Laryngeal Nerve Identification during Thyroid Surgery with Automatic Adjustment of Electrical Signal Parameters
DOI:
https://doi.org/10.47839/ijc.23.4.3754Keywords:
algorithm and hardware, electrical signal, operations on neck organs, recurrent laryngeal nerve, electrical stimulation, intraoperative monitoringAbstract
The article presents the results of developing the method and tools for localization and visualization of the recurrent laryngeal nerve (RLN). It is based on an electrophysiological method of tissue surgical wound stimulation with software adjustment of the electrical signal parameters to achieve a maximum response of the vocal cords depending on the electrophysiological properties of the surgical wound tissue. The reaction to tissue stimulation is recorded by a sound sensor, and subsequent processing of the received information signal is done by a computer based on a Raspberry Pi 4 single-board computer. The results of processing are visualized by a portable display indicating the area on the surgical wound with the greatest risk of possible damage to the RLN. The time characteristics of each of the stages of obtaining an information signal, setting the parameters of the electrical signal, and visualizing the results of the detection of the RLN are studied. Optimization of the specified time characteristics provides a response to stimulation during a single inhale or exhale of the patient during surgery. The article also proposes a method for building an interval model of the distribution of information signal characteristics, which determines the properties and type of tissue on a surgical wound and, accordingly, makes it possible to build the area of the highest risk of damage to the RLN. The mentioned method is based on the analysis of interval data and the iterative procedure of refining the model every time the surgeon stimulates the tissues of the surgical wound with an electric current. In total, the developed methods and tools provide a reduction in the time for the operation and reduce the risk of damage to the RLN as a result of visualization of its location on the surgical wound.
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