JP2002085353A - Remote diagnosing system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To enable a doctor to perform diagnosis by remote operating a diagnosing instrument and the like as if he diagnoses a patient at that place. SOLUTION: In this remote diagnosing system, the doctor 11 residing in a hospital 1 operates a master manipulator 30 while visually confirming the relative position relationship between a patient 51 and a diagnosing probe 71 displayed on a received image monitor 19. Whereupon, in response to the operation, a slave manipulator 70 brings the diagnosing probe 71 into contact with the patient 51 to obtain desired diagnosis information. At this time, since the slave manipulator 70 is provided with a force detecting means 90 for detecting force information corresponding to the contact state between the diagnosing probe 71 and the patient 51, the reaction force according to the force information is reflected on the master manipulator 30. Thus, the sense obtained as if the doctor touches the patient at that time can be transmitted to the doctor side in the remote place so that according to the sense, the doctor remote- operates the diagnosing probe 71 to make precise diagnosis.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a remote diagnosis system in which a doctor at a hospital or the like diagnoses a patient at a home at a remote location or a clinic near the same.

[0002]

2. Description of the Related Art With the recent rapid aging of society,
Medical care in Japan will increasingly shift from hospital treatment to home care and nursing care. Home healthcare can greatly reduce the burden on patients of having to travel to a hospital, thereby eliminating waiting time at the hospital and eliminating the possibility of contacting other patients' infections within the hospital. It has advantages and is the most desirable medical method for patients. However, the limited number of specialists limits the number of patients who can receive home medical care by specialists. Further, for patients living in remote and inconvenient areas such as remote islands, it was difficult for a doctor to move to such a location.

Therefore, as a remote diagnostic system for solving such a problem, a specialist in a basic hospital or the like has the same diagnostic image and test data (X
Diagnostic support by providing appropriate diagnostic advice to the patient's physician by looking at lines, CT, MRI images, waveforms such as electrocardiograms and electromyograms, ultrasound images, endoscopes, heart sounds, etc. Various things have been proposed.

[0004]

In the remote diagnosis system described above, the specialist on the hospital side and the doctor on the patient side share the same diagnostic image and test data, so that the doctor on the patient side can use the advice of the specialist. It is to do. Therefore, the specialist on the hospital side can only make a judgment based on the diagnostic video and examination data (image data and audio data) acquired by the doctor on the patient side, and the specialist cannot directly palpate the patient. Was. In particular, in the case of diagnosis using ultrasonic images, the probe can be freely moved along the body surface to obtain an image of an arbitrary field of view, and one object (eg, an organ) can be taken from several different directions. By superimposing the ultrasonic image, it is possible to see a structure that is difficult to see from only one direction. However, even if a specialist wishes to observe a tomographic image from a position and an angle at which diagnosis is most easily performed, it is not possible to directly operate the probe as intended.

An object of the present invention is to provide a remote diagnostic system capable of performing a diagnosis by remotely operating a diagnostic instrument or the like as if a physician is palpating a patient at a distant place. Aim.

[0006]

According to the present invention, there is provided a remote diagnostic system according to the present invention, wherein the remote diagnostic system is arranged at a second location, and obtains diagnostic information on biological information of the subject by contacting the subject. Means, and display means arranged at a first location separated from the second location and displaying an image based on image information indicating a relative positional relationship between the diagnostic means and the subject; A first operation unit arranged at the first location, operated by an operator operating while visually recognizing the display unit, and outputting control information corresponding to the operation; and a first operation unit arranged at the second location, A second operation unit that outputs the force information corresponding to a contact state between the subject and the diagnostic unit while acquiring the diagnostic information by contacting the diagnostic unit with the subject based on the control information; Disposed serial first place, a reproduction means for reproducing at least one of the image and sound based on the diagnostic information to allow recognition to the operator, the first
And control means for controlling the first operating means based on the force information, and the various kinds of information being connected between the first place and the second place so as to be capable of two-way communication. Communication means. Image information indicating the relative positional relationship between the subject at the second location and the diagnostic means is transmitted to the display means at the first location via the communication means and displayed there. The operator at the first place, that is, the doctor, operates the first operation means while visually recognizing the image. Then, control information corresponding to this operation is transmitted to the second operation means at the second place via the communication means. The second operating unit that has received the control information makes the diagnostic unit such as an ultrasonic diagnostic probe contact the subject, and obtains diagnostic information on the biological information of the subject. The acquired diagnostic information is transmitted to the first location via the communication means, where it is reproduced as an image and / or sound. At this time, the second operation means detects force information indicating a contact state between the diagnosis means and the subject, and detects the first force information via the communication means.
Is transmitted to the first operation means at the location. The first operation means is controlled based on the received force information, and can transmit it to the doctor as a reaction force. Therefore, the doctor can feel as if he or she is palpating the patient at a remote place, and can perform a more accurate diagnosis by remotely operating the diagnostic means based on the palpation.

According to a second aspect of the present invention, a remote diagnostic system according to the present invention is disposed at a first location, and is separated from first operating means operated by an operator, from the first location. A second operating means disposed at a second location and controlled by control information from the first operating means; and a second operating means disposed at the second location and associated with (cooperated with) the second operating means. Diagnostic means for obtaining biological information from a subject present at a second location and outputting image diagnostic information, and information relating to the relative positional relationship between the second operating means and the subject, which is disposed at the second location Detecting means for detecting
Display means for displaying each information from the diagnostic means and the detection means for controlling the first operating means, and displaying various information from the first and second places. Communication means for connecting in a bidirectional communication manner.
The first and second operating means are located at first and second locations, respectively, spaced apart. Since the second operating means is controlled by control information from the first operating means, when an operator such as a doctor operates the first operating means, control information corresponding to this operation is transmitted via the communication means. The operation is transmitted to the second operation means at the second place, and the second operation means performs a movement corresponding to the operation. The diagnostic means contacts (cooperates with) the second operating means to bring an ultrasonic diagnostic probe or the like into contact with the subject, obtains the biological information of the subject, and outputs the image diagnostic information. On the other hand, the detecting means may include, for example, image information indicating the relative positional relationship between the subject at the second location and the diagnostic means, or information on the relative positional relationship between the second operating means and the subject. For example, force information indicating a contact state between the two is detected. The information detected by the detection means is transmitted to the display means at the first place via the communication means, displayed there, and provided for control of the first operation means. For example, the operator or doctor at the first location
The first operating means is operated while visually recognizing the image indicating the relative positional relationship between the subject and the diagnostic means. Further, the first operating means is controlled based on force information indicating a contact state between the diagnostic means and the subject, and transmits this to the doctor as a reaction force. This allows the physician to feel as if palpating the patient at a distance,
Based on this, more accurate diagnosis can be performed by remotely operating the diagnosis means.

According to a third aspect of the present invention, a remote diagnostic system according to the present invention is operated by an operator, outputs control information corresponding to the operation state, and is controlled based on force information input from the outside. (1) first operation means, first reproduction means for reproducing at least one of an image and sound based on diagnostic information, and second reproduction for reproducing an image and sound based on the first image and first sound information Means, a second image pickup means for photographing an image relating to the operator and outputting second image information, and a second microphone means for collecting sound emitted by the operator and outputting second sound information A second operating means controlled based on the control information, a diagnostic means provided in the second operating means, for diagnosing a subject, and outputting diagnostic information obtained as a result of the diagnosis; Between the diagnostic means and the subject Force detection means for outputting a contact state as the force information, and first imaging means for shooting an image in which a relative positional relationship between the subject and the diagnosis means can be recognized and outputting the first image information A third reproducing unit that reproduces an image and a sound based on the second image information and the second audio information; the first operating unit; the first reproducing unit; and the second reproducing unit , A second imaging unit, the second microphone unit is located at a first location, the second operation unit,
When the diagnostic means, the force detecting means, the first imaging means, and the third reproducing means are present at a second location, the information is transmitted between the first location and the second location. And communication means for transmitting and receiving. This has the same basic configuration as the remote diagnostic apparatus according to the first aspect, and acquires information (image and sound) on the operator (doctor) side by the second imaging means and the second microphone means. This is added with the point that it is reproduced by the third reproducing means and transmitted to the subject (patient) side.

The remote diagnostic system according to the present invention according to claim 4 is the remote diagnostic system according to claim 3, wherein a third reproducing means for reproducing an image based on the second image information is provided at the first location. And a fourth reproducing means for reproducing an image based on the first image information and the diagnostic information at the second location. In this case, a means for monitoring information transmitted to the other party on its own side is added to the remote diagnostic apparatus according to the second aspect.

According to a fifth aspect of the present invention, in the remote diagnostic system according to the first, second or third aspect, the first operating means is constituted by at least three four-node parallel links, and the first operating means is located at a tip thereof. Link type articulated robot means configured such that the link member to be maintained is always parallel to the ground, and a rotational posture 3 free provided on the link member located at the tip of the parallel link type articulated robot. And a hand means. This is a specific configuration of the first operating means, and its basic configuration is a parallel link type articulated robot configured by combining three 4-node parallel links. Usually, a parallel link type articulated robot is often configured with one four-section parallel link, but in the present invention, two more four-section parallel links are added,
The link member located at the distal end is always kept parallel to the ground. Since the link member which is always parallel to the ground is provided with a hand means having a rotational attitude of three degrees of freedom, the attitude of the link member to which the hand means is attached does not change with respect to a horizontal plane, so that the calculation of the rotational attitude is easy. Becomes Further, regardless of the stop position of the hand means, the hand means can secure a movable range of three degrees of freedom in the rotational posture.

According to a sixth aspect of the present invention, there is provided a remote diagnosis system according to the first, second or third aspect, wherein the second operating means is a first curved guide means having an arcuate guide; A first moving unit that moves along the arcuate guide of the first curved guide unit; and an arcuate guide having a radius smaller than the radius of the arcuate guide, wherein the respective arcuate guides are orthogonal to each other. A second moving guide attached to the first moving means, a second moving means moving along an arc-shaped guide of the second moving guide, and a second moving means. A first driving unit provided in the second moving unit, the second driving unit being provided in the second moving unit, and moving the diagnostic unit in a radial direction of the arcuate guide; First guide with curvature Those constructed and a third moving means for moving at translatable position 3 automatic degree. This is a specific configuration of the second operating means, and its basic configuration is a cross so that the first curved guiding means, the second curved guiding means, and the respective arc-shaped guides are orthogonal to each other. The guide means with built-in curvature is configured to be positioned using the second moving means having three degrees of freedom in the translational position. With this configuration, the third
The operation of the translation axis of the moving means and the rotation axis of the first and second guide means with curvature do not overlap with each other, so that the diagnosis means can be operated independently, and each axis can be surely operated. Can be operated safely.

[0012]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS The present invention will be described below in detail with reference to the embodiments shown in the accompanying drawings. FIG. 1 is a diagram showing a schematic configuration of a remote diagnosis system using an ultrasonic diagnostic apparatus according to one embodiment of the present invention. In the embodiment of FIG. 1, the specialist 11 at the hospital 1 serving as the backbone operates the master manipulator 30 for the doctor to operate the diagnostic slave manipulator 70 at the clinic 5, and the front side thereof is operated. Ultrasonic diagnosis is performed on the patient 51 sitting in the room. The hospital 1 and the clinic 5 are connected by ISDN lines 3 and 4. The image and sound information of the specialist 11 and the image and sound information of the patient are stored on the ISDN line 3.
Is transmitted bi-directionally. Control information between the doctor's master manipulator 30 and the diagnostic slave manipulator 70 is bidirectionally transmitted via the ISDN line 4.

[0013] The audio / video transmission system for transmitting image and audio information employs the technology employed in the conventional remote diagnosis system, and will be briefly described here. The audio and video transmission system on the hospital 1 side is a microphone 13, CCD
It comprises a camera 14, a transmission image monitor 17, a speaker 18, a reception image monitor 19, a codec 20, and a router 21. The sound image transmission system on the clinic 5 side is
Microphone 53, CCD camera 54, ultrasonic diagnostic device 55,
Image synthesizer 56, transmission image monitor 57, speaker 58,
It comprises a reception image monitor 59. And the router 21
And the router 61 are connected by the ISDN line 3.

The configuration of the audio / video transmission system of the hospital 1 is as follows. The microphone 13 collects the voice of the specialist 11 and supplies the voice information to the codec 20.
The CCD camera 14 captures images of the appearance and face of the specialist 11 and supplies the image information to the transmission image monitor 17. The transmission image monitor 17 displays an image captured by the CCD camera 14 and supplies the image information to the codec 20. The speaker 18 is a codec 20
From the clinic 5, that is, voice based on the voice information of the patient 51 transmitted from the clinic 5. The reception image monitor 19 displays an image based on the image information supplied from the codec 20, that is, the image information transmitted from the clinic 5. Codec 20
The voice information from the microphone 13 and the image information from the transmission image monitor 17 are converted into communication data and supplied to the router 21, and conversely, the communication data from the router 21 is converted into voice information and image information, and the speaker 18 and the Image monitor 19
To supply. The router 21 transmits communication data from the codec 20 to the router 61 via the ISDN line 3,
The communication data from the router 61 received via the ISDN line 3 is transmitted to the codec 20.

The configuration of the audio / video transmission system of the clinic 5 is as follows. The microphone 53 collects the voice of the patient 51 and supplies the voice information to the codec 60.
The CCD camera 54 is an image of the appearance and face of the patient 51, an enlarged image of a portion where the ultrasonic diagnostic probe 71 attached to the tip of the diagnostic slave manipulator 70 is in contact with the patient 51, and a diagnostic slave. An image such as an entire image that allows the positional relationship between the manipulator 70 and the patient to be understood is captured, and the image information is supplied to the screen synthesizer 56.
In FIG. 1, a plurality of images as described above may be photographed by remotely controlling one CCD camera 54, or a plurality of CCD cameras may be photographed. When the acoustic vibration generated from the ultrasonic diagnostic probe 71 propagates in the living body, a part of the vibration is reflected at a place where the acoustic impedance is discontinuous such as a blood vessel or a pustule. It utilizes the property of scattering and scattering to image the structure in a living body, and is conventionally known. As the ultrasonic diagnostic device 55, a B-mode device, an M-mode device, an A-mode device, a Doppler blood flow measuring device, or the like is used. The ultrasonic diagnostic apparatus 55 operates an ultrasonic diagnostic probe 71 attached to a diagnostic slave manipulator 70 to capture an ultrasonic image. The ultrasonic image captured by the ultrasonic diagnostic device 55 is supplied to the screen synthesizer 56.

The screen synthesizer 56 supplies a combined image obtained by combining both images from the CCD camera 54 and the ultrasonic diagnostic apparatus 55 to the transmission image monitor 57 and the codec 60.
The transmission image monitor 57 displays the composite image from the screen compositor 56. The synthesized image from the screen synthesizer 56 may not be directly supplied to the codec 60 but may be supplied to the codec 60 via the transmission image monitor 57. The speaker 58 emits sound based on the sound information supplied from the codec 60, that is, the sound information of the patient 51 transmitted from the hospital 1. Received image monitor 59
Displays an image based on the image information supplied from the codec 60, that is, the image information transmitted from the hospital 1. The codec 60 converts voice information from the microphone 53 and image information from the screen synthesizer 56 into communication data and supplies the communication data to the router 61, and conversely converts communication data from the router 61 into voice information and image information. It is supplied to the speaker 58 and the received image monitor 59. The router 61 transmits communication data from the codec 60 to the router 21 via the ISDN line 3, and transmits communication data from the router 21 received via the ISDN line 3 to the codec 60. In this manner, the image and voice information of the specialist 11 and the image and voice information of the patient are bidirectionally transmitted via the ISDN line 3.

The remote control system for actually controlling the ultrasonic diagnostic probe includes a doctor master manipulator 30, a master manipulator control computer 25, a router 26 on the hospital 1 side, and a diagnostic slave manipulator on the clinic 5 side. 70, a slave manipulator control computer 65 and a router 66. The control information between the master manipulator control computer 25 for controlling the doctor's master manipulator 30 and the slave manipulator control computer 65 for controlling the diagnostic slave manipulator 70 is stored in the router 2.
6. Two-way transmission is performed via the ISDN line 4 and the router 66. Master / manipulator control computer 2
5 and computer 6 for controlling slave manipulator
The configuration 5 is software-deformed and implemented according to the configuration of the respective manipulators to be controlled. Therefore, the details are omitted here, and the configuration of the manipulator will be described below.

FIG. 2 is a diagram showing a detailed configuration of the doctor's master manipulator 30 of FIG. The doctor's master manipulator 30 holds a pseudo probe member corresponding to the ultrasonic diagnostic probe 71 and outputs a hand (hand member) for information on the posture of the probe member. And an arm (arm member) to be conveyed to the position. In this embodiment, the master manipulator 30 for the doctor controls the position and orientation of the ultrasonic diagnostic probe 71 on the clinic 5 side freely.
It is composed of a parallel link type articulated robot having six degrees of freedom, three degrees of freedom in position and three degrees of posture. As shown in FIG. 2, the doctor master manipulator 30 includes eight link members 31 to 38 and eight joint members 39 to 3G.
And a hand member 40. Joint member 39
Has an actuator (not shown) with an angle detecting device and an angle detecting device (not shown) for separately rotating and driving the link members 31 and 32. That is, the joint member 39
Are a first actuator that rotationally drives the link member 31, a second actuator that rotationally drives the link member 32, a first angle detection device that detects the attitude of the link member 31, and a posture of the link member 32. And a second angle detection device for detection. The joints 3A to 3G other than the joint member 39 are rotatable joints without such an actuator. The joint member 3
Reference numerals 9 and 3G are fixed to an actuator (not shown) for driving the entire parallel-link type articulated robot to turn, and the whole is turned in accordance with the turning operation. Therefore, even when the entire parallel link articulated robot turns, the relative positional relationship between the joint member 39 and the joint member 3G remains constant. An actuator that turns the entire parallel link type articulated robot is provided with a third angle detection device (not shown) that detects the turning angle.

This parallel link type articulated robot is basically composed of three four-node parallel links. First four
The node parallel link 301 includes four link members 31 to 34 and four joint members 39 to 3C, and the second four node parallel link 302 includes three link members 31, 36, and 38.
And four joint members 39, 3C, 3D, and 3G, and the third four-node parallel link 303 is composed of four link members 34 to 37 and four joint members 3C to 3F. Each symbol of the four-section parallel links 301 to 303 is
It is attached corresponding to the lead line drawn from the central part of the parallelogram.

In the first four-node parallel link 301, the link member 31 and the link member 33 face in parallel, and the link member 32 and the link member 34 face in parallel. One end of the link member 31 is connected to the first actuator of the joint member 39, and the other end is rotatably connected to the joint member 3C. One end of the link member 32 is connected to the second actuator of the joint member 39, and the other end is rotatably connected to the joint member 3A. One end of the link member 33 is rotatably connected to the joint member 3A, and the other end is rotatably connected to the joint member 3B. One end of the link member 34 is a joint member 3C
The other end is rotatably connected to the joint member 3F. Further, a joint member 3B is provided at the same position as the length of the link member 32 from the joint member 3C of the link member 34, and the link member 34 is rotatably connected to the link member 33 via the joint member 3B.

The first four-node parallel link 301 controls the position of the hand member 40. FIG. 3 is a diagram showing different operation states of the doctor master manipulator 30 of FIG. As shown in FIG. 3, the link member 31 is rotated counterclockwise by the first actuator of the joint member 39, and the link member 32 is rotated clockwise by the second actuator of the joint member 39. The joint member 3 connected to the other end of the link member 34 by reducing the angle formed by the link member 31 and the link member 32
F can be positioned away from the joint member 39. By performing the reverse operation, the link member 37 can be positioned near the joint member 39. The position is obtained using information of the first to third angle detection devices.

Second and third four-node parallel links 302 and 3
03 is a link member 3 to which the hand member 40 is attached.
7 is held parallel to the ground. In the second four-node parallel link 302, the link member 31 and the link member 38 face in parallel, and there is no link member facing the link member 36. This is because, as described above, the joint member 39 and the joint member 3G are fixed so that the relative positional relationship is constant, so that a virtual link member is set on the line connecting the joint member 39 and the joint member 3G. Exists, and the link member 36 faces the virtual link member in parallel. This virtual link member is parallel to the ground. The link member 31 is connected to the first
One end is connected to the first joint member of the joint member 39, and the other end is rotatably connected to the joint member 3C. One end of the link member 38 is rotatably connected to the joint member 3D, and the other end is rotatably connected to the joint member 3G. One end of the link member 36 is rotatably connected to the joint member 3C, and the other end is rotatably connected to the joint member 3D.

In the third four-node parallel link 303, the link member 34 and the link member 35 face in parallel, and the link member 36 and the link member 37 face in parallel. The link member 34 is common to the first four-joint parallel link 301, and has one end rotatably connected to the joint member 3C and the other end rotatably connected to the joint member 3F. One end of the link member 35 is connected to the joint member 3D, and the other end is connected to the joint member 3E.
Are rotatably connected to each other. Link member 36
Is common to the second four-joint parallel link 302, and has one end rotatably connected to the joint member 3C and the other end rotatably connected to the joint member 3D. One end of the link member 37 is rotatably coupled to the joint member 3E, and the joint member 3F is provided at the same position as the length of the link member 36 from the joint member 3E of the link member 34, and the link member 37 is connected via the joint member 3F. Is rotatably connected to the link member 34. The other end of the link member 37 is connected to a hand member 40 as shown in FIG.

Since the second four-node parallel link 302 and the third four-node parallel link 303 use the link member 36 as a common link member, a virtual link on a line connecting the joint member 39 and the joint member 3G. The member and the link member 36 are always in a parallel state, and the link member 36 and the link member 37 are always in a parallel state. Therefore, the first four-node parallel link 301
Accordingly, even when the position of the joint member 3F is variously changed, the posture of the link member 37 can be always kept parallel to the ground. Thereby, since the posture of the three-axis force sensor provided on the hand member 40 does not change with respect to the horizontal plane, the calculation amount of the rotation posture can be significantly reduced. Also, regardless of the stop position of the hand member 40, the hand member 40 can secure a movable range of three rotational degrees of freedom.

FIG. 4 is a diagram showing a schematic configuration of the hand member 40. As shown in FIG. As is apparent from the figure, the hand member 40 is configured such that the movable rotation axes X, Y, and Z of the three movable members U-shaped member 41, annular member 42, and pseudo probe member 43 intersect at one point. This is a three-axis one-point intersection type posture input structure. The upper end of the U-shaped member 41 is fixed to the distal end of the link member 37 shown in FIGS. 2 and 3, and has a movable rotation axis Z connecting both ends thereof. The annular member 42
It has a movable rotation axis Y in the diameter direction, and this movable rotation axis Y is U
It is attached to the movable rotation axis Z of the character member 41. The pseudo probe member 43 has substantially the same shape as the ultrasonic diagnostic probe 71, has a movable rotation axis X at its end,
The movable rotation axis X is attached to a side surface of the ring member 42. The point at which the movable rotation axes X, Y, and Z intersect corresponds to the vicinity of the distal end of the ultrasonic diagnostic probe 71, that is, the point where the ultrasonic diagnostic probe 71 actually contacts the patient or the point where the probe 71 is displaced in the longitudinal direction.

FIGS. 5 and 6 show the diagnostic slave of FIG.
FIG. 5 is a diagram showing a detailed configuration of the manipulator 70, FIG. 5 is a side view thereof, and FIG. 6 is a top view thereof. The diagnostic slave manipulator 70 only needs to operate in correspondence with the doctor's master manipulator 30 on the hospital 1 side, and it is usually more technically preferable to use the same structure as the doctor's master manipulator 30. It is preferable from an economic point of view. Therefore, since the slave slave manipulator 70 for diagnosis is a machine in which the machine directly touches a human, in this embodiment, safety is emphasized, and the master manipulator 3 for doctors is used.
A highly safe manipulator with a new structure different from zero is adopted.

The diagnostic slave manipulator 70 includes:
As shown in FIG. 5, in order to control the position / posture of the ultrasonic diagnostic probe 71 in accordance with the pseudo probe member 40 of the master manipulator 30 for the doctor on the hospital 1 side, the translation position 3 degrees of freedom and the rotation position 3 The robot is configured by a robot having seven degrees of freedom, one degree of freedom for translating the ultrasonic diagnostic probe 71 in the longitudinal direction. The diagnostic slave manipulator 70 converts the translational position 3 degrees of freedom into the X axis, the Y axis, and the Z axis.
It is realized by a linear guide member provided along each axis, and a rotation posture two degrees of freedom of the rotation posture three degrees of freedom are realized by a curved guide member. In FIG.
The linear guide member includes an XY table 7XY and a Z-axis linear guide 7Z. XY table 7XY
Has a structure in which linear guides are provided on the X axis and the Y axis. A guide member with a curvature is attached to the Z-axis linear guide 7Z.

The guide member with a curvature includes a guide member with a curvature 72 provided with an arc-shaped guide having a radius of curvature R1 centered on the vicinity of the tip of the ultrasonic diagnostic probe 71, and also near the tip of the ultrasonic diagnostic probe 71. And a guide member 73 with a curvature provided with an arc-shaped guide having a radius of curvature R2 with the center O as the center O. here,
Incorporating into a cross means that the moving member 74 moves along the arc-shaped guide of the curved guide member 72 so that the respective arc-shaped guides of the curved guide members 72 and 73 are orthogonal to each other.
Is to attach the guide member 73 with a curvature. The moving member 74 moves along the arc-shaped guide of the curved guide member 72 by the rotational driving force of the motor 7A. In this way, the guide member with curvature 7 incorporated in a cross is provided.
The ultrasonic diagnostic probe 71 is attached to the moving member 75 that moves along the third arc-shaped guide. Moving member 75
Move along the arc-shaped guide of the guide member 73 with curvature by the rotational driving force of a motor (not shown). Further, the moving member 75 moves the ultrasonic diagnostic probe 71 to X
A motor (not shown) is provided which is driven to rotate about the axis and is driven linearly in a direction along the X axis. That is, the moving member 75 realizes one rotation degree of freedom among the three degrees of freedom of the rotation posture described above and one translational degree of freedom added thereto. This is for the following three reasons. The first is
This is because when a doctor makes a diagnosis using an ultrasonic diagnostic probe, the doctor performs a delicate operation of pressing the tip of the probe against the affected part or, on the contrary, loosening the tip. Secondly, in actual ultrasonic diagnosis, a plurality of probes are properly used, and at that time, fine adjustment is required along the X-axis direction.
Third, it is necessary to retreat the probe in the X-axis direction when an excessive force is applied to the affected part from the viewpoint of safety and the patient feels pain.

The moving member 74 rotates along the arcuate guide of the guide member 72 with a curvature, and the moving member 75 rotates along the arcuate guide of the guide member 73 with a curvature. That is, the moving member 74 rotates around the Y axis as a movable rotation axis, and the movement member 75 rotates around the Z axis as a movable rotation axis. Further, the moving member 75 drives the ultrasonic diagnostic probe 71 to rotate about the X axis as a movable rotation axis.
These rotation axes respectively correspond to the movable rotation axis Z of the U-shaped member 41, the movable rotation axis Y of the ring member 42, and the movable rotation axis X of the pseudo probe member 43, which constitute the hand member 40 in FIG. Therefore, the posture of the hand member 40 of the doctor master manipulator 30 is faithfully reproduced by the curvature guide members 72 and 73 and the moving member 75 of the diagnostic slave manipulator 70.

By configuring the diagnostic slave manipulator 70 as described above, the operation of each translation axis and rotation axis does not overlap with other axes, so that the ultrasonic diagnostic probe 71 can be operated independently. . For example, the ultrasonic diagnostic probe 71 is positioned near the affected part of the patient 51 using a linear guide member having a translational position of three degrees of freedom, and each linear guide member is locked. (Including one degree of freedom). Thereby, it is possible to operate each axis without fail, which is safe. It is also possible to increase the accuracy. The diagnostic slave manipulator 70
Is often used in homes and clinics, so it is necessary to be able to move easily. Therefore, any place can be connected as long as it can be connected to a power supply and a communication line such as a telephone line such as an ISDN or a mobile phone. It can be installed in.

FIG. 7 is a diagram showing a schematic configuration of a force detecting means attached to the moving member 75 and detecting a force in three axial directions applied to the ultrasonic diagnostic probe 71. Force detection means 9
0 has a T-shape such that one end of the rectangular parallelepiped 92 in the longitudinal direction is connected to the side surface of the rectangular parallelepiped 91. The rectangular parallelepiped 91 corresponding to the T-shaped horizontal portion has rectangular parallelepiped voids 93 and 94 that penetrate from the side surface of the rectangular parallelepiped 92 in the direction in which the rectangular parallelepiped is not connected to the opposite side surface. The rectangular parallelepiped 92 corresponding to the T-shaped vertical portion has rectangular parallelepiped voids 95 and 96 penetrating from the side surface to the opposite side surface. The gaps 93 and 94 are provided substantially near the center between the connection between the rectangular parallelepipeds 91 and 92 and the ends of the rectangular parallelepipeds 91, and have the same penetration direction. On the other hand, the gaps 95 and 96 are provided at a predetermined distance near the center of the rectangular parallelepiped 92, and their penetration directions are orthogonal to each other. The ultrasonic diagnostic probe 71 is
0 is attached to the other end of the rectangular parallelepiped 92, and is rotationally driven and linearly driven by driving means (not shown) as a whole.

In the force detecting means 90 having such a structure, when a force in each axis (X-axis, Y-axis, Z-axis) is applied to the front end of the rectangular parallelepiped 92, FIG.
As shown in (C), the shape of the force detecting means 90 is distorted. Therefore, in this force detecting means 90, the strain gauges 9A to 9A are attached to the side surfaces of the rectangular parallelepipeds 91 and 92 corresponding to the gaps 93 to 96, respectively.
D, 9E to 9H, 9J to 9M are provided, and the direction and magnitude of the force are detected based on the amount of strain detected by each strain gauge. The strain gauges 9 </ b> A and 9 </ b> B are provided on two sides of the rectangular parallelepiped 91 corresponding to the gap 93, where two lines extending both ends of the gap 93 in the X-axis direction intersect with the side of the rectangular parallelepiped 91. Similarly, strain gauges 9C, 9
D is a side surface of the rectangular parallelepiped 91 corresponding to the gap 94, and is provided at two locations near lines where both ends of the gap 94 extend in the X-axis direction intersect with the side surface of the rectangular parallelepiped 91. In the figure, the strain gauges 9A to 9D are provided on the side of the rectangular parallelepiped 92, but may be on the opposite side. Strain gauge 9
Reference numerals E to 9F denote side surfaces of the rectangular parallelepiped 92 corresponding to the gaps 95, and are provided at four locations near lines where both ends of the gap 95 extend in the Y-axis direction intersect with the side surfaces of the rectangular parallelepiped 92. Similarly, the strain gauges 9J to 9M are the side surfaces of the rectangular parallelepiped 92 corresponding to the gaps 96, and the four lines near the intersections of the lines extending both ends of the gaps 96 in the Z-axis direction with the side surfaces of the rectangular parallelepipeds 92.
It is provided in each place. FIG. 8A shows a rectangular solid 9.
2 shows a case where a force is applied to the tip portion in the X-axis direction, that is, from right to left in the drawing. In this case, the void 9
The thin portion of the rectangular parallelepiped 91 formed by 3, 94 is deformed, and the central portion of the rectangular parallelepiped 91 protrudes leftward as shown in the figure. Due to such deformation of the rectangular parallelepiped 91, the side surface of the rectangular parallelepiped 91 near where the strain gauges 9A and 9D are provided is in an expanded state, and conversely, the side surface of the rectangular parallelepiped 91 near where the strain gauges 9B and 9C are provided is in a contracted state. At this time, a bridge circuit is configured such that the strain gauge 9A and the strain gauge 9D face each other, and the strain gauge 9B and the strain gauge 9C face each other. An input voltage is applied to one terminal of the bridge circuit, and The output voltage can be taken out from the terminal of. Accordingly, the output voltage changes due to the deformation of the rectangular parallelepiped 91 as shown in FIG. 8A, and the force in the X-axis direction is detected according to the change.

FIG. 8B shows that the tip of the rectangular parallelepiped 92 has a Y shape.
It shows a case where a force is applied in the axial direction, that is, from the upper side to the lower side of the drawing. In this case, the thin portion of the rectangular parallelepiped 92 formed by the gap 95 is deformed, and the rectangular parallelepiped 92 is bent around the gap 95 as shown in the figure. Due to such deformation of the rectangular parallelepiped 92, the sides of the rectangular parallelepiped 92 near the locations where the strain gauges 9E and 9H are provided are in an expanded state, and conversely, the sides of the rectangular parallelepiped 92 near the locations where the strain gauges 9F and 9G are provided are in a reduced state. At this time, the strain gauge 9F and the strain gauge 9 are arranged such that the strain gauge 9E and the strain gauge 9H face each other.
A bridge circuit is configured so that G faces each other, an input voltage is applied to one terminal of the bridge circuit, and an output voltage is extracted from the other terminal. Therefore, the output voltage changes due to the deformation of the rectangular parallelepiped 92 as shown in FIG. 8B, and the force in the Y-axis direction is detected according to the change.

FIG. 8 (C) shows that a Z
It shows a case where a force is applied in the axial direction, that is, from the upper side to the lower side of the drawing. In this case, the thin portion of the rectangular parallelepiped 92 formed by the gap 96 is deformed, and the rectangular parallelepiped 92 is bent around the gap 96 as illustrated. Due to such deformation of the rectangular parallelepiped 92, the side surface of the rectangular parallelepiped 92 near where the strain gauges 9K and 9L are provided is in an extended state, and conversely, the side surface of the rectangular parallelepiped 92 near where the strain gauges 9J and 9M are provided is in a contracted state. At this time, the strain gauge 9K and the strain gauge 9 are arranged such that the strain gauge 9J and the strain gauge 9M face each other.
A bridge circuit is configured such that L faces each other, an input voltage is applied to one terminal of the bridge circuit, and an output voltage is extracted from the other terminal. Therefore, the output voltage changes due to the deformation of the rectangular parallelepiped 92 as shown in FIG. 8C, and the force in the Z-axis direction is detected according to the change.

The force detecting means 90 is characterized in that the deformation due to the force in each axial direction acts only in that axial direction and does not affect the other axial directions. The force detecting means 9
Instead of 0, a triaxial force detecting means using a cross beam may be used. However, it is necessary to consider this point because the force in each axial direction affects the other axial directions. Further, by incorporating a structure in which the force detecting means 90 is hard to a certain force and becomes soft when a force exceeding the certain force is applied, unnecessary force can be prevented from being applied to the affected part.

In the remote diagnostic system having the above-described configuration, in order to obtain an appropriate ultrasonic diagnostic image, the doctor 11 uses the pressing force of the ultrasonic diagnostic probe 71 as a reaction force.
It is important to provide accurate feedback to the master manipulator 30 operated by the user. For this purpose, in this embodiment, impedance control that is advantageous for presenting a tactile / force sense is used as a control method. By using this impedance control, not only the reaction force can be presented, but also the contact state of the ultrasonic diagnostic probe 71 with the affected part can be transmitted to the doctor 11 as a change in viscosity. Also,
In order to obtain an appropriate ultrasonic diagnostic image, it is important that the master manipulator 30 accurately realize and maintain the position and orientation of the pseudo probe. Accordingly, when the force applied to the slave manipulator 70 becomes larger than the force applied to the master manipulator 30, the ultrasonic diagnostic probe 71
Can be pulled away from the affected area, but cannot be pushed further. Further, the control is performed so as to prevent the ultrasonic diagnostic probe 71 from moving against the intention of the doctor 11 due to the force felt by the slave when no force is applied to the master manipulator 30.
Thereby, control stability is improved.

In the above-described embodiment, an ultrasonic diagnostic apparatus has been described as an example of a diagnostic apparatus. However, the present invention is not limited to this. It goes without saying that also can be applied. In addition, the ISD employed in the above-described embodiment
Instead of the N lines 3 and 4, a dedicated communication line or a satellite communication line may be used regardless of wired or wireless.

In the above-described embodiment, the doctor 11 directly operates the doctor's master manipulator 30 to guide the ultrasonic diagnostic probe 71 to the affected part of the patient 51, and finely adjusts the ultrasonic diagnostic probe 71 therefor. Although the case where an image is obtained has been described, the present invention is not limited to this, and may be as follows. That is, the doctor 11 specifies an affected part (for example, the right shoulder, the left shoulder, the throat, the abdomen, the brain, the eyes, and the like) of the patient 51 to be diagnosed. Then, the slave manipulator control computer 65 performs predetermined image processing based on the image information from the CCD camera 54 based on the site designation information, and automatically causes the distal end portion of the ultrasonic diagnostic probe 71 to Move to the designated affected area. Furthermore, the doctor 11 operates in advance the ultrasonic diagnostic probe 71 in each part to acquire an ultrasonic image, and learns in advance, and the diagnostic slave manipulator 70 automatically operates based on the learning result. An ultrasonic diagnostic image may be obtained. Further, the force for pressing the ultrasonic diagnostic probe 71 against the patient 51 may be automatically controlled, and the doctor 11 may change only the position and orientation of the ultrasonic diagnostic probe 71 to acquire an ultrasonic diagnostic image. .

Further, in the above-described embodiment, the force detecting means 9 provided in the slave manipulator 70 for diagnosis is provided.
Although the case where the master manipulator 30 for doctors is controlled based on the force information from 0 has been described, a force information waveform based on this force information may be displayed, or the force information may be pronounced by voice. Thereby, the doctor 11 can visually and audibly recognize the state in which the ultrasonic diagnostic probe 71 is moving in contact with the affected part.
The condition of the affected part can be grasped more accurately than only the reaction force transmitted to the hand. For example, when a lump or thrombus is present in the affected area and the movement is not smooth, it can be recognized by the reaction force applied to the hand, the waveform can be confirmed with the eyes, and the ear can further understand the condition Is also possible.

[0040]

According to the remote diagnosis system of the present invention,
There is an effect that a diagnosis can be performed by remotely operating a diagnostic instrument or the like as if a doctor is palpating a patient at a remote place.

[Brief description of the drawings]

FIG. 1 is a diagram showing a schematic configuration of a remote diagnostic system using an ultrasonic diagnostic apparatus according to one embodiment of the present invention.

FIG. 2 is a diagram showing the detailed configuration of a master manipulator for doctors shown in FIG. 1;

FIG. 3 is a diagram showing different operation states of the master manipulator for doctor of FIG. 2;

FIG. 4 is a diagram showing a schematic configuration of a hand member.

FIG. 5 is a side view showing the detailed configuration of the diagnostic slave manipulator of FIG. 1;

FIG. 6 is a top view showing a detailed configuration of the diagnostic slave manipulator of FIG. 1;

FIG. 7 is a diagram showing a schematic configuration of force detecting means for detecting a force in three axial directions applied to the ultrasonic diagnostic probe.

FIG. 8 is a diagram showing the axes (X axis,
The figure which shows the shape of the force detection means 90 when the force of the direction of (Y-axis, Z-axis) is applied.

[Explanation of symbols]

1 Hospital 11 Doctor 13,53 Microphone 14,54 CCD Camera 17,57 Transmission Image Monitor 18,58 Speaker 19,59 Reception Image Monitor 20,60 Codec 21,26 Router 30 Master Manipulator 301-303 Section 4 Parallel Link 40 Hand Member 5 Clinic / Patient's home 51 Patient 55 Ultrasonic diagnostic device 56 Screen synthesizer 61, 66 Router 65 Slave manipulator control computer 70 Slave manipulator 71 Ultrasonic diagnostic probe (probe) 72, 73 Curved guide Member 74, 75 Moving member 90 Force detecting means

──────────────────────────────────────────────────の Continued on the front page (51) Int.Cl. ⁷ Identification symbol FI Theme court ゛ (Reference) B25J 9/06 B25J 9/06 B G06F 17/60 126 G06F 17/60 126G (72) Inventor Fuji Tsuda 2710-262 Miho-cho, Midori-ku, Yokohama-shi, Kanagawa (72) Inventor Takuya Higuchi 818-16 Hiki-cho, Hachioji-shi, Tokyo F-term (reference) GD05 GD15 4C301 AA01 CC02 CC04 CC05 DD01 DD02 EE13 JA01 JA04 JC13 KK08 KK40 LL20

Claims (6)

[Claims] A diagnostic unit that is arranged at a second location and acquires diagnostic information on biological information of the subject by contacting the subject; and a diagnostic unit that is located at a first location separated from the second location. ,
Display means for displaying an image based on image information indicating a relative positional relationship between the diagnostic means and the subject; and an operator arranged at the first location and operating while visually recognizing the display means A first operating means which is operated by the controller and outputs control information corresponding to the operation, and is arranged at the second place, and the diagnostic means is brought into contact with the subject based on the control information, and the diagnostic information is obtained. A second operating means for acquiring and outputting force information corresponding to a contact state between the subject and the diagnostic means; and at least one of an image and a sound arranged at the first location and based on the diagnostic information A reproducing unit that reproduces one so that the operator can recognize it; a control unit that is arranged at the first location and controls the first operating unit based on the force information; And before Remote diagnosis system, characterized in that it is configured to include a communication means for connecting the various types of information to be capable of two-way communication between the second location. 2. A first operating means disposed at a first location and operated by an operator; and a first operating means disposed at a second location separated from the first location. Second operating means controlled by control information from the means, and biological information from a subject located at the second location and present at the second location in association with (cooperation with) the second operating means A diagnostic unit that obtains image diagnostic information and outputs image diagnostic information; a detecting unit that is disposed at the second location and detects information about a relative positional relationship between the second operating unit and a subject; A display unit arranged to display each information from the diagnosis unit and the detection unit and to control the first operation unit; and interactively display the various information from the first location and the second location. Communication means communicably connected to the remote diagnosis system 3. An operation device which is operated by an operator, outputs control information corresponding to the operation state, and is controlled based on force information input from the outside. A first reproducing unit that reproduces at least one of audio, a second reproducing unit that reproduces an image and a sound based on the first image and the first audio information, A second imaging unit that outputs the second image information, a second microphone unit that collects a voice emitted by the operator and outputs the second voice information, and a second microphone that is controlled based on the control information. Operating means, provided in the second operating means, for diagnosing a subject, and outputting diagnostic information obtained as a result of the diagnosis; and a contact state between the diagnosing means and the subject. Force detection output as force information A step, first imaging means for photographing an image in which the relative positional relationship between the subject and the diagnostic means can be recognized, and outputting the first image information; and the second image information and the second image information. A third reproducing unit that reproduces an image and a sound based on the audio information of the first operation unit, the first reproduction unit, the second reproduction unit, the second imaging unit, and the second reproduction unit. The microphone means is located at a first location, the second operating means, the diagnostic means, the force detecting means, the first imaging means and the third reproducing means are located at a second location.
A communication means for transmitting and receiving the information between the first location and the second location when the information is present at the location. 4. The apparatus according to claim 3, further comprising a third reproducing unit for reproducing an image based on the second image information at the first location, based on the first image information and the diagnostic information. A fourth diagnostic means for reproducing the reproduced image at the second location. 5. The first operating means according to claim 1, 2 or 3, wherein the first operating means is constituted by at least three four-node parallel links, and a link member located at the tip thereof is always kept parallel to the ground. A parallel link type articulated robot means configured as described above; and a hand means having three degrees of freedom in a rotational posture provided on the link member positioned at the tip of the parallel link type articulated robot. Features a remote diagnostic system. 6. The first operating means according to claim 1, 2 or 3, wherein the second operating means includes a first guiding means having an arcuate guide and an arcuate guide of the first guiding means. A first moving unit that moves along the first and second moving units; and a second moving unit that is attached to the first moving unit so that the respective arc guides are orthogonal to each other. And a second moving unit that moves along an arcuate guide of the second curved guiding unit; a first moving unit that is provided in the second moving unit and rotationally drives the diagnostic unit. A driving means provided on the second moving means for moving the diagnostic means in the radial direction of the arcuate guide, and the first curved guide means being entirely translated. 3rd move to move by 3 degrees Remote diagnosis system, characterized in that it is configured and means.