Near infra red fluorescence imaging for visualization of blood vessels during endoscopic harvest

• US 10,492,671 B2
• Filed: 05/10/2010
• Issued: 12/03/2019
• Est. Priority Date: 05/08/2009
• Status: Active Grant

• Current Assignee: Stryker Corporation
• Original Assignee: Novadaq Technologies ULC (Stryker Corporation)
• Inventors: Carroll, Douglas R., Flower, Robert W., Docherty, John C.
• Primary Examiner(s): Park, Patricia J
• Application Number:
  US12/776,835
• Publication Number:
  US 20100286529A1
• Time in Patent Office: 3,494 Days
• Field of Search: None
• CPC Class Codes: A61B 1/0005 combining images e.g. side-by-side, superimposed or tiled
• CPC Class Codes: A61B 1/043 for fluorescence imaging
• CPC Class Codes: A61B 1/05 characterised by the image sensor, e.g. camera, being in the distal end portion
• CPC Class Codes: A61B 5/0071 by measuring fluorescence emission
• CPC Class Codes: A61B 5/0086 using infrared radiation
• CPC Class Codes: A61B 5/489 Blood vessels

Abstract

Endoscopic identification and dissection of a blood vessel in tissue during endoscopic harvest can be enhanced by injecting a bolus of ICG into the bloodstream, illuminating the target vessels with excitation light capable of exciting fluorescence in the ICG, and locating the vessel to be harvested by observing the ICG fluorescence. Moreover, collapsed blood vessel may be harvested by inserting an endoscope into the collapsed blood vessel, injecting into the collapsed blood vessel a bolus containing ICG to re-inflate the blood vessel, illuminating the target vessels with excitation light capable of exciting fluorescence in the ICG; and locating the re-inflated blood vessel by observing the ICG fluorescence.

Claims

1. A method for enhancing endoscopic identification and dissection of a blood vessel in tissue during endoscopic harvest, comprising the steps of:

introducing an endoscope to a target region containing a blood vessel to be harvested;

injecting ICG into the bloodstream;

illuminating the blood vessel in situ, via a multi-mode light source, with excitation light capable of exciting fluorescence in the ICG;

capturing, via a camera, fluorescence and color images of the blood vessel in situ;

providing, via a processor, video signals to a display to facilitate visualization of the blood vessel in situ;

locating the blood vessel to be harvested by observing the ICG fluorescence; and

harvesting the located blood vessel for use in a subsequent procedure.

2. The method of claim 1, further comprising the step of:

identifying vessel branches from ICG fluorescence intensity in the vessel branches and absence of ICG fluorescence in tissue surrounding the vessel branches.

3. The method of claim 1, further comprising the step of harvesting the blood vessel by:

before said harvesting, incising an area where the blood vessel to be harvested is located, said harvesting including harvesting at least the located blood vessel; and

transplanting at least the harvested blood vessel to a diseased or traumatized area to be reconstructed.

4. The method of claim 1, further comprising the step of tracking a course of the blood vessel during dissection by observing the ICG fluorescence.

5. The method of claim 1, wherein the ICG is injected as a bolus.

6. The method of claim 1, wherein the ICG is injected as autologous blood for identifying the blood vessel in the presence of stasis in the blood vessel.

8. The method of claim 5, wherein the bolus comprises autologous blood containing ICG at a concentration in the range of 0.01 to 0.05 mg per ml of blood.

11. The method of claim 1, further comprising imaging, via a camera associated with the endoscope, the blood vessel to be harvested.

12. The method of claim 1, further comprising carrying out a subsequent procedure using said harvested blood vessel.

7. A method for identifying and dissecting a collapsed blood vessel during endoscopic harvest, comprising the steps of:

inserting a needle-tipped catheter introduced through a port of an endoscope into the collapsed blood vessel;

injecting, via the catheter, into the collapsed blood vessel a bolus containing ICG to re-inflate the blood vessel;

illuminating the blood vessel in situ, via a multi-mode light source, with excitation light capable of exciting fluorescence in the ICG;

capturing, via a camera, fluorescence and color images of the blood vessel in situ;

providing, via a processor, video signals to a display to facilitate visualization of the blood vessel in situ; and

locating the re-inflated blood vessel to be harvested by observing the ICG fluorescence.

9. The method of claim 7, further comprising imaging, via a camera associated with the endoscope, the re-inflated blood vessel to be harvested.

10. The method of claim 7, further comprising harvesting the located re-inflated blood vessel.

20. The method of claim 7, further comprising carrying out a subsequent procedure using said harvested blood vessel.

13. A method for enhancing endoscopic identification and dissection of a blood vessel in tissue during endoscopic harvest, comprising the steps of:

introducing an endoscope to a target region containing a blood vessel to be harvested;

injecting ICG into the bloodstream;

illuminating the blood vessel in situ, via a multi-mode light source, with excitation light capable of exciting fluorescence in the ICG;

capturing, via a camera, fluorescence and color images of the blood vessel in situ;

providing, via a processor, video signals to a display to facilitate visualization of the blood vessel in situ; and

harvesting the visualized blood vessel for use in a subsequent procedure.

14. The method of claim 13, further comprising:

identifying vessel branches from ICG fluorescence intensity in the vessel branches and absence of ICG fluorescence in tissue surrounding the vessel branches.

15. The method of claim 13, further comprising the step of harvesting the blood vessel by:

before said harvesting, incising an area where the blood vessel to be harvested is located, said harvesting including harvesting at least the located blood vessel; and

transplanting at least the harvested blood vessel to a diseased or traumatized area to be reconstructed.

16. The method of claim 13, further comprising the step of tracking a course of the blood vessel during dissection by observing the ICG fluorescence.

17. The method of claim 13, wherein the ICG is injected as a bolus.

18. The method of claim 13, wherein the ICG is injected as autologous blood for identifying the blood vessel in the presence of stasis in the blood vessel.

19. The method of claim 13, further comprising carrying out a subsequent procedure using said harvested blood vessel.