Clinical Research Center, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan.
Surg Endosc. 2011 Jun;25(6):2029-33. doi: 10.1007/s00464-010-1498-8. Epub 2010 Dec 7.
Endoscopic surgery has become an accepted major type of minimally invasive surgery. However, complications arising from heat generated by sources of endoscopic illumination can include surgical fire or burns, and intense illumination during ob-gyn/fetoscopic surgery might damage fetal ocular development. Fiber-optic bundles for illumination within the endoscope essentially double the outer diameter of the endoscope, which is a major obstacle to miniaturization and decreasing costs. Light cables also decrease the maneuverability of the endoscope
We developed a novel endoscope with ultralow illumination to visualize dark body cavities and investigated its feasibility in vivo. An adaptor was created to connect a conventional endoscope to an ultrahigh-sensitivity camera developed by the Japan Broadcasting Corporation (NHK) for broadcasting. The ability to visualize rabbit visceral blood vessels in vivo by the new prototype and by a current endoscope under ultralow illumination provided by a standard light source was compared. In addition, the performance of the two endoscopes was compared using only an extracorporeal flashlight without any specific light source placed within body cavities.
The new endoscope could visualize the target under ultralow illumination of approximately 100 lx. Very little could be visualized using the current endoscope, whereas the prototype generated clear images of the rabbit blood vessels under both ultralow illumination and extracorporeal illumination provided by a flashlight.
The potential for damage caused by a light source can be minimized using our new endoscope, which results in safer and less invasive procedures. Further studies are under way to develop a nonilluminated endoscope without a light cable or source and to miniaturize the camera to decrease costs and improve the maneuverability of the entire endoscope system.
内镜手术已成为一种被广泛接受的微创手术类型。然而，内镜照明源产生的热会引发并发症，包括手术火灾或灼伤，妇产科/胎儿镜手术中强烈的光照可能会损害胎儿眼部发育。用于内镜内照明的光纤束基本上会使内镜的外径增加一倍，这是微型化和降低成本的主要障碍。光电缆还会降低内镜的可操作性。
我们开发了一种具有超低照明的新型内镜来可视化黑暗的体腔，并研究了其在体内的可行性。创建了一个适配器，将传统内镜连接到日本广播协会（NHK）为广播开发的超高灵敏度相机。比较了新原型和标准光源提供的超低照明下当前内镜在体内可视化兔内脏血管的能力。此外，还比较了仅使用体外闪光灯而不将任何特定光源放置在体腔内的情况下这两种内镜的性能。
新型内镜可在约 100lx 的超低照明下观察目标。当前的内镜几乎无法观察到任何东西，而原型则在超低照明和体外闪光灯提供的体外照明下都能清晰地显示兔血管图像。
使用我们的新型内镜可以最大限度地减少光源造成的潜在损伤，从而使手术更安全、更微创。目前正在进一步研究开发一种无光电缆或光源的非照明内镜，并使相机微型化，以降低成本并提高整个内镜系统的机动性。
