National Institute for Research and Development of Isotopic and Molecular Technologies, Donath Street, No 67-103, 400293, Cluj-Napoca, Romania.
National Institute for Research and Development of Isotopic and Molecular Technologies, Donath Street, No 67-103, 400293, Cluj-Napoca, Romania.
Surg Oncol. 2020 Dec;35:504-514. doi: 10.1016/j.suronc.2020.10.012. Epub 2020 Oct 29.
The accurate localization of small tumors of the digestive tract is of paramount importance in surgical oncology because it dictates the limits of resection and the extent of lymph node dissection. In this view, we have designed and fabricated a highly efficient sensing laparoscopic instrument focused on precise non-invasive extralumenal intraoperative detection of small colorectal or gastric tumors. The equipment is fully adapted for laparoscopic surgery and consists of an inductive proximity sensor encapsulated into a watertight stainless-steel case that is connected to an electronic functional block dimensionally scaled-down by the desired form and size for optimal surgical manipulation. The sensor-case unit and the electronic block are coupled together using a modular system which allows disconnection of the latter and sterilization by autoclavation of the former, followed by swift plugging of the electronic block just before surgery in a sterile-controlled environment. The instrument works in tandem with a modified endoscopic hemostatic clip which is attached endoscopically, before surgery, in the mucosa proximal and distal to the tumor. By scanning the serosal side of the digestive organ during the laparoscopic surgical procedure, the detector senses the modified clip and thus pinpoints to the location of the tumor. Additional engineering of the standard endoscopic hemostatic clips by coating them with various combinations of metallic alloys of Cu and Zn was necessary to improve the detection range and sensitivity without compromising on their functionality. The clips were also covered with nanometric layers of Au to ensure their biocompatibility. The ex-vivo dry-lab experiments showed a satisfactory detection distance which was later confirmed in ex-vivo wet-lab experiments on animal organs and human surgical specimens.
胃肠道小肿瘤的精确定位在外科肿瘤学中至关重要,因为它决定了切除的范围和淋巴结清扫的程度。基于这一观点,我们设计并制造了一种高效的感应腹腔镜仪器,专注于精确的非侵入性腔外术中检测小的结直肠或胃肿瘤。该设备完全适用于腹腔镜手术,由一个感应式接近传感器封装在一个防水不锈钢外壳中组成,该外壳连接到一个电子功能模块,该模块的尺寸按所需的形状和大小缩小,以便于最佳的手术操作。传感器-外壳单元和电子模块通过一个模块化系统连接在一起,可以断开后者,并对前者进行高压灭菌消毒,然后在无菌控制环境中迅速将电子模块插入,就在手术前进行。该仪器与改良的内镜止血夹配合使用,该止血夹在手术前通过内镜夹在肿瘤近端和远端的黏膜上。在腹腔镜手术过程中扫描消化器官的浆膜侧时,探测器会感应到改良的夹子,并确定肿瘤的位置。通过对标准内镜止血夹进行工程设计,在不影响其功能的前提下,用各种组合的 Cu 和 Zn 金属合金对其进行涂层处理,以提高检测范围和灵敏度。夹子还覆盖了纳米级的 Au 层,以确保其生物相容性。离体干实验室实验显示了令人满意的检测距离,随后在动物器官和人体手术标本的离体湿实验室实验中得到了证实。