and the operation area is located at the center of the field of view as much as possible, that is, the tangent line of any point on the cutting line of the operation area is kept coincident with the midline of the visual range of the endoscope as much as possible in the tumor cutting process, as shown in fig. 6.
In one embodiment, for step S3, the main operation hole and its position on the pneumoperitoneum are determined by:
s34, selecting a plurality of operation holes B according to a principle of main operation Kong Xuanqu based on a human pneumoperitoneum simulation model;
s35, simulating the main scalpel to cut a tumor in the operation hole B according to the operation area;
s36, calculating and selecting an operation hole B closest to the tumor and with the minimum liver cutting volume as a main operation hole, wherein the position of the operation hole B is the position of the main operation hole on the pneumoperitoneum.
Specifically, the principle of selecting the main operation hole is as follows: should be as close to the lesion as possible (lesions under the xiphoid process in right liver and lesions under the left clavicle midline rib in left liver). The liver laparoscopic surgery is to cut off the liver wrapping the tumor in the pneumoperitoneum through a small hole on the belly by using a main surgical knife in a heating mode, so the resected liver is generally prismatic table, and the volume and gradient of the resected liver are different from each other at different points on the belly, so the main operation hole can be determined according to the cutting volume of the liver.
In one embodiment, the determination of the secondary operation hole and its position on the pneumoperitoneum is performed by:
s37, determining the positions of the main operation holes based on a human pneumoperitoneum simulation model, and selecting a plurality of operation holes C according to a principle of auxiliary operation Kong Xuanqu;
s38, simulating the insertion of a main scalpel into the main operation hole, and simulating the insertion of an auxiliary scalpel into the operation hole C;
s39, analyzing the movement ranges of the main surgical knife and the auxiliary surgical knife, calculating the interference degree of the main surgical knife and the auxiliary surgical knife, and selecting an operation hole C with the minimum interference degree as an auxiliary operation hole, wherein the position of the operation hole C is the position of the auxiliary operation hole on the pneumoperitoneum.
Specifically, after the positions of the endoscope hole and the main operation hole are determined, the determination of the sub operation hole is performed. The selection principle of the auxiliary operation hole is as follows: a certain distance is kept between the main operation hole and the endoscope hole, and the lower part of the right collarbone midline rib and the lower part of the right armpit anterior line rib are generally adopted.
The traditional method for searching the position of the operation hole is to search the position of the operation hole through CT scanning before operation and external heuristics, the method mainly depends on experience of doctors, lacks data support and actual verification, even has positioning errors and other conditions for doctors with low experience, builds a human pneumoperitoneum simulation model before operation, calculates and selects the operation hole according to the operation hole selection principle based on the human pneumoperitoneum simulation model, carries out simulation check and motion interference check calculation, determines the positions of an endoscope hole, a main operation hole and an auxiliary operation hole on the pneumoperitoneum, returns the pneumoperitoneum to an uninflated state, and positions corresponding to the endoscope hole, the main operation hole and the auxiliary operation hole on an uninflated outer abdominal wall. The method not only analyzes the abdominal environment in advance, but also positions the operation hole at the uninflated outer abdominal wall through the inverse transformation of simulated inflation, thereby effectively helping doctors to determine the operation hole which is easier to operate under the condition of no inflation before operation.
The embodiments given above describe in more detail the positioning method of the laparoscopic operation hole based on pneumoperitoneum simulation, and the following embodiments will attempt to simply describe a positioning system implementing the positioning method, i.e., a positioning system of the laparoscopic operation hole based on pneumoperitoneum simulation.
Referring to fig. 1, the positioning system for the laparoscopic operation hole based on pneumoperitoneum simulation comprises a three-dimensional pneumoperitoneum reconstruction module, an operation hole measuring and verifying module and an operation hole positioning module.
The three-dimensional pneumoperitoneum reconstruction module is provided with a reconstruction sub-module and a construction sub-module. The reconstruction sub-module reconstructs an uninflated abdominal cavity three-dimensional model according to abdominal cavity CT data or abdominal cavity MRI data, and displays the liver, the liver pipeline, the tumor and the abdominal wall in the abdominal cavity three-dimensional model. The building sub-module is based on the abdominal cavity three-dimensional model, and human pneumoperitoneum under different elastic modulus or air pressure is simulated by changing the elastic modulus or air pressure, so as to obtain a human pneumoperitoneum simulation model, as shown in figures 2 and 3.
The operation hole measuring and verifying module is provided with an endoscope hole sub-module, a main operation hole sub-module and an auxiliary operation hole sub-module. Based on the human pneumoperitoneum simulation model, the operation hole measuring and verifying module can determine the endoscope hole, the main operation hole, the auxiliary operation hole and the positions thereof on the pneumoperitoneum.
Specifically, the endoscope hole sub-module selects an operation hole A according to the principle of an endoscope Kong Xuanqu, simulates the extension and rotation of the endoscope in the operation hole A, adjusts the center of the visual field of the endoscope, observes the operation field, calculates the coincidence rate of the operation field and the center of the visual field, and selects the operation hole A with the largest coincidence rate as the endoscope hole, wherein the position of the operation hole A is the position of the endoscope hole on the pneumoperitoneum.
Specifically, the main operation hole sub-module selects an operation hole B according to a main operation Kong Xuanqu principle, simulates a main scalpel to cut a tumor in the operation hole B according to a working field, calculates and selects the operation hole B closest to the tumor and having the smallest liver cutting volume as a main operation hole, wherein the position of the operation hole B is the position of the main operation hole on a pneumoperitoneum.
Specifically, the sub-module of the auxiliary operation hole selects an operation hole C according to the principle of auxiliary operation Kong Xuanqu, simulates the insertion of the auxiliary operation knife into the operation hole C, and the insertion of the main operation knife into the determined main operation hole, analyzes the movement range of the main operation knife and the auxiliary operation knife, calculates the interference degree of the main operation knife and the auxiliary operation knife, selects the operation hole C with the minimum interference degree as the auxiliary operation hole, and the position of the operation hole C is the position of the auxiliary operation hole on the pneumoperitoneum.
The operation hole positioning module removes the abdominal pressure by canceling the pressure value of the gas filled in, and enables the pneumoperitoneum to return to the uninflated state, so that the positions of the corresponding endoscope hole, the main operation hole and the auxiliary operation hole on the uninflated outer abdominal wall are obtained.
In one embodiment, the positioning system further comprises a data recording and processing module for recording the tumor location and the procedure hole location in a database. The tumor position and the position of the operation hole of each patient are recorded in the database, one side can be used for experimental teaching, the doctor can select the operation hole in the early stage, the operation hole can be rapidly positioned at the similar lesion position through system training and self-learning in the later stage, and the operation hole is recommended to the doctor, so that repeated operation steps are reduced, and the time is saved.
The positioning system constructs a human body pneumoperitoneum simulation model through a three-dimensional pneumoperitoneum reconstruction module, an operation hole measuring and verifying module determines the positions of an endoscope hole, a main operation hole, an auxiliary operation hole and pneumoperitoneum on the human body pneumoperitoneum simulation model, the operation hole positioning module removes abdominal pressure to enable the pneumoperitoneum to return to an unaerated state, the positions of the corresponding endoscope hole, the main operation hole and the auxiliary operation hole on an unaerated outer abdominal wall are obtained, and finally the positions of tumors and the positions of the operation holes are recorded in a database through a data recording and processing module, so that the model can be used for learning and training.
The positioning system solves the problems that the traditional method relies on a doctor to find the operation hole to lack data support and actual verification, positioning errors can occur, operation time is wasted and the like, and solves the problems that the positioning of the operation hole under the condition before abdominal cavity inflation is inaccurate after the operation hole is inflated and the operation effect is poor based on the operation hole.
The above is only a preferred embodiment of the present invention, and is not intended to limit the present invention, but various modifications and variations can be made to the present invention by those skilled in the art. Any modification, equivalent replacement, improvement, etc. made within the spirit and principle of the present invention should be included in the protection scope of the present invention.
Claims (4)
1. Positioning system to peritoneum emulation is to peritoneoscope operation hole, its characterized in that includes:
the three-dimensional pneumoperitoneum reconstruction module is used for constructing an abdominal cavity three-dimensional model in an uninflated state, and simulating human pneumoperitoneum under different elastic modulus or air pressure based on the abdominal cavity three-dimensional model to obtain a human pneumoperitoneum simulation model;
the operation hole measuring and verifying module is used for determining the endoscope hole, the main operation hole, the auxiliary operation hole and the positions of the endoscope hole, the main operation hole and the auxiliary operation hole on the pneumoperitoneum on the human body pneumoperitoneum simulation model;
firstly, selecting a plurality of operation holes A on a human pneumoperitoneum simulation model according to the principle of an endoscope Kong Xuanqu, simulating the operation of the endoscope in the operation holes A, adjusting the center of a visual field of the endoscope, observing the operation field, calculating the coincidence rate of the operation field and the center of the visual field, and selecting the operation hole A with the largest coincidence rate as an endoscope hole;
then on the human pneumoperitoneum simulation model, selecting a plurality of operation holes B according to the principle of main operation Kong Xuanqu, simulating a main scalpel to cut tumors in the operation holes B according to an operation field, and calculating and selecting the operation hole B closest to the tumors and with the minimum liver cutting volume as a main operation hole;
then, on the human pneumoperitoneum simulation model, selecting a plurality of operation holes C according to the principle of auxiliary operation Kong Xuanqu, simulating the operation of an auxiliary scalpel in the operation holes C, and the operation of a main scalpel in a determined main operation hole, analyzing the movement ranges of the main and auxiliary scalpels, calculating the interference degree of the main and auxiliary scalpels, and selecting the operation hole C with the minimum interference degree as an auxiliary operation hole;
and the operation hole positioning module is used for returning the pneumoperitoneum to an uninflated state to obtain the positions of the corresponding endoscope hole, the main operation hole and the auxiliary operation hole on the uninflated outer abdominal wall.
2. The positioning system for a laparoscopic procedure hole based on pneumoperitoneum simulation according to claim 1, wherein the three-dimensional pneumoperitoneum reconstruction module comprises:
the reconstruction sub-module is used for reconstructing a three-dimensional abdominal cavity model in an uninflated state according to abdominal cavity CT data or abdominal cavity MRI data, and displaying the liver, the liver pipeline, the tumor and the abdominal wall in the three-dimensional abdominal cavity model;
and constructing a sub-module for changing the elastic modulus or the air pressure and simulating the human pneumoperitoneum under different elastic modulus or air pressure to obtain the human pneumoperitoneum simulation model.
3. The pneumoperitoneum simulation-based positioning system for laparoscopic procedure hole according to claim 2, wherein the procedure hole measuring and verifying module comprises:
the endoscope hole sub-module is used for selecting an operation hole A according to the principle of an endoscope Kong Xuanqu, simulating the extension and rotation of the endoscope in the operation hole A, adjusting the center of a visual field of the endoscope, observing the operation field, calculating the coincidence rate of the operation field and the center of the visual field, and selecting the operation hole A with the largest coincidence rate as an endoscope hole, wherein the position of the operation hole A is the position of the endoscope hole on a pneumoperitoneum;
the main operation hole sub-module is used for selecting an operation hole B according to a main operation Kong Xuanqu principle, simulating a main scalpel to cut a tumor in the operation hole B according to an operation domain, calculating and selecting the operation hole B closest to the tumor and having the smallest liver cutting volume as a main operation hole, wherein the position of the operation hole B is the position of the main operation hole on a pneumoperitoneum;
the auxiliary operation hole sub-module is used for selecting an operation hole C according to an auxiliary operation Kong Xuanqu principle, simulating the insertion of an auxiliary surgical knife into the operation hole C, simulating the insertion of a main surgical knife into a determined main operation hole, analyzing the movement range of the main surgical knife and the auxiliary surgical knife, calculating the interference degree of the main surgical knife and the auxiliary surgical knife, and selecting the operation hole C with the minimum interference degree as the auxiliary operation hole, wherein the position of the operation hole C is the position of the auxiliary operation hole on a pneumoperitoneum.
4. A pneumoperitoneum simulation based laparoscopic procedure hole positioning system according to claim 3, wherein the positioning system further comprises a data recording and processing module for recording the tumor location and the respective procedure hole locations in a database.
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Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JPH05154092A (en) * | 1991-12-02 | 1993-06-22 | Olympus Optical Co Ltd | Pneumoperitoneum apparatus |
| CN203931309U (en) * | 2014-05-07 | 2014-11-05 | 上海世德医学科技有限公司 | A kind of laparoscopic surgery simulation trainer |
| CN109758228A (en) * | 2019-02-28 | 2019-05-17 | 四川大学华西医院 | Optimization method is disposed through jugular vein Door deformation surgical stent based on three-dimensional reconstruction |
| CN210250062U (en) * | 2019-05-31 | 2020-04-07 | 四川大学华西医院 | Simulated digestive tract tumor model |
Family Cites Families (13)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JP2005000318A (en) * | 2003-06-10 | 2005-01-06 | Olympus Corp | Aeroperitonia apparatus |
| JP2005245772A (en) * | 2004-03-04 | 2005-09-15 | Olympus Corp | Pneumoperitoneum system |
| WO2010084869A1 (en) * | 2009-01-21 | 2010-07-29 | 国立大学法人大阪大学 | Guide tube system for forming pneumoperitoneum and providing route for accessing body cavity |
| EP3117421B1 (en) * | 2014-03-13 | 2020-02-19 | Applied Medical Resources Corporation | Advanced first entry model for surgical simulation |
| CN103886797B (en) * | 2014-03-13 | 2017-06-20 | 西安交通大学 | A kind of height emulation laparoscopic surgery simulation trainer |
| CN206240689U (en) * | 2016-11-25 | 2017-06-13 | 武汉力祯环保科技有限公司 | A kind of dosing shower nozzle easy for removal and installation |
| CN106780706B (en) * | 2017-02-06 | 2019-09-17 | 青岛海信医疗设备股份有限公司 | Image display method and apparatus based on laparoscope |
| CN206844694U (en) * | 2017-05-22 | 2018-01-05 | 陈力攀 | A kind of detachable combination balustrade for building |
| CN107374604A (en) * | 2017-09-06 | 2017-11-24 | 南陵县生产力促进中心有限公司 | A kind of Watch for monitoring blood pressure |
| CN109223178B (en) * | 2018-08-29 | 2021-04-06 | 合肥工业大学 | Cavity mirror intelligent edge computing system with target positioning function |
| CN209347108U (en) * | 2018-10-16 | 2019-09-06 | 大连医科大学附属第二医院 | A kind of incision protection device of quick reconstruction celioscope pneumoperitoneum |
| CN210895399U (en) * | 2020-01-02 | 2020-06-30 | 零壹人工智能科技研究院(南京)有限公司 | Artificial intelligence touch-sensitive screen |
| CN113269995B (en) * | 2021-05-28 | 2023-05-02 | 黑龙江拓盟科技有限公司 | MR-based simulation training system for peritoneal dialysis catheterization by using B ultrasonic guided puncture method |
-
2022
- 2022-01-12 CN CN202210032749.9A patent/CN114424974B/en active Active
Patent Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JPH05154092A (en) * | 1991-12-02 | 1993-06-22 | Olympus Optical Co Ltd | Pneumoperitoneum apparatus |
| CN203931309U (en) * | 2014-05-07 | 2014-11-05 | 上海世德医学科技有限公司 | A kind of laparoscopic surgery simulation trainer |
| CN109758228A (en) * | 2019-02-28 | 2019-05-17 | 四川大学华西医院 | Optimization method is disposed through jugular vein Door deformation surgical stent based on three-dimensional reconstruction |
| CN210250062U (en) * | 2019-05-31 | 2020-04-07 | 四川大学华西医院 | Simulated digestive tract tumor model |
Non-Patent Citations (1)
| Title |
|---|
| 腹腔镜手术的虚拟仿真研究;方驰华等;《中国内镜杂志》;全文 * |
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