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US-20260124017-A1 - WAVEBAND-SELECTIVE IMAGING SYSTEMS AND METHODS

US20260124017A1US 20260124017 A1US20260124017 A1US 20260124017A1US-20260124017-A1

Abstract

An illustrative surgical system may access a plurality of images captured outside a structure within a patient; detect a difference between spectral reflectances of scenes captured in the plurality of images; and identify, based on the detected difference between the spectral reflectances of the scenes captured in the plurality of images, pixels in at least one of the plurality of images that correspond to structure tissue of the structure.

Inventors

  • Jeffrey M. Dicarlo
  • Ian E. McDowall
  • Jonathan M. Sorger

Assignees

  • Intuitive Surgical Operations, Inc.

Dates

Publication Date
20260507
Application Date
20260105

Claims (20)

  1. 1 . A surgical system comprising: an illuminator configured to selectively provide first illumination in a first waveband or second illumination in a second waveband more narrow than the first waveband; and a controller configured to: cause, while operating in a first mode, the illuminator to illuminate a scene with the first illumination, an image capture system to capture a first set of one or more images based on the first illumination reflecting from tissue within the scene, and a display unit to display the first set of one or more images; obtain a signal; switch, based on the obtaining the signal, from operating in the first mode to operating in a second mode; and cause, while operating in the second mode, the illuminator to illuminate the scene with the second illumination instead of with the first illumination, the image capture system to capture a second set of one or more images based on the second illumination reflecting from tissue within the scene, and the display unit to display the second set of one or more images.
  2. 2 . The surgical system of claim 1 , wherein: the second set of one or more images includes a plurality of images depicting a structure within the scene; and the controller is further configured to: detect a difference between spectral reflectances of the plurality of images, and identify, based on the detected difference between the spectral reflectances, pixels in at least one image of the plurality of images that correspond to structure tissue of the structure.
  3. 3 . The surgical system of claim 2 , wherein the controller is further configured to cause the display unit to: display the at least one image; and artificially highlight the pixels that correspond to the structure tissue in the at least one image.
  4. 4 . The surgical system of claim 2 , wherein the second illumination comprises at least one of: a first narrowband light component having wavelengths in a range from 450 nm to 580 nm; a second narrowband light component having wavelengths in a range from 640 nm to 750 nm; or a third narrowband light component having wavelengths in a range from 900 nm to 1080 nm.
  5. 5 . The surgical system of claim 2 , wherein the controller is further configured to identify, based on the detected difference between the spectral reflectances, additional pixels in at least one image of the plurality of images that correspond to non-structure tissue outside the structure.
  6. 6 . The surgical system of claim 5 , wherein: the structure is a ureter; the structure tissue is ureter tissue of the ureter; and the non-structure tissue is non-ureter tissue outside the ureter.
  7. 7 . The surgical system of claim 2 , wherein the identifying comprises: transforming a location in each of the plurality of images into a structure signal; and determining whether the structure signal is indicative of the structure tissue at the location.
  8. 8 . The surgical system of claim 7 , wherein the determining comprises comparing a ratio of the structure signal and a non-structure signal with a threshold.
  9. 9 . The surgical system of claim 1 , wherein the image capture system comprises an endoscope.
  10. 10 . The surgical system of claim 1 , further comprising: a manipulator arm, wherein an endoscope comprising the image capture system is mounted on the manipulator arm.
  11. 11 . The surgical system of claim 1 , wherein the first illumination comprises white light illumination.
  12. 12 . A surgical system comprising: an illuminator configured to selectively provide first illumination in a first waveband or second illumination in a second waveband more narrow than the first waveband; a controller configured to: cause, while operating in a first mode, the illuminator to illuminate a scene with the first illumination, an image capture system to capture a first set of one or more images based on the first illumination reflecting from tissue within the scene, and a display unit to display the first set of one or more images; switch from operating in the first mode to operating in a second mode; and cause, while operating in the second mode, the illuminator to illuminate the scene with the second illumination instead of with the first illumination, the image capture system to capture a second set of one or more images based on the second illumination reflecting from tissue within the scene, and the display unit to display the second set of one or more images; and a manipulator arm, wherein an endoscope implementing the image capture system is mounted on the manipulator arm.
  13. 13 . The surgical system of claim 12 , wherein: the second set of one or more images includes a plurality of images depicting a structure within the scene; and the controller is further configured to: detect a difference between spectral reflectances of the plurality of images, and identify, based on the detected difference between the spectral reflectances, pixels in at least one image of the plurality of images that correspond to structure tissue of the structure.
  14. 14 . The surgical system of claim 13 , wherein the controller is further configured to cause the display unit to: display the at least one image; and artificially highlight the pixels that correspond to the structure tissue in the at least one image.
  15. 15 . The surgical system of claim 13 , wherein the second illumination comprises at least one of: a first narrowband light component having wavelengths in a range from 450 nm to 580 nm; a second narrowband light component having wavelengths in a range from 640 nm to 750 nm; or a third narrowband light component having wavelengths in a range from 900 nm to 1080 nm.
  16. 16 . The surgical system of claim 13 , wherein the controller is further configured to identify, based on the detected difference between the spectral reflectances, additional pixels in at least one image of the plurality of images that correspond to non-structure tissue outside the structure.
  17. 17 . The surgical system of claim 16 , wherein: the structure is a ureter; the structure tissue is ureter tissue of the ureter; and the non-structure tissue is non-ureter tissue outside the ureter.
  18. 18 . The surgical system of claim 13 , wherein the identifying comprises: transforming a location in each of the plurality of images into a structure signal; and determining whether the structure signal is indicative of the structure tissue at the location.
  19. 19 . The surgical system of claim 18 , wherein the determining comprises comparing a ratio of the structure signal and a non-structure signal with a threshold.
  20. 20 . A method comprising: causing, by one or more processors of a surgical system while operating in a first mode, an illuminator to illuminate a scene with first illumination in a first waveband, an image capture system to capture a first set of one or more images based on the first illumination reflecting from tissue within the scene, and a display unit to display the first set of one or more images; obtaining a signal; switching, based on the obtaining the signal, from operating in the first mode to operating in a second mode; and causing, while operating in the second mode, the illuminator to illuminate the scene with a second illumination instead of with the first illumination, the second illumination in a second waveband more narrow than the first waveband, the image capture system to capture a second set of one or more images based on the second illumination reflecting from tissue within the scene, and the display unit to display the second set of one or more images.

Description

RELATED APPLICATIONS This application is a continuation of U.S. patent application Ser. No. 18/736,170, filed Jun. 6, 2024, which is a continuation of U.S. patent application Ser. No. 17/840,130, filed Jun. 14, 2022, now U.S. Pat. No. 12,016,378, which is a continuation of U.S. patent application Ser. No. 16/775,806, filed Jan. 29, 2020, now U.S. Pat. No. 11,389,267, which is a continuation of U.S. patent application Ser. No. 15/536,210, filed Jun. 15, 2017, now U.S. Pat. No. 10,588,711, which application is the U.S. national phase of International Application No. PCT/US2015/065561, filed Dec. 14, 2015, which claims priority to U.S. Provisional Patent Application 62/092,651, filed Dec. 16, 2014, each of which is incorporated herein by reference. BACKGROUND Field of the Invention The present invention relates generally to imaging techniques used in surgical procedures, and more particularly to ureter detection and imaging during surgical procedures. Description of Related Art A ureter is a narrow tube that carries urine from a kidney to the bladder. Muscles in the ureter walls continually tighten and relax forcing urine downward, away from the kidneys. About every ten to fifteen seconds, small amounts of urine are emptied into the bladder from the ureters. Injury to ureters is an adverse event associated with surgery involving the pelvis or colorectal region. To prevent injury to the ureters during surgery, several different techniques have been tried to assist the surgeon in locating the ureters. For example, the surgeon can call an urologist to thread a small scope with a camera into the urethra to place a wire into each of the two ureters. Alternatively, lighted stents can be inserted through the urethra and up through the urinary bladder to access the ureters. However, both of these approaches are disruptive to the clinical workflow in a majority of benign surgical procedures and an urologist may not be available in some instances. In another technique to determine the location of the ureters, a small amount of a radioactive chemical dye (TC99-DTPA) is injected through a vein in the patient's arm. The radioactive chemical dye passes through the body and is excreted through the urine, and so the radioactive chemical dye passes through the ureters. The ureters are detected by a hand held probe that senses the radioactivity. In still another technique to locate the ureters, an IV injection, or a catheter-based retrograde injection of a near infrared (NIR) fluorophore is used to image the ureters using infrared illumination. It was reported that the ureters could be visualized even when embedded in surrounding tissue, and injury could be assessed in real time using invisible light. Eiichi Tanaka, et al. “Real-Time Intraoperative Ureteral Guidance Using Near-Infrared Fluorescence,” J. Urol. 178 (5), pgs. 2197-2201 (2007) describe using Indocyanine green (ICG) and CW800-CA, the carboxylic acid form of IRDye™ 800CW NIR dye, from LI-COR (Lincoln, NE) as the NIR fluorophores. Aya Matsui, M.D., et al., “Real-Time Near-Infrared Fluorescence-Guided Identification of the Ureters using Methylene Blue,” Surgery, 148 (1) pgs. 78-86 (2010) use methylene blue as the NIR fluorophore. Another approach to locate the ureters used infrared thermography. Room-temperature saline was used as an irrigant in the operative field so that the whole operative field was cooled temporarily. As the operative field differentially rewarmed, structures such as blood vessels rewarmed quickly and appeared as white lines against a dark background in an infrared image. A second application of this same concept involved filling the upper urinary system with room-temperature saline. The pelvis and ureter appeared black against a warmer background, which appeared white in an infrared image. See Jeffrey A. Cadeddu, M.D., et al, “Laparoscopic Infrared Imaging,” Journal of Endourology, Vol. 15, No. 1, pgs. 111-116 (2001). SUMMARY Unlike the known techniques used to locate ureters that require introduction of a fluorophore, creation of a temperature difference, introduction of an object into the ureters, or introduction of a radioactive dye, selective reflection of light by ureters and by tissue around the ureters is used to safely and efficiently image the ureters. Thus, endogenous contrast is used to visualize ureters without need for illuminating catheters or the administration, for example, of exogenous fluorophores or radioactive dyes. In one aspect, a plurality of surgical site scenes is captured. Each of the plurality of surgical site scenes is captured from reflected light having a different light spectrum. In one aspect the plurality of surgical site scenes is captured about simultaneously, i.e., within the timing and optical tolerances associated with capturing scenes at the same time, while in another aspect the plurality of surgical site scenes is captured sequentially. The plurality of captured surgical site scenes is analyzed to identify