Kajimoto Yoshinaga, Ota Hidefumi, Kameda Masahiro, Nonoguchi Naosuke, Furuse Motomasa, Kawabata Shinji, Kuroiwa Toshihiko, Takami Toshihiro, Wanibuchi Masahiko
Department of Neurosurgery, Osaka Medical Pharmaceutical University, Takatsuki-City 569-8686, Japan.
Stryker Japan, Tokyo 160-0023, Japan.
Sensors (Basel). 2025 May 28;25(11):3412. doi: 10.3390/s25113412.
The development of an intelligent ultrasonic aspirator controlled by a fiber-optic neoplasm sensor that detects 5-aminolevulinic acid-derived porphyrin fluorescence presents a significant advancement in glioma surgery. By leveraging the fluorescence phenomenon associated with 5-aminolevulinic acid in malignant neoplasms, this device integrates an excitation laser and a high-sensitivity photodiode into the tip of an ultrasonic aspirator handpiece. This setup allows for real-time tumor fluorescence detection, which in turn modulates the aspirator's power based on fluorescence intensity. Preliminary testing demonstrated high sensitivity, with the device capable of differentiating between weak, strong, and no fluorescence. The sensor sensitivity was comparable to human visual perception, enabling effective tumor differentiation. Tumors with strong fluorescence were effectively crushed, while the aspirator ceased operation in non-fluorescent areas, enabling precise tissue resection. Furthermore, the device functioned efficiently in bright surgical environments and was designed to maintain a clean sensor tip through constant saline irrigation. The system was successfully applied in a surgical case of recurrent glioblastoma, selectively removing tumor tissue while preserving surrounding brain tissue. This innovative approach shows promise for safer, more efficient glioma surgeries and may pave the way for sensor-based robotic surgical systems integrated with navigation technologies.
由检测5-氨基乙酰丙酸衍生卟啉荧光的光纤肿瘤传感器控制的智能超声吸引器的开发，是胶质瘤手术的一项重大进展。通过利用恶性肿瘤中与5-氨基乙酰丙酸相关的荧光现象，该设备将激发激光和高灵敏度光电二极管集成到超声吸引器机头的尖端。这种设置允许实时肿瘤荧光检测，进而根据荧光强度调节吸引器的功率。初步测试显示出高灵敏度，该设备能够区分弱荧光、强荧光和无荧光。传感器灵敏度与人类视觉感知相当，能够有效区分肿瘤。强荧光的肿瘤被有效粉碎，而吸引器在无荧光区域停止操作，从而实现精确的组织切除。此外，该设备在明亮的手术环境中高效运行，并设计通过持续盐水冲洗保持传感器尖端清洁。该系统已成功应用于一例复发性胶质母细胞瘤的手术病例，在保留周围脑组织的同时选择性地切除肿瘤组织。这种创新方法有望实现更安全、更高效的胶质瘤手术，并可能为与导航技术集成的基于传感器的机器人手术系统铺平道路。
