DeepGuide: a novel wavelength-specific navigation system for membrane visualization in surgery.

IF 12.5 2区医学 Q1 SURGERY

International journal of surgery Pub Date : 2025-04-01 DOI:10.1097/JS9.0000000000002370

Zehong Chen, Xuejie Li, Zongheng Zheng, Jianpei Liu, Jiafeng Fang, Jianglong Huang, Tufeng Chen, Hongbo Wei

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引用次数: 0

Abstract

Background: Membrane anatomy (MA) has become pivotal in modern surgery, enabling surgeons to operate within avascular natural planes to minimize concomitant injury. However, intraoperative identification of membranous structures remains challenging. Poor membrane visualization compromises both radical resection and functional preservation, underscoring the need for innovative solutions.

Methods: In this study, we develop a innovative tool, DeepGuide, to help surgeon make membrane visualization during surgery. Moreover, we design a single-arm prospective study to validated its effectiveness. A total of 60 patients undergoing laparoscopic radical resection for gastrointestinal tumors at The Third Affiliated Hospital of Sun Yat-sen University were enrolled. Primary outcomes included signal-to-background ratio (SBR), mesenteric integrity, absorbance of membrane specimens, and immunofluorescence staining of collagen components.

Results: DeepGuide significantly improved mesenteric integrity rates from 75% (conventional laparoscopy) to 98%. SBR under DeepGuide (2.30 ± 0.15) surpassed conventional lighting (1.32 ± 0.16). Absorbance analysis revealed reduced light absorption at 385 nm. Immunofluorescence confirmed collagen I/III enrichment in mesenteric submucosa, aligning with 385 nm-excited autofluorescence properties.

Conclusion: DeepGuide revolutionizes intraoperative membrane visualization without requiring contrast agents. It enhances surgical precision and supports MA principles. These findings highlight DeepGuide's potential to redefine standards in oncologic surgery.

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DeepGuide：一种用于外科膜可视化的新型波长特异导航系统。

背景：膜解剖（MA）已成为现代外科手术的关键，使外科医生能够在无血管的自然平面内进行手术，以尽量减少伴随损伤。然而，术中膜性结构的识别仍然具有挑战性。较差的膜可视化损害了根治性切除和功能保存，强调了创新解决方案的必要性。方法：在本研究中，我们开发了一种创新的工具DeepGuide，以帮助外科医生在手术中进行膜可视化。此外，我们设计了一项单臂前瞻性研究来验证其有效性。在中山大学第三附属医院行腹腔镜胃肠肿瘤根治术的患者共60例。主要结果包括信号背景比（SBR）、肠系膜完整性、膜标本的吸光度和胶原成分的免疫荧光染色。结果：DeepGuide将肠系膜完整性率从75%（常规腹腔镜）显著提高到98%。DeepGuide下的SBR（2.30±0.15）优于传统照明（1.32±0.16）。吸光度分析显示在385 nm处光吸收降低。免疫荧光证实肠系膜粘膜下层胶原I/III富集，符合385 nm激发的自身荧光特性。结论：DeepGuide彻底改变了术中膜成像，无需造影剂。它提高了手术精度并支持MA原则。这些发现凸显了DeepGuide重新定义肿瘤手术标准的潜力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International journal of surgery SURGERY-

CiteScore

17.70

自引率

3.30%

发文量

审稿时长

6-12 weeks

期刊介绍： The International Journal of Surgery (IJS) has a broad scope, encompassing all surgical specialties. Its primary objective is to facilitate the exchange of crucial ideas and lines of thought between and across these specialties.By doing so, the journal aims to counter the growing trend of increasing sub-specialization, which can result in "tunnel-vision" and the isolation of significant surgical advancements within specific specialties.