PubMed · 15529426
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Rhonda Becker. 2004. Remote diagnostics. Cyber service.. https://pubmed.ncbi.nlm.nih.gov/15529426/
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Multi-sensory fluence rate probes (MSPs) yield several simultaneous measurements of photodynamic therapy (PDT) treatment light fluence from a single interstitial probe. Fluorescent sensors are embedded at desired positions along the axis of the optical fibre. A single fluorescence emission spectrum is obtained and decomposed using a partial least squares (PLS)-based analysis to yield the fluence at each sensor's location. The responsivity, linearity and possible photodegradation of each fluorophore chosen for the MSPs were evaluated using single-sensor probes. The performance of two- and three-sensor MSPs was evaluated experimentally. Individual fluorescence spectra collected from each sensor on the MSP were used to construct the training set necessary for the PLS-based analysis. The MSPs' responsivity, spatial resolution and accuracy were evaluated relative to a single scattering-tip detector. Three-fluorophore MSPs permitted three simultaneous measurements of the fluence rate gradient in a tissue-like phantom, with an average accuracy of 6.7%. No appreciable photodegradation or cross-talk was observed.
The functional-anatomic structure of the liver according to Couinaud classification based on the intrahepatical course of the vascular structures is the basis of all modern liver surgery. Consequently, the use of intraoperative ultrasound is an undisputed requirement for every liver resection. Exact following of the planned resection plane can be realized only with the application of permanent online navigation based on intraoperative ultrasound during the dissection of the hepatical tissue. Now that the authors have established ultrasound navigated resection in open liver surgery using a navigated parenchymal dissecting instrument, they intend to transfer this technique from open to laparoscopic liver surgery. A special adapter was developed to connect an ultrasound-based navigation system to laparoscopic instruments. The authors present the first results in terms of technical aspects and feasibility.
For operative laryngoscopy, a laryngoscope is introduced into the anesthetized patient's mouth for exploration of the larynx and vocal cords. To improve the vision, a binocular microscope is positioned between the operator and the laryngoscope. This interferes, to some degree, with the introduction of instruments, particularly if the surgeon is using bimanual manipulation. In the case of lengthy operations, a fatigue or stress factor can be troublesome to the operator. The authors developed a video laryngoscope using standard blades. An angulated telescope attached to a TV camera was introduced in the top portion of the blade. An enlarged image from the anatomy was produced and viewed from a convenient distance. The manipulations are unobstructed, and simultaneous records can be obtained. It is the method of choice for teaching. The operative laryngoscope is less cumbersome and supersedes the microscope for viewing the endolarynx. This new technique was used successfully in 532 cases.